Thoai Ngo, Vice President of Social and Behavioral Science Research, advocates for a misoprostol-only option for medication abortion. The regimen is aligned with international standards for existing clinical practices. An excerpt is provided here. The full commentary is available at Health Affairs Forefront.

To realize this goal, US health officials, medical institutions, pharmaceutical companies, and advocates need to campaign for the support, registration, and authorization of a misoprostol-only regimen for medication abortion before 13 weeks of gestational age. Just as importantly, they must also allow the drug to be prescribed by pharmacists and dispensed at any pharmacy, particularly in states where abortion is available upon request.

These steps may sound unprecedented, but in reality they are aligned with international standards for existing clinical practices. The World Health Organization’s (WHO’s) latest abortion guidelines recommend a misoprostol-only regimen for terminating pregnancies before 13 weeks, based on the drug’s high efficacy and excellent safety profile. Surveys carried out in Africa, Asia, and Latin America show that pregnant people in both restrictive and nonrestrictive environments regularly use pharmacy-prescribed and -dispensed misoprostol-only regimen.

Policymakers and advocates need to look ahead to years or decades of restrictions on reproductive health care without federal protection of abortion rights. Despite these circumstances, our healthcare policy around abortion needs to find ways to ensure the broadest possible access and expanding choices to care without relying on the possibility of an eventual federal protection.

To that end, moving forward with a misoprostol-only regimen for medication abortion would have a tremendous impact on access to care, especially for pregnant people forced to cross state borders to receive treatment. The effort will require private-sector commitment and ambition, input from advocates and activists, and expert advice from medical professional bodies, all brought together by the Biden administration’s determination to live up to their goals. If our nation is truly committed to protecting abortion access in the United States, it should pursue adoption of the misoprostol-only regimen.