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The recommended protocol for misoprostol-only abortion

An anti-abortion group is currently attacking the FDA’s decade-old approval of mifepristone in an ongoing lawsuit. If a ruling goes in their favor and the FDA removes mifepristone as an option, patients should be reassured that misoprostol-only is a well-studied and recommended option for abortion. Here’s a brief summary of data on misoprostol-only abortion and a sample protocol for clinicians who wish to offer it.

The protocol summarizes the following:

Misoprostol-only treatments are extremely safe, with 99.3% of patients not requiring hospitalization or transfusion; however they may have more side effects.
On average, the recommended protocol for misoprostol is very effective for abortion care, 93% of patients completing their abortions without additional intervention.
The protocol recommends patients be given 3-4 doses with an additional dose in case there is a need.

Implications

From a medical and scientific standpoint, banning the use of mifepristone for abortion care is senseless, especially considering its conclusively established safety and efficacy. However, offering medication abortion with misoprostol-only is also a safe, effective, and patient-centered approach that would continue to enable access to abortion care.

The researchers conclude:

"In settings where mifepristone is not available, and especially outside the U.S., clinicians and people who self-manage abortion have been using misoprostol-only for decades. Misoprostol-only regimens are endorsed as a medically acceptable option by the World Health Organization and other international and national professional guidelines for abortion care.”

The publication, Medication abortion with misoprostol-only: A sample protocol, is available in Contraception.