What Happens if You Only Take the First Abortion Pill (Mifepristone)?
- Catherine Farley
- 1 day ago
- 3 min read
Chemical abortions typically involve two drugs: mifepristone followed by misoprostol. Each drug plays a different role in the process. But what happens if someone takes only the first pill and does not take the second?
Medical research shows that the outcome can vary. Possible outcomes include continued pregnancy or pregnancy loss/incomplete abortion.
How Mifepristone Works
Mifepristone works by blocking progesterone, a hormone that is necessary for a pregnancy to continue. When progesterone is blocked, the uterine lining begins to break down and the baby may stop developing.
According to the U.S. Food and Drug Administration drug label for mifepristone, the medication also makes the uterus more sensitive to prostaglandins, the hormones responsible for uterine contractions. In a standard medication abortion regimen, the second drug, misoprostol, is taken 24–48 hours later to cause contractions that expel the fetus.
Without misoprostol, the uterus may not contract enough to complete the abortion.
Possible Outcomes if Only Mifepristone Is Taken
Continued Pregnancy
One possible outcome is that the pregnancy continues.
A systematic review published in the medical literature found that between 8% and 46% of pregnancies were still ongoing 1–2 weeks after mifepristone alone. This means that taking the first pill does not always end the pregnancy.
Research examining pregnancies exposed to mifepristone alone has also found that many pregnancies continued and resulted in live births. In one prospective study of 105 pregnancies, 94 resulted in live births while 10 resulted in pregnancy loss, and the rate of major birth defects was similar to the general population.
Pregnancy Loss/Incomplete Abortion
Because progesterone support is disrupted, some pregnancies may end after mifepristone alone. In some cases, the fetus may stop developing, and the pregnancy is no longer viable, but the fetus is not expelled from the uterus. This is sometimes called an incomplete abortion and typically requires medical follow-up to determine the next steps.
Is It Possible to Reverse the Effects of Mifepristone?
If someone has taken mifepristone but wishes to continue the pregnancy, there may still be options depending on timing.
The Abortion Pill Reversal Network provides a protocol that involves administering progesterone after mifepristone exposure in an attempt to support the pregnancy. Progesterone has been used for decades in obstetrics to help support certain pregnancies, including those at risk for pregnancy loss.
The network operates a 24-hour hotline connecting patients with medical providers who may offer this treatment if the second abortion pill has not yet been taken.
If you are interested in learning more about continuing your pregnancy after taking mifepristone, you can contact the Abortion Pill Reversal hotline at: 1-877-558-0333
Check out our post, Can I Continue My Pregnancy After Taking the Abortion Pill?
The Importance of Medical Follow-Up
Because outcomes after taking only mifepristone can vary, medical follow-up is important. A healthcare provider can confirm whether the pregnancy is continuing, has ended, or if additional care is needed.
If you need help navigating your pregnancy options or would like more information on this topic, we're here for you. Schedule a free consultation today.
If you're experiencing reproductive loss and need support, Alight offers both one-on-one and group support at no cost.
*This article was developed with research and drafting assistance from artificial intelligence and reviewed by our team for accuracy. Sources are listed below.
Sources
Bernard, Nathalie, et al. “Continuation of Pregnancy after First-Trimester Exposure to Mifepristone.” BJOG: An International Journal of Obstetrics and Gynaecology, vol. 120, no. 5, 2013, pp. 568–574. https://pubmed.ncbi.nlm.nih.gov/23346916/.
Grossman, Daniel, et al. “Continuing Pregnancy after Mifepristone Alone: A Systematic Review of the Literature.” Contraception, vol. 92, no. 3, 2015, pp. 206–211. https://pubmed.ncbi.nlm.nih.gov/26057457/.
United States, Food and Drug Administration. Mifeprex (Mifepristone) Tablets: Prescribing Information. U.S. Food and Drug Administration, 2000, https://www.accessdata.fda.gov/drugsatfda_docs/label/2000/20687lbl.htm.
Abortion Pill Reversal Network. “Abortion Pill Reversal.” Abortion Pill Reversal, https://www.abortionpillreversal.com/.
Comments