Answers To The Most Common Questions About Medical Abortion: Part 2

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Common Questions, Scarce Answers

In a 2017 study, researchers in the United States ordered medical abortion pills from unregulated online pharmacies in order to assess their safety and effectiveness. Their conclusion? Although all of the pills were medically effective, none of the pills actually came with instructions.

This is not an isolated experience. Women living around the world- even in countries with some of the most restrictive abortion legislation- often find access to the pills before they find access to reliable information about them. Thanks to social stigma and cultural taboos, getting honest, informed, and unbiased answers to even the most common questions about abortion can be a daunting task.

That’s why HowToUse has launched this three part blog series dedicated to fielding our most commonly received questions about medical abortion. We’re providing straightforward answers, complete with links to some of our most trusted resources. Missed our opening installation from last week? We suggest you read it first.


Frequently Asked Question #3: How do you use medical abortion pills?


Before a woman decides to have a medical abortion, she’ll want to clarify a few things. Most importantly, she’ll want to confirm that she is indeed pregnant. This can usually be done with an at-home urine pregnancy test. She’ll also want to calculate the gestational length of the pregnancy. Medical abortion is usually recommended for women as a safe option within the first 10 weeks. Other considerations before having a medical abortion, specifically for women who are breastfeeding, have an IUD, or are HIV+, are discussed in more depth on our website.

There are two different methods for a safe medical abortion: a woman can either use a combination of mifepristone and misoprostol, or she can use a repeated dose of misoprostol only. Which regimen she chooses may depend on country legislation, availability, cost, or doctor recommendation. Both regimens are considered effective.

Using Mifepristone and Misoprostol Together

If a woman is using a combination of mifepristone and misoprostol within her first 10 weeks of pregnancy, she will need a total of 5 pills: 1 mifepristone pill (200mg) and 4 misoprostol pills (200 mcg each).

The woman begins by swallowing the mifepristone pill and drinking it down with a glass of water. She will then need to wait 24-48 hours before taking the next step. Though she may notice dizziness or light bleeding after taking the mifepristone, most women are able to go about their days as usual.

After 24 hours has passed since taking mifepristone (and waiting no more than 48 hours), she can begin with the next step: misoprostol.

First, the woman takes a sip of water to wet her mouth. The misoprostol pills will be placed in the space between her lower gums and the inside of her cheek. (This is called buccal administration.) She places 2 pills along the lower gum line on the left side of her mouth, and 2 pills along the lower gum line on the right side of her mouth. Thus, all 4 misoprostol pills are used at the same time.

Though it may taste chalky, she will need to hold the pills along her lower gum line for 30 minutes as the pills dissolve. She cannot eat or drink during these 30 minutes. Once 30 minutes has passed, she should drink a glass of water and swallow any remnants of the pills left insider her mouth.

Using Misoprostol Only

If a woman is using a misoprostol-only regimen within the first 10 weeks of pregnancy, she will need a total of 12 misoprostol pills (200 mcg each).

Just like in the misoprostol instructions above, she will start by taking a sip of water to make her mouth moist. She then places a total of 4 misoprostol pills in the space between her lower gum line and her cheek: 2 of the misoprostol pills will go on the left side of her mouth and 2 of the misoprostol pills will go on the right side of her mouth.

The woman keeps the pills along her lower gum line for 30 minutes as they dissolve. She cannot eat or drink anything during this time. After 30 minutes, she drinks a glass of water and swallows down any remaining bits of the misoprostol pills. Now she waits for 3-4 hours before continuing on with the next round of pills.

After waiting 3 hours, the woman repeats the same exact process with another set of 4 misoprostol pills: 2 pills are placed along the lower left gum line, 2 pills are placed along the lower right gum line. She will wait another 30 minutes for them to dissolve and then drink down all the remnants with a glass of water. Again, she has to wait another 3-4 hours before continuing on.

And finally, 3 hours after her last dose of misoprostol, the woman repeats the same process with the remaining 4 misoprostol pills. She places two pills along the lower left gum line, two pills along the lower right gum line, she allows them to dissolve for 30 minutes without eating or drinking, and finally washes all remnants down with a glass of water.

To be fully transparent, these are the instructions that HowToUse currently offers on our website. Some providers may suggest using the misoprostol pills under the tongue (sublingually) or inside the vagina (vaginally) instead of storing them along the lower gum line. These are also recognized as safe methods of administration.

Please note though, if a woman is living in a country where abortion is legally restricted, she may want to avoid vaginal use. Misoprostol pills dissolve slowly within the vagina and can leave their trace behind. This means that if the woman needs to quickly see a doctor, the pills may still be partially visible upon vaginal inspection.

Want to know what to expect after using the pills? Check out our After Using page for more information.


Frequently Asked Question #4: Can I Use (Fill In The Blank) Instead Of Abortion Pills?


No. That’s our answer, plain and simple. If you are using anything aside from clinically recognized medication for an induced medical abortion, you are not following a safe procedure.

Women commonly ask us if it’s okay for them to use a homemade remedy or an alternate medication instead of using mifepristone or misoprostol. With estimates suggesting that 22,800 women will die this year because of unsafe abortion practices, we take these questions very seriously.

If you know someone considering an unsafe method of abortion, make sure that she understands the resources available to her. You can connect her with some of our most trusted medical abortion providers who work tirelessly to ensure that all women have safe options: www.safe2choose.org, www.womenhelp.org, and www.womenonweb.org.

That does it for this week’s installment of our most commonly asked questions. Join us next week for our last piece in this series. Like what you read? Share it. Want to learn more? Follow us on Facebook, Twitter, Instagram and Pinterest , or visit our website.

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