In May, a slew of legal attacks on mifepristone, one of two medications used in a medication abortion, have sparked many discussions about the future of medication abortion care. The Supreme Court has issued a stay to keep mifepristone available via telehealth while lower court litigation plays out. While these attacks on mifepristone are based on junk science and refute decades of evidence that prove the medication’s astounding safety and efficacy, it’s crucial we understand the expansiveness of abortion care while mifepristone access is under attack [1].

Medication abortion is used in about 63% of all abortions nationwide, remaining one of the most accessible and necessary methods to access care [2]. Medication abortion can happen in one of two ways: using mifepristone and then misoprostol, or using misoprostol alone. We celebrate and demand mifepristone access – but that doesn’t mean we shouldn’t be sharing other safe and effective regimens that abortion seekers may be less knowledgeable about. At Reproaction, we’ve been committed to uplifting the self-managed abortion (SMA) protocol using misoprostol alone according to the World Health Organization throughout the entirety of our campaign.

The misoprostol-only regimen requires 12 pills in total, administered buccally (inside the cheeks) and left to dissolve for 30 minutes. A person would administer these 4 pills at a time in 3 rounds, repeating the process every 3 hours. This regimen has been widely used around the world for abortion care for decades [3]. (Are you looking for the mifepristone plus misoprostol regimen for self-managed abortion? Click here.)

Existing research has proven the misoprostol-only method to be around 85-90% effective at ending a pregnancy, compared to around 95% with mifepristone and misoprostol combined [3]. While this data suggests that this regimen may have a slightly lower effectiveness rate and more side effects than the combined regimen, the truth is that every pregnancy is unique. Every person’s abortion experience may differ, including subsequent side effects after taking either regimen. Stigmatizing care with misoprostol alone because of its slightly lower efficacy rate and what some have reported as a more unpleasant experience does a disservice to its resounding effectiveness and safety record, as well as those relying on it for care [3].

The bottom line is that serious complications for abortion seekers taking misoprostol alone is well below 1%, as it is with the combined regimen using both mifepristone and then misoprostol [4]. While some abortion seekers may experience more cramping, nausea, or other symptoms when taking misoprostol alone as compared to using the mifepristone/misoprostol combination method, fear-mongering about what can be a normal abortion experience is unnecessary [3]. It is a best practice during self-managed abortion with pills to have a support person available to provide care and comfort, as well as to provide support in the unlikely need to seek medical attention.

Overstating discomfort associated with misoprostol-only self-managed abortions might actually result in more follow-up visits in the emergency room or elsewhere due to heightened fear around normal side effects [3]. For this reason, it’s crucial we continue to destigmatize the misoprostol-only regimen and uplift it for what it is: a safe avenue of care that serves as an effective abortion protocol. This isn’t an “alternative” to the combined protocol that uses mifepristone and misoprostol, or a “less safe” option. It’s a well-studied protocol in the spectrum of medication abortion access, that of which relies on a medication that’s used for a wide variety of medical purposes [5].

Abortion seekers looking to self-manage their abortions with pills can order medication abortion by mail from sites like AidAccess.org or HeyJane.com. While it’s critical to keep mifepristone available, sound medication abortion options will remain available if the courts overreach. You can read more about our campaign about self-managed abortion with pills, and how you can spread this critical information, here.

[1] https://www.acog.org/news/news-releases/2025/05/leading-medical-organizations-reaffirm-the-safety-of-mifepristone
[2] https://www.guttmacher.org/2024/03/medication-abortion-accounted-63-all-us-abortions-2023-increase-53-2020
[3] https://www.ibisreproductivehealth.org/misoprostol-only-resource-hub
[4] https://www.heyjane.com/articles/misoprostol-only-abortion