Mifepristone and misoprostol

Mifepristone is taken orally and blocks the action of progesterone. This results in:

1. Uterine lining thinning
2. Pregnancy detachment
3. Cervical softening and dilation
4. Uterine contractions

Subsequent administration of buccal, sublingual, or vaginal misoprostol, a prostaglandin E₁analogue, results in uterine contractions and expulsion of the products of conception.

• High success rate (95%-98%)
• Very effective during early pregnancy (through nine weeks' LMP)
• For many women, the process resembles a heavy period
• For many women, the experience is considered more "private"
• Usually avoids surgical intervention
• Anesthesia not required
• Can sometimes be obtained through telemedicine services

• May take days or occasionally weeks for the abortion to complete
• Efficacy decreases at later gestational ages
• Bleeding may continue for several weeks after the abortion is complete
• Women may see blood clots and the products of conception
• Sometimes requires multiple clinic visits
• Mifepristone can be expensive
• Mifepristone is not available in many countries

Methotrexate and misoprostol

Methotrexate is an anti-metabolite that inhibits DNA synthesis. Given by injection or taken orally, methotrexate interferes with the implantation process.

Subsequent administration of oral or vaginal misoprostol, a prostaglandin E₁ analogue, results in uterine contractions and expulsion of the products of conception.

• High success rate (95%) if used in the first seven weeks of pregnancy
• For many women, the experience is considered more "private"
• Usually avoids aspiration intervention
• Anesthesia not required
• Treats ectopic pregnancy

• Requires at least two clinic visits
• Often takes longer than the mifepristone and misoprostol regimen
• Efficacy decreases significantly after 7 weeks gestation
• Post-procedure bleeding may last for weeks
• Women may see blood clots and the products of conception

Misoprostol alone

Misoprostol is a prostaglandin E ₁ analogue that causes uterine contractions and cervical softening. Administration of buccal, sublingual, vaginal misoprostol alone results in uterine contractions and expulsion of the products of conception.

• Used during early pregnancy  (through nine weeks)
• For many women, the process resembles a heavy period
• For many women, the experience is considered more "private"
• Usually avoids aspiration intervention
• Anesthesia not required
• Available in many more countries than either mifepristone or methotrexate
• Often much cheaper than other medication abortion methods
• May be available directly from pharmacies

• Success rate is low (75%-85%) compared to other medication abortion regimens
• Often takes days to weeks to complete
• Cramping and bleeding more significant than other medication abortion regimen
• Post-procedure bleeding my last for weeks
• Women may see blood clots and the products of conception

Vacuum aspiration procedures

A straw-like tube (a cannula), which is attached to a suction apparatus is inserted into the uterus through the open (dilated) cervix. The uterine contents are then emptied by suction.

• Very high success rate (>99%)
• Often requires only one clinic visit
• Procedure completed within minutes
• Sedation is available

• Involves instrumentation and a procedure
• Requires an in-person interaction with a clinician
• Often considered to be less "private"
• May not be widely available