Women are put at risk by abortion advocates’ promotion of ‘misoprostol only’ abortions

Disclaimer: The opinions expressed in this article are solely those of the guest author.

As abortion limits have been implemented in many states in the wake of the Supreme Court’s Dobbs decision, pro-abortion media sources have begun negligently recommending simplifying the chemical abortion regimen to only one of its components — misoprostol — because it may be more readily obtained.  The widely read and influential Atlantic magazine recently promoted this “one drug regimen” as a viable alternative to the standard combination chemical abortion regimen. Yet, evidence from around the globe demonstrates that misoprostol alone is a poor abortifacient and very likely to cause injury to women.  

The World Health Organization (WHO), motivated by population control ideology, has long been a promoter of chemical abortions in countries where unsafe abortions occur through nonsterile uterine instrumentation and other dangerous methods. Despite its much lower record of safety, the WHO also promotes misoprostol alone under the assumption that women will always seek abortion when facing unintended pregnancy and should be directed toward “safer” methods (1).

In 2013 the WHO acknowledged that “randomized controlled trials have consistently shown that combined regimens (mifepristone and misoprostol) are more effective than single medication (misoprostol alone) regimens” and stated that there was “limited evidence” to support its use beyond nine weeks gestation (2). Nevertheless, WHO guidelines continue to advocate for this dangerous method in countries where emergency health care may be inaccessible, where blood banking systems are suboptimal and blood transfusion may not be readily available, and where surgical treatment following failed misoprostol abortions may not be easily found.

READ: Papua New Guinea teen dies after taking misoprostol to abort her baby

As an example of how poorly misoprostol alone functions to cause abortion, a 2010 study documented that misoprostol alone led to a 23.8% failure rate requiring surgery and the fetus continued to survive in 16.6% of the pregnancies. Misoprostol is known to produce birth defects such as Moebius Syndrome, associated with craniofacial and limb abnormalities (3). In contrast, there were 3.5% failures and 1.5% continuing pregnancies in the mifepristone and misoprostol group (4). Likewise, a 2013 study demonstrated 38.8% failures when misoprostol was used vaginally and 29.9% when used sublingually (under the tongue) (5). Similarly, a randomized trial in 2000 documented that 35% of women using unmoistened vaginal misoprostol had failures requiring surgery (6).  

Finally, a worldwide systematic review of more than 12,000 misoprostol abortions found that 22% (nearly one in four) required surgical completion because misoprostol failed to completely empty the uterus of the remains of the child (7). Unfortunately, there was no uniformity of dosing or route of administration in these misoprostol-only studies, leading to difficulty in comparisons or determination of the most effective way to provide misoprostol.

Nonetheless, the review demonstrated conclusively that misoprostol alone failed far more frequently than mifepristone and misoprostol regardless of the dose or administration used.

Promotion of misoprostol alone seems to have been prioritized in states with restrictive abortion laws bordering countries where misoprostol is more readily available. I’ve personally verified that crossing the Texas-Mexican border leads to many opportunities to purchase misoprostol in border-town pharmacies, as it is readily available, inexpensive, and available without a prescription. However, women who follow these vague recommendations may have no idea of the quality of the unregulated medications they have obtained. 

One study on the feasibility of obtaining abortion drugs from international distributors over the internet found in some cases misoprostol tablets contained only 17% of the advertised amount of medication (8). Using one sixth the recommended amount is unlikely to produce contractions sufficient to evacuate the child and all the pregnancy tissue from the woman’s uterus.  

These recommendations by abortion advocates in the media demonstrate conclusively that their goal is not the safety and well-being of women, but merely the death of as many unborn humans as possible. 

Sources:

1. WHO Fact Sheet: Preventing Unsafe Abortion. (2003, revised 2017). Singh. Abortion Worldwide 2017: Uneven Progress and Unequal Access. New York: Guttmacher Institute, 2018.

2. Tang. WHO recommendations for misoprostol use for obstetric and gynecologic indications. Int J Gynecol Obstet. 2013;121:186-189.

3. Vauzelle. Birth defects after exposure to misoprostol in the first trimester of pregnancy: prospective follow-up study. Reprod Toxicol. 2012;36:98-103.

4. Ngoc. Comparing two early medical abortion regimens: mifepristone+misoprostol vs. misoprostol alone. Contraception. 2010.

5. 2013 Tanha. Sublingual vs vaginal misoprostol for second trimester termination: A RCT. Arch Gynecol Obstet. 2013;287(1):65-69.

6. Ngai. Vaginal misoprostol alone for medical abortion up to 9 weeks of gestation: efficacy and acceptability. Human Reproduction. 2000;15(5):1159-1162.

7. Raymond. Efficacy of misoprostol alone for first trimester medical abortion: a systematic review. Obstet Gynecol 2019;133:137-147.

8. Murtaugh. Exploring the feasibility of obtaining mifepristone and misoprostol from the internet. Contraception 2018;97(4):287-291.

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