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Can Misoprostol Work Without Mifepristone?

Recently, women have turned to misoprostol-only abortions as an alternative to the two-step abortion pill regimen. If you’re facing an unplanned pregnancy, you may be wondering if a misoprostol-only abortion is the right choice for you.


In this article, we’ll explore how misoprostol-only abortions work, their risks and side effects, and help you take your next steps! Keep reading to learn more.


How Does a Misoprostol-Only Abortion Work?

Normally, two pills are taken in the abortion pill regimen.


Mifepristone is taken first, which blocks the supply of the hormone progesterone to the embryo, which is needed to maintain the pregnancy. The embryo stops growing without a steady supply of progesterone. Misoprostol is taken 24-48 hours later, which causes the uterus to cramp, bleed, and expel the pregnancy.


In a misoprostol-only abortion, you skip the mifepristone and take multiple doses of misoprostol instead. The dose you take depends on your gestational age. Misoprostol can only be taken through ten weeks gestation (or 70 days or less since the first day of the last period)[1].


Are Misoprostol Only Abortions Safe?

Although misoprostol alone can be used to induce an abortion, this method is not as effective as the combination of mifepristone and misoprostol[2]. Misoprostol can also cause severe side effects, such as[3]:


  • Low blood pressure (hypotension)

  • Faster than normal heart rhythm (sinus tachycardia)

  • Heart attack (myocardial infarction)

  • Cuts or tears to the cervix (cervical laceration)

  • Uterine rupture

  • Infection (caused by a uterine rupture)

  • Severe allergic reaction


It’s also important to note that not everyone can take misoprostol. Those who experience kidney disease, stomach ulcers, inflammatory bowel disease, heart or blood vessel problems, or dehydration should not take misoprostol, as it could worsen their conditions[4]. Speak to your doctor beforehand and never order misoprostol online without a prescription!


Which is Safer: D&C or Misoprostol?

If you’re not able to take misoprostol, you may be wondering if a dilation and curettage (D&C) is a better option. Unfortunately, D&Cs also come with serious risks, including:


Asherman’s Syndrome

Asherman’s Syndrome is a condition where scar tissue builds up inside the uterus[5]. Women who have had multiple D&Cs are at greater risk of developing Asherman’s Syndrome. In the first trimester, up to 13% of women develop the condition after a D&C. For women who have late-term abortions, the risk jumps to 30%[6].


Cervical Damage

The cervix can be torn during a D&C. The provider may have to administer medicine or stitch the wound to stop the bleeding[7].


Uterine Perforation

The surgical tools used in a D&C may accidentally poke a hole in the uterus. The wound may be able to heal on its own, but if an organ is damaged, you may need surgery to treat it[7].


Explore Your Options at Pregnancy Care Center

An unplanned pregnancy comes with a lot of overwhelming choices. Even one choice can feel like one too many. You don’t have to take this next step alone! Pregnancy Care Center is a safe, confidential place to explore your pregnancy options at your own pace. We’re here to help you make an informed and empowered decision.


Give us a call at (559) 237-0683 to schedule your free appointment! All services are free and confidential.


Please be aware that Pregnancy Care Center does not provide or refer for abortion services.


Sources

  1. FDA. (2023, September 1). Questions and Answers on Mifeprex. U.S. Food and Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation

  2. Schreiber, C. A., Creinin, M. D., Atrio, J., Sonalkar, S., Ratcliffe, S. J., & Barnhart, K. (2018, June 7). Mifepristone Pretreatment for the Medical Management of Early Pregnancy Loss. The New England Journal of Medicine. https://pubmed.ncbi.nlm.nih.gov/29874535/

  3. Krugh, M., & Maani, C. V. (2023, April 21). Misoprostol. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK539873/

  4. Mayo Foundation for Medical Education and Research. (2023, February 1). Misoprostol (Oral Route) Side Effects. Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/misoprostol-oral-route/side-effects/drg-20064805?p=1

  5. Asherman's Syndrome. Cleveland Clinic. (2022, January 8). Retrieved from https://my.clevelandclinic.org/health/diseases/16561-ashermans-syndrome

  6. Smikle, C., Yarrarapu, S. N. S., & Khetarpal, S. (2023, July 24). Asherman Syndrome. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK448088/

  7. Mayo Foundation for Medical Education and Research. (2021, October 19). Dilation and Curettage (D&C). Mayo Clinic. https://www.mayoclinic.org/tests-procedures/dilation-and-curettage/about/pac-20384910

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