If you are unexpectedly pregnant, you might be researching information about the abortion pill. Below is a deep dive into the second pill taken in the abortion pill regimen, misoprostol.

To learn more about the first abortion pill, mifepristone, read more here.

Let’s look at what misoprostol is, how it works, what the potential side effects are, and if you can take it alone to end a pregnancy. 

What is misoprostol? 

Misoprostol (also known as Cytotec) is one of the two drugs used in a medical abortion (often known as the abortion pill). 

The first drug taken during a medical abortion is mifepristone. Mifepristone blocks the body’s production of progesterone – a necessary hormone needed for a pregnancy’s growth. Mifepristone is what ends the pregnancy. 

Misoprostol is taken 24 to 48 hours after mifepristone. Misoprostol prepares the body to expel the pregnancy by softening the cervix and causing the uterus to contract. 

 When taken together with mifepristone, misoprostol can be used to end a pregnancy up to 10 weeks gestation (how far along you are in your pregnancy).  

How does misoprostol work?  

Many abortion providers say the abortion pill process will be like a heavy period. However, many women who have taken the abortion pill say they felt underprepared for the amount of pain and blood they experienced.  

Sometimes women see the developing fetus when it is expelled, especially if they are further along in their pregnancy. This can be a distressing and shocking sight for many women. It’s a good idea to have someone you trust there to support you when having a medical abortion.  

What are the possible side effects of misoprostol?  

Common side effects include:  

• Diarrhea 
• Abdominal pain 
• Uterine cramping 
• Bleeding 
• Dizziness 
• Nausea 
• Vomiting 
• Fever 
• Headache 

Severe side effects include:  

• Cuts or tears to the cervix 
• Uterine rupture 
• Dangerous uterine bleeding 
• Serious infection 
• Severe allergic reaction  
• Incomplete abortion 
• Severe or persistent abdominal pain 

Are there possible complications and risks?  

Often, a medical abortion is chosen because it seems to be a more private, safer option than a surgical abortion. However, medical abortion has been linked to more complications and risks. 

Approximately 7% of medical abortions will be incomplete and need a follow up surgical procedure to complete the abortion or stop heavy bleeding. 

If the abortion pill is accidentally taken in the second trimester, 39% of women will need surgery to complete the abortion. That’s why it’s important to confirm gestational age with an ultrasound. 

Are misoprostol–only abortions safe?  

Although misoprostol has been used alone to induce abortion, this method is not as effective as the combination of mifepristone and misoprostol. Misoprostol only abortions have a 39% fail rate when the drug is used vaginally and a 30% fail rate when used under the tongue. 

The fetus has a survival rate of 17% during misoprostol only abortions. Since you are skipping mifepristone, the drug that ends the pregnancy, you also risk expelling a live pregnancy. Misoprostol is also known to cause birth defects; this leaves the fetus at risk of defects if continued to birth.  

When to call a doctor? 

If you are bleeding through more than 2 regular-sized sanitary pads per hour for more than two hours, run a fever over 100.4 F, or are passing blood clots the size of a lemon, call your nearest emergency room.  

For the emergency room staff to properly treat you, you must be truthful about taking the abortion pill.