It’s important to remember that no matter what happens in the courts, people will still have access to medication abortion care with misoprostol alone.
We’re with you. We’re nervous about what is going to happen in the upcoming court battle around access to mifepristone, one of the medications often used in medication abortion care in the United States. But as we await news as to whether or not the Supreme Court is going to weigh in on the case threatening access to this safe and essential medication, we can’t help but notice that people seem to be forgetting about mife’s right-hand guy: misoprostol.
What is misoprostol? I’m so glad you asked!
To understand misoprostol, we need to talk about medication abortion. Medication abortion is when medications, in the form of pills, are taken either sublingually (under the tongue), buccally (held in the space between the cheek and the gums), or vaginally (in the vaginal canal) to end a pregnancy.
When mifepristone and misoprostol are used together, mifepristone is taken to stop the hormones from going to the pregnancy. Misoprostol is then taken 24-48 hours later to cause the uterus to cramp and expel the contents of the uterus.
But we can’t forget! Misoprostol can also be used safely and effectively on its own for medication abortion care.
So while we love access to mifepristone and we realize that it is commonly used to help patients end their pregnancies, it’s important to remember that no matter what happens in the courts, people will still have access to medication abortion care with misoprostol alone.
Misoprostol alone has been used by communities around the world for decades. But unfortunately, we’ve heard clinicians, policy makers, and advocates share inaccurate information about its efficacy making it seem like misoprostol-alone is an inferior method.
This couldn’t be further from the truth and the most recent research demonstrates that. We know that when patients take 800 micrograms of misoprostol every 4-8 hours sublingually or vaginally until the abortion is complete, the effectiveness is comparable to mifepristone and misoprostol combined
Every medication abortion has side effects. There are varied experiences of cramping, levels of bleeding, and gastrointestinal distress (shout out to all my friends with tummy problems) with both methods of medication abortion.
The bottom line?
Medication abortion is safe. Period. It’s effective. Double period. This is true when mifepristone and misoprostol are used in combination and it’s true when misoprostol is used alone. This is true whether the medications are accessed in a clinic setting with a health care provider, via a telehealth appointment, or when care is managed on your own!
Talking about medication abortion and feeling stuck? Here are some helpful do’s and don’ts guided by medical evidence:
- Do affirm the safety and efficacy of mifepristone. Mifepristone was first approved by the FDA over 20 years ago and is safe and effective.
- Do affirm the safety and efficacy of a misoprostol only protocol. Misoprostol used alone can safely and effectively end a pregnancy. Misoprostol alone is likely the most common method of medication abortion used worldwide – likely because it is available in many places over the counter without a prescription and at low cost. Misoprostol alone has been used as a method of medication abortion both before and after mifepristone’s approval by the FDA.
- Do call out that any restrictions on medication abortion care are harmful and unnecessary. Don’t make patients jump through onerous and medically unnecessary hoops! Ever! No matter what!
- Do name the harm of this moment. No one should have their options for abortion care limited by politics. Any delay or disruption in abortion care is unacceptable and leads to people being forced to remain pregnant.
- Do work to actively humanize people who self-manage their care and do name that the real risk of self-managed abortion care is legal, not medical. People have been self-managing abortion care for as long as abortion has existed. Get over it. Don’t spread lies about it.
- Do call out the harm of radical Judges hell bent on taking away access to all abortion care. This case should not have moved forward. The decision is not based on facts, medicine, or science, and it is not supported by the law.
- Don’t say abortions will be unsafe, use coat hanger or knitting needle imagery. Just like the mifepristone and misoprostol protocol, misoprostol alone is a safe and effective way to end a pregnancy. Saying abortions will be unsafe as a result of the decision or using coat hanger or knitting needle imagery does not accurately reflect the reality of abortion today.
- Don’t say misoprostol is unsafe. The overwhelming body of scientific and medical evidence shows that misoprostol is a very safe and effective way to end a pregnancy. You would be very wrong if you said something like this.
- Don’t equate self-managed abortion with illegal or unsafe abortion. That language is stigmatizing and can lead to further targeting and criminalization of people who self-manage their abortions as well as those who experience pregnancy loss.
Thanks for all you’re doing to combat the misinformation and disinformation about medication abortion. If we all center the evidence and our common goal of trusting people to make informed decisions about their lives and futures, we will get a whole lot closer to a future where everyone, no matter who they are, can access all of the health care they need without barrier, delay, or stigma.
If we want to outwit, outplay, and outlast these anti-abortion extremists trying to take away our autonomy, then we need to work together. Keep on keeping on, friends!