About Misoprostol: How it works and different options
If you live in a country where mifepristone is not available, or highly restricted, you may be preparing for a misoprostol-only abortion. Misoprostol alone is 85-95% effective, depending on the dosage. Misoprostol is needed to start uterine cramping and remove the pregnancy tissue.
To pass the pregnancy, your cervix will dilate. Misoprostol helps with this dilation process by softening the cervix, so it can more easily open. You will feel pain and cramping during this part of the process, as the muscle opens. The more a person can relax during this process, the less pain they will feel.
Before taking misoprostol, it is advisable to take ibuprofen at least 1 hour before. Do NOT take aspirin, as it thins the blood and could make you bleed more.
There are many different regimens available by doctors and on the internet of how to take misoprostol for abortion, but most experts in the field agree that the best regimen follows a rule of 3. Three doses of misoprostol (800mcg each) taken 3 hours apart.
SafeToChoose offers the following recommendation:
- You will need at least 12 pills(800mcg which is 4 pills of 200mcg)
- Choose a route of administration: this can be between your cheeks, under your tongue, or deep in the vagina. Misoprostol takes at least 30 minutes to dissolve. DO NOT SWALLOW
- Take 800mcg, which is 4 pills of 200mcg each, and start the process
- 3 hours later, take 4 more
- 3 hours after that, take 4 more
- Generally, this should complete your abortion, but if not, subsequent doses could be needed. In some cases, your doctor may recommend a subsequent dose of misoprostol to remove the remaining tissue. In other cases, they will perform a surgical abortion to remove the remaining tissue.
The 2018 World Health Organization Guidelines for Medical Abortion does not recommend a maximum amount of misoprostol doses to complete an abortion with misoprostol alone. Ideally, one would consult with a medical provider if the abortion is not complete after 3 or 4 doses of misoprostol.
It is a touchy subject to know when your abortion is complete. Sometimes products of conception can remain in the uterus even after the fetus and most of the tissue has passed. If you notice that your bleeding has stopped after a week, but it starts up again some weeks later and is accompanied by abdominal cramping, lower back pain, and big blood clots, you could have some retention of the products of conception.
Additional doses of misoprostol could remove retained products of conception, but a surgical procedure, done by a doctor or midwife is the only sure way to complete an abortion with fetal retention.
If you are concerned that your abortion is not complete, always seek assistance from a medical provider in your country. Misoprostol cannot be detected in your blood after an abortion, so your healthcare provider will have no way of knowing you had an abortion–unless you tell them. Choose wisely what you say to them, in accordance with laws on abortion in your country.
For more information on medical abortion, including some questions that I may not have answered here, see Women On Web HERE