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  • Writer's pictureMosaic Health

What is a Misoprostol Only Abortion?

Updated: Mar 21

The pending United States Supreme Court on the distribution of mifepristone, the first drug in a medication abortion (also known as Mifeprex), has caused significant controversy and discussion about the drug's safety and legality. While the ruling allows the continued distribution of the drug according to current FDA regulations, that does not mean the case is over. The Supreme Court has sent the issue back to lower courts, meaning it may have to rule directly on the case's merits in the future. 

With rumors of the FDA approval of mifepristone potentially being revoked, many women have questions about the legality of abortion pills and the safety and possibility of a misoprostol-only abortion. Misoprostol is the second pill in the two pill medication abortion regime.

(Note: This is an active, ongoing court case. Information on this blog was last updated March 6, 2024.)

Woman wrapped in a blue blanket, opening a pill package.

What does Misoprostol do?

Misoprostol is typically the second drug in a medication abortion and is taken within 24 hours of Mifepristone. Misoprostol works by causing the uterus to contract, leading to the expulsion of the pregnancy. In a misoprostol-only abortion, women do not take the first drug, mifepristone. It works by blocking the hormone progesterone, which is needed for a pregnancy to continue. Mifepristone causes the lining of the uterus to break down and cuts off nutrients the developing fetus needs to live.

Is a Misoprostol-only abortion a safe alternative?

Using Misoprostol alone can also lead to increased pain and bleeding and a higher risk of incomplete abortion. The medical community does not broadly recommend a misoprostol-only abortion due to the increased side effects and pain. Side effects of a misoprostol-only abortion are:

  • increased cramping and stomach pain

  • nausea and/or vomiting

  • gas

  • heavy bleeding

  • inability to urinate

  • heavy sweating

  • hot and dry skin and feeling very thirsty 

  • severe ongoing stomach discomfort or diarrhea

  • painful menstruation and heavy menstrual flow 

What do I need to know before I decide?

If you are considering a medical abortion, it is wise and in the best interest of your health and well-being to first confirm the placement and viability of your pregnancy by having an ultrasound. The ultrasound will help you gather the necessary information to help you make an informed decision by determining the location of the pregnancy, ruling out an ectopic pregnancy, as well as determining how far along you are and if your pregnancy is viable. Findings during an ultrasound may make an abortion unnecessary.

It is crucial for your overall health and well-being to speak with a healthcare provider to understand the potential short and long-term risks of any abortion method, signs of incomplete abortion after misoprostol, and get answers to your questions before you make a decision.

Pregnant? Start with us.

It is essential to consider all options and consult with professionals to make informed decisions about your pregnancy and health. 

Whether you need free pregnancy services, community referrals, or access to additional resources, we are committed to empowering and equipping you through the process. While we do not provide or refer for abortion services, we can provide answers in a safe, supportive environment. 

Contact us today to learn more about our services and how we can help you.


Pain during medical abortion, the impact of the regimen: a neglected issue? A review. Fiala C, Cameron S, Bombas T, Parachini M, Saya L, Gemzell-Danielsson K. Eur J Contracept Reproductive Health Care. 2014 Dec;19(6):404-19. doi: 10.3109/13625187.2014.950730. Epub 2014 Sep 2. PMID: 25180961

Supreme Court Puts on Hold Ruling That Restricts Access to Abortion Pill Mifepristone. (2023, April 16).

Bourne, L. (2023). Breaking: Supreme Court extends stay permitting access to abortion pill, deadline set for Friday. Pregnancy Help News.

Misoprostol (Oral Route) Side Effects - Mayo Clinic. (n.d.). 


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