Combined, mifepristone and misoprostol are considered the clinical "gold standard" for medication abortion. Misoprostol can be taken alone to induce an abortion, but some studies have suggested it's less effective, Foster warned patients. Plus, it can make the process longer and more painful, with more side effects, such as nausea and vomiting.
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Two developments often get lost in the public's perception of the abortion wars.
One is that there were nearly twice as many abortions in the U.S. in 2025, compared to 2021, the year before the Supreme Court overturned Roe v. Wade in its momentous Dobbs decision in 2022.
The numbers come from the Society of Family Planning's latest #WeCount report. By December 2025, 29% of abortions were through telehealth.
The second is that, because the mailing of abortion pills has become so widespread in the post-Dobbs era, abortion opponents may simply be unable to stop it.
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If mifepristone is restricted, many telehealth groups will immediately switch to using only misoprostol instead, they say.
Misoprostol is approved by the FDA to treat ulcers, and is also widely used off-label to manage miscarriages, induce labor and end pregnancies.
And while states could individually ban misoprostol, the FDA doesn't typically regulate how a drug is used off-label, according to David Cohen, a law professor at Drexel University and national expert on abortion law.
"There would have to be some finding that it is not safe or effective for ulcer treatment, something that there's no argument anyone could possibly show," Cohen said.
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Other organizations are already directing patients to mifepristone from outside the U.S., through groups such as Aid Access and online pharmacies in places like India.
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