Mifepristone and misoprostol are two oral medicines (tablets) that, when taken in the correct sequence, cause the termination of pregnancy (abortion). This is also called 'medical termination' of pregnancy, and is different from 'surgical termination'.

Mifepristone

Mifepristone is sometimes referred to as RU486 or the 'abortion pill'; however, this medicine should not be taken by itself, and has to be followed by misoprostol to terminate a pregnancy.

This medicine interferes with the body's use of progesterone — a key hormone for maintaining a pregnancy.

When it is taken as the first step in this sequence of two medicines, mifepristone starts the medical termination by:

relaxing and opening the cervix (the neck of the womb)

making the uterus (womb) sensitive to hormones called prostaglandins, which are responsible for starting contractions.

Misoprostol

This medicine mimics the natural hormones (prostaglandins) produced by the body, which are responsible for starting contractions. When it is taken as the second step in this sequence of two medicines, misoprostol continues the process of medical termination by:

further relaxing and opening the cervix

causing contractions of the uterus so that its contents are expelled through the vagina.

 Who can take mifepristone/misoprostol?

Mifepristone and misoprostol are available on the PBS and approved for use in women who are seeking to terminate a pregnancy, are no more than 9 weeks pregnant (i.e. it has been no more than 63 days since your last period), and who would like an alternative to surgical termination.

To use these medicines, you will need to:

have a medical examination (usually including an ultrasound) to confirm that your pregnancy is 9 weeks or less and to exclude the possibility of an ectopic pregnancy (a pregnancy occurring outside the uterus, e.g. in the fallopian tubes)

follow through with all required doses, rest, and clinic attendance, including follow-up visits

have access to a telephone and transport to a medical facility in case of emergency. It is also preferable to have a support person with you after taking the second medicine (misoprostol)

be prepared to undergo a surgical termination if the effect of mifepristone/misoprostol is incomplete or unsuccessful. Up to 7 in 100 medical terminations are unsuccessful, and follow-up surgical termination may be needed.

Talk with your health professional about all the options for terminating a pregnancy.

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