This pharmaceutical approach is called “medical abortion.” In the United States and Europe it typically consists of two sets of “M” pills. The first is mifepristone, formerly known as RU-486, and then a day or two later the misoprostol.
Using the drugs in combination produces a miscarriage more than 95 percent of the time in early pregnancy. But mifepristone is difficult to obtain in much of the world, because it is used only to induce abortions. In contrast, misoprostol is very widely available and can’t easily be banned because it is also used for ulcers and can save lives of women with postpartum hemorrhages. Whatever one thinks of misoprostol for abortions, it also is a potential lifesaver for women who hemorrhage after childbirth.
Researchers are finding that if women take misoprostol alone, effectiveness drops to 80 to 85 percent. That may sound low, but it’s typically far better and safer than alternatives that women turn to, Dr. Winikoff noted.
“Medical abortion represents a revolution in women’s reproductive health,” said Dana Hovig, the chief executive of Marie Stopes International, an aid group that provides women’s reproductive health services in 43 countries around the world. “It saves women’s lives and has enormous potential to increase access to safe abortion at minimal cost.”
Medical abortion causes a miscarriage that is indistinguishable from a natural one. That’s important for women in countries where they risk arrest if they seek help in a hospital after a botched abortion. The risks to a woman seem no greater than with a natural miscarriage, and there’s no known harm to a woman who turns out not to have been pregnant after all.
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