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  • Narda Skov

How to Use Misoprostol-Only for a Medication Abortion

Over a year ago the Supreme Court handed down the Dobb's decision overturning of Roe v. Wade I feel it is important to continue to speak out about reproductive health access for all women. Whether you will ever have an unwanted pregnancy, or not, this deeply personal decision should be made by the person who is pregnant and no one else.

Reproductive Health Access Project is one of the many organizations focusing on helping women get the health care they need. With numerous groups continuing to try to limit access to medication abortion, the more information we need to have access to. The fact sheet link is here and below are the steps to be aware of if someone is taking a Misoprostol-Only medication abortion pill(s). This is widely publicized information, but wanted to share as a resource guide. Please contact your local clinic or MD with any questions.

Misoprostol pills can end a pregnancy. The mifepristone/misoprostol method causes fewer side effects and works better. People who cannot get mifepristone may choose to use misoprostol alone.

Step 1: Make sure you are pregnant. Take a urine pregnancy test available at a local pharmacy.

Step 2: Check your dates. Use a calendar or a gestational age calculator. Measure the time from the first day of your last period to today. This method works for up to 12 weeks from the first day of your last period.

Step 3: Be sure that you do not have:

  • IUD in place (must be removed before abortion).

  • Ectopic pregnancy (Sharp pain in your lower belly could be a sign of an ectopic pregnancy. You should be examined by a provider).

  • Bleeding problem or treatment with a blood thinner (aspirin is ok).

Step 4: The Pills. You need 12 Misoprostol pills. Each one contains 200 mcg.

Step 5: Take pain medication. Up to four 200-mg ibuprofen pills, up to two 220-mg naproxen pills, or up to two 500-mg acetaminophen pills. You can take any of these pain pills before misoprostol. You can take more if needed - follow the directions on the package.

Step 6: Use Misoprostol.

  • Choose: Put pills inside your cheeks, under your tongue, or in your vagina.

  • If abortion is a crime in your state, you should put the pills inside your cheeks or under your tongue. This way, there will be no pill fragments left behind (in the event that you need a medical exam).

  • Take misoprostol three times, every three hours.

Step 7: Expect bleeding. For most people, cramps and bleeding start within seven hours. You should have heavy bleeding, and you may see clots. You may have loose stools, fever, or chills. If you have no bleeding (or only light spotting) within 72 hours, you should contact your clinician.

Step 8: How much bleeding is too much? If you soak through two maxi-pads per hour, two hours in a row, you should contact a clinician. Remember 2x2 = 2 pads/hour for 2 hours is too much bleeding!

Step 9: When to start birth control. If you start the implant, pill, patch, ring, or shot within 7 days of taking misoprostol, they take effect right away. If you start them later, use a back-up method - like condoms - for the first seven days. Please be aware the effectiveness of the shot might be slightly decreased. You can get an IUD as soon as a few days after Misoprostol.

Beyond 12 weeks, consult a clinician or M+A Hotline (1-833-246-2632)

Reproductive Health Access Project

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