Medication abortion with misoprostol-only is one of two safe, highly effective, WHO-recommended regimens for medication abortion. Our SAFE Study and other findings support a renewed look at misoprostol-only regimens for medication abortion, no longer as a second-tier method, but one that offers similar effectiveness, and often greater accessibility, than the mifepristone + misoprostol regimen.

Download our "Misoprostol-Only Medication Abortion: Quick Reference Guide" here

Our quick-reference guide provides clinicians with evidence-based protocols for and information about misoprostol-only medication abortion, including dosing regimens, expected outcomes, safety data, and patient counseling guidance. It is intended for providers exploring or considering integrating misoprostol-only care into their practice.

Publications

Ibis research shows that misoprostol-only is highly effective, and more effective than previously thought.

According to data from our SAFE Study, 98.8% of those who used the misoprostol-only regimen had a complete abortion without surgical intervention. Additionally, misoprostol-only is less costly, carries fewer restrictions for use, and can be offered by a wider cadre of providers.

Please see below for additional resources on the safety and effectiveness of misoprostol only, sample protocols, and information on patient experiences.

• Moseson H, Jayaweera R, Baum SE, Gerdts C. How effective is misoprostol alone for medication abortion? NEJM Evidence
• Jayaweera R, Egwuatu I, Nmezi S, Kristianingrum IA, Zurbriggen R, Grosso B, Bercu C, Gerdts C, Moseson H.  Medication abortion safety and effectiveness with misoprostol alone. JAMA Network Open.
• Jayaweera R, Moseson H, Gerdts C. "Misoprostol in the era of COVID-19: A love letter to the original medical abortion pill." Sexual and Reproductive Health Matters.
• Moseson H, Jayaweera R, Egwuatu I, Grosso B, Kristianingrum IA, Nmezi S, Zurbriggen R, Motana R, Bercu C, Carbone S, Gerdts C. Effectiveness of medication abortion with misoprostol alone in the SAFE study: A prospective observational cohort study. The Lancet Global Health.
• Raymond EG, Mark A, Grossman D, Beasley A, Brandi K, Castle J, Creinin MD, Gerdts C, Gil L, Grant M, Lockley A, Perritt J, Shochet T, Truan D, Upadhyay UD. Medication abortion with misoprostol-only: A sample protocol. Contraception.
• Johnson DM, Michels-Gualtieri M,  Gomperts R, Aiken ARA. Safety and effectiveness of self-managed abortion using misoprostol-only acquired from an online telemedicine service in the United States. Perspectives on Sexual and Reproductive Health.

Research Briefs

• Misoprostol-Only Medication Abortion: Quick Reference Guide
• Misoprostol-only medication abortion is safe and effective (compiled in partnership with the Society of Family Planning)
• Recent evidence on the use of medication abortion with misoprostol-only
• Experiences with misoprostol-only for medication abortion: Considerations when counseling patients on misoprostol-only

SAFE Study​

• Studying Accompaniment model Feasibility & Effectiveness (SAFE) Study
• SAFE Study website

MORE Study

The MORE Study—led by Ibis researchers, Heidi Moseson and Ruvani Jayaweera, and Lori M. Gawron, MD, MPH, FACOG at the University of Utah—is a randomized clinical trial in the United States that aims to compare abortion completion and side-effects between an updated single drug regimen (3-4 doses of 800ug misoprostol every three hours) for medication abortion as compared to the standard combined regimen (mifepristone followed by misoprostol).

The MORE Study will, for the first time, measure experiences and outcomes following use of the misoprostol-only and combined regimen in the same study, allowing for greater clarity and nuance in understanding what to expect from each and contributing rigorous evidence that providers need to confidently prescribe and counsel patients on both medication abortion regimen options.

• The MORE (Misoprostol-Only Regimen Evidence) Study

Media

• Nina Martin. "They Came for Mifepristone. The Abortion Rights Movement Is Ready." Mother Jones.
• Katelyn Jetelina and Heidi Moseson. "Abortion pills: An option not talked about enough." Your Local Epidemiologist.
• Carrie N. Baker. "If Trump Restricts Mifepristone, Clinicians Are Ready to Pivot to Misoprostol-Only Abortions." Ms. Magazine.
• Dana Johnson. Terri-Ann Thompson. "Without Roe,  abortion pills are more important than ever. We must remove barriers." Ms. Magazine.
• Dana Johnson. "A new battle in the war on abortion pills." The New York Times.
• Caitlin Gerdts, Ruvani Jayaweera, Carrie N. Baker. "Let’s talk about misoprostol—the original abortion pill." Ms. Magazine. 
• Ijeoma Eguwatu, Ruvani Jayaweera, Ika Ayu Kristiangrum, Heidi Moseson. "The effectiveness of self-managed abortion using misoprostol alone." SRHM Podcast.