1. World Health Organization (2018). Medical management of abortion.

2. World Health Organization (WHO) (2022). Abortion Care Guideline.

3. World Health Organization (WHO) (2023) – Clinical Practice Handbook for Quality Abortion Care.

4. World Health Organization (WHO) (2022) - WHO recommendations on self-care interventions: self-management of medical abortion, 2022 update.


MA Regimens

5. Abubeker, F.A., Lavelanet, A., Rodriguez, M.I. et al. Medical termination for pregnancy in early first trimester (≤ 63 days) using combination of mifepristone and misoprostol or misoprostol alone: a systematic review. BMC Women's Health 20, 142 (2020).

6. Medication abortion with misoprostol-only: A sample protocol. Elizabeth G. Raymond, Alice Mark, Daniel Grossman, Tara Shochet, Dominique Truan, Ushma D. Upadhyay. Published: February 25, 2023. DOI:

7. Sheldon, W.R., Durocher, J., Dzuba, I.G., Sayette, H., Martin, R., Velasco, M.C., Winikoff, B. (2019). Early Abortion with Buccal versus Sublingual Misoprostol Alone: A Multicenter, Randomized Trial. Contraception; Vol. 99(5):272-277;

8.  Elizabeth G Raymond, Margo S Harrison, Mark A Weaver (2019). Efficacy of Misoprostol Alone for First-Trimester Medical Abortion: A Systematic Review. Obstetrics and Gynecology. Jan;133(1):137-147.

9. The SAFE Study, Ibis Reproductive Health, 2021-2023 (multiple publications)

10. Beaman J, Prifti C, Schwarz EB, Sobota M. Medication to Manage Abortion and Miscarriage. J Gen Intern Med. 2020 Aug;35(8):2398-2405. doi: 10.1007/s11606-020-05836-9. Epub 2020 May 14. PMID: 32410127; PMCID: PMC7403257

11. H von Hertzen  1 , N T M Huong, G Piaggio, M Bayalag, E Cabezas, A H Fang, K Gemzell-Danielsson, N D Hinh, S Mittal, E H Y Ng, K Chaturachinda, B Pinter, L Puscasiu, L Savardekar, S Shenoy, A Khomassuridge, H T D Tuyet, A Velasco, A Peregoudov, WHO Research Group on Postovulatory Methods of Fertility Regulation. Misoprostol dose and route after mifepristone for early medical abortion: a randomised controlled noninferiority trial. BJOG 2010 Sep;117(10):1186-96. doi: 10.1111/j.1471-0528.2010.02636.x.

12. Chen MJ, Creinin MD. Mifepristone With Buccal Misoprostol for Medical Abortion: A Systematic Review. Obstet Gynecol. 2015 Jul;126(1):12-21. doi: 10.1097/AOG.0000000000000897. PMID: 26241251.

13. Endler M, Lavelanet A, Cleeve A, Ganatra B, Gomperts R, Gemzell-Danielsson K. Telemedicine for medical abortion: a systematic review. BJOG. 2019 Aug;126(9):1094-1102. doi: 10.1111/1471-0528.15684.

14. Ferguson I, Scott H. Systematic Review of the Effectiveness, Safety, and Acceptability of Mifepristone and Misoprostol for Medical Abortion in Low- and Middle-Income Countries. J Obstet Gynaecol Can. 2020 Dec;42(12):1532-1542.e2. doi: 10.1016/j.jogc.2020.04.006. Epub 2020 Apr 27. PMID: 32912726.

15. The Reproductive Health Access Project (RHAP) Answers to most common calls from medication abortion patients


Very Early Medical Abortion

16. Fiala C, Bombas T, Parachini M, Agostini A, Lertxundi R, Lubusky M, Saya L, Danielsson KG. Management of very early medical abortion-An international survey among providers. Eur J Obstet Gynecol Reprod Biol. 2020 Mar;246:169-176. doi: 10.1016/j.ejogrb.2020.01.022. Epub 2020 Feb 1. PMID: 32035281.

17. Kapp N, Baldwin MK, Rodriguez MI. Efficacy of medical abortion prior to 6 gestational weeks: a systematic review. Contraception. 2018 Feb;97(2):90-99. Doi: 10.1016/j.contraception.2017.09.006. Epub 2017 Sep 18. PMID: 28935220.

18. Brandell K, Reynolds-Wright JJ, Boerma C, Gibson G, Hognert H, Tuladhar H, Heikinheimo O, Cameron S, Gemzell-Danielsson K; VEMA Study Group. Medical Abortion before Confirmed Intrauterine Pregnancy: A Systematic Review. Semin Reprod Med. 2022 Nov;40(5-06):258-263. doi: 10.1055/s-0042-1760117. Epub 2023 Jan 10. PMID: 36626915.

19. Tai NQR, Reynolds-Wright JJ, Cameron S. Very early medical abortion: treatment with mifepristone and misoprostol before ultrasonographic visualisation of an intrauterine pregnancy. BMJ Sex Reprod Health. 2022 Nov 9:bmjsrh-2022-201677. doi: 10.1136/bmjsrh-2022-201677. Epub ahead of print. PMID: 36351785.

20. Schmidt-Hansen M, Cameron S, Lord J, Hasler E. Initiation of abortion before there is definitive ultrasound evidence of intrauterine pregnancy: A systematic review with meta-analyses. Acta Obstet Gynecol Scand. 2020 Apr;99(4):451-458. doi: 10.1111/aogs.13797. Epub 2020 Jan 22. PMID: 31883371.


Abortion “Reversal”

21. Daniel Grossman, Kari White, Lisa Harris, Paul D. Blumenthal, Beverly Winikoff, David A. Grimes. Continuing pregnancy after mifepristone and “reversal” of first-trimester medical abortion: a systematic review. Contraception, 2015.

22. Creinin MD, Hou MY, Dalton L, Steward R, Chen MJ. Mifepristone antagonization with progesterone to prevent medical abortion: a randomized controlled trial. Obstet Gynecol 2020;135:158–65



Second Trimester Medical Abortion

23. Kapp N, Andersen K, Griffin R, Handayani AP, Schellekens M, Gomperts R. Medical abortion at 13 or more weeks gestation provided through telemedicine: A retrospective review of services. Contraception X. 2021 Jan 25;3:100057. doi: 10.1016/j.conx.2021.100057.

24. B. Zwerling, A. Edelman, A. Jackson et al., Society of Family Planning Clinical Recommendation: Medication abortion between 14 0/7 and 27 6/7 weeks of gestation. Contraception, 2023. DOI:

25. Schmidt-Hansen M, Lohr PA, Cameron S, et al. Surgical or medical abortion of pregnancies between 13+0 and 23+6 weeks’ gestation? A systematic review and new NICE national guidelines. 2021. BMJ, doi:10.1136/bmjsrh-2019-200460.

26. Prodan N, Breisch J, Hoopmann M, Abele H, Wagner P, Kagan KO. Dosing interval between mifepristone and misoprostol in second and third trimester termination. 2018. DOI: 10.1007/s00404-018-5017-9

27. Cameron S. Recent advances in improving the effectiveness and reducing the complications of abortion. F1000Res. 2018 Dec 2;7:F1000 Faculty Rev-1881. doi: 10.12688/f1000research.15441.1. PMID: 30631424; PMCID: PMC6281004.


Misoprostol Exposure and Continuing Pregnancy

28. Philip N, Shannon C, and Winikoff B. Misoprostol and teratogenicity: Reviewing the evidence–Report of a meeting. Robert H. Ebert Program on Critical Issues in Reproductive Health Publication Series. New York: Population Council, 2003.

29. Sitruk-Ware R, Spitz IM (2003) Pharmacological properties of mifepristone: toxicology and safety in animal and human studies. Contraception. Dec;68(6):409-20.


MA Contraindications, Precautions and Preparation

30. Das R, Panda S, Sharma N, Deb P. A rare case of misoprostol hypersensitivity. J Family Med Prim Care 2022;11:2226-7. DOI:10.4103/jfmpc.jfmpc_1301_21

31. Mayo Clinic Staff, Patient Care & Health Information, Diseases & Conditions, Ectopic pregnancy.

32. FIGO (2012) Consensus Statement on Uterine Evacuation

33. Warriner IK and Shah IH, eds. (2006) Preventing Unsafe Abortion and its Consequences: Priorities for. Research and Action, New York: Guttmacher 

34. Merck Manual (Raul Artal-Mittelmark, MD, Saint Louis University School of Medicine. Full review/revision May 2021 | Modified Sep 2022) Detecting and Dating a Pregnancy. 

35. Merck Manual, (Raul Artal-Mittelmark, MD, Saint Louis University School of Medicine. Full review/revision May 2021 | Modified Sep 2022), Physical Changes During Pregnancy.

36. Mayo Clinic Staff (retrieved March 2023) Diseases and Conditions: Porphyria. 

37. FFPRHC Guidance (April 2007). Intrauterine Contraception. Faculty of Family Planning and Reproductive Health Care Clinical Effectiveness Unit.

38. Merck Manual, Hemolytic Disease of the Fetus and Neonate, (Erythroblastosis Fetalis; Rh Incompatibility), Antonette T. Dulay, MD, Main Line Health System, Last review/revision Oct 2022.

39. WHO Abortion care guideline. 8 March 2022. Chapter 3. Recommendations and best practice statements across the continuum of abortion care. Clinical services Recommendation 8: Rh isoimmunization for abortion at gestational ages < 12 weeks (3.3.3)

40. Hayes JL, Achilles SL, Creinin MD, Reeves MF. Outcomes of medical abortion through 63 days in women with twin gestations. Contraception. 2011 Nov;84(5):505-7. doi: 10.1016/j.contraception.2011.02.015. Epub 2011 Apr 15. PMID: 22018125; PMCID: PMC3979718..

41. Drugs (last reviewed march 2014) Misoprostol use while Breastfeeding 

42. Drugs and Lactation Database (LactMed®) [Internet]. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. Misoprostol. [Updated 2022 Jul 18]. Available from:

43. Saleem HT, Narasimhan M, Ganatra B, Kennedy CE. Medical and surgical abortion for women living with HIV. Cochrane Database of Systematic Reviews 2018, Issue 12. Art. No.: CD012834. DOI: 10.1002/14651858.CD012834.pub2

44. de Bruyn M. (2003) Safe abortion for HIV-positive women with unwanted pregnancy: a reproductive right. Reprod Health Matters. Nov;11(22):152-61.

45. Wedisinghe L1, Elsandabesee D. (2009) Flexible mifepristone and misoprostol administration interval for first-trimester medical termination. Contraception. 2010 Apr;81(4):269-74.

46. Medical abortion contraindications and precautions, Last reviewed: January 22, 2021, Clinical Updates in Reproductive Health, Ipas, Retreived April 2023.

47. A.J. Lowik, University of British Columbia with the Institute for Gender, Race, Sexuality and Social Justice, for Fédération du Québec pour le planning des naissances (FQPN) (2017). Trans-Inclusive Abortion Services: A manual for providers on operationalizing trans-inclusive policies and practices in an abortion setting.


Pain Management

 48. Livshits A, Machtinger R, David LB, Spira M, Moshe-Zahav A, Seidman DS. Ibuprofen and Paracetamol for pain relief during medical Abortion: a double-blind randomized controlled study. Fertil Steril 2009; 91:1877–80

49.  Jackson E, Kapp N. Pain control in first-trimester and second-trimester medical termination of pregnancy: a systemic review. Contraception 2011;83: 116–26.

50. Fiala C, Swahn ML, Stephansson O, et al. (2005) The effect of non-steroidal anti-inflammatory drugs on medical abortion with mifepristone and misoprostol at 13–22 weeks gestation. Human Reproduction 2005; 20(11):3072–77. abortion. Obstetrics & Gynecology 1999;94(1):139–41.


After Abortion

51. Shannon C., Brothers LP, Philip NM, Winikoff B. (2004) Infection after medical abortion: a review of the literature. Contraception. Sep;70(3):183-90.

52. Gynuity FAQ on Misoprostol Detection in Blood February 12th, 2014. (retrieved 1 June 2023)

53. The Reproductive Health Access Project (RHAP) Answers to most common calls from medication abortion patients

54. Tang OS, Gemzell-Danielsson K, Ho PC. (2007) Misoprostol: pharmacokinetic profiles, effects on the uterus and side-effects. Int J Gynaecol Obstet. Dec;99 Suppl 2:S160-7. 

55. Bernard N, Elefant E, Carlier P, Tebacher M, Barjhoux CE, Bos-Thompson MA, Amar E, Descotes J, Vial T.(2013) Continuation of pregnancy after first-trimester exposure to mifepristone: an observational prospective study. BJOG. 2013 Apr;120(5):568-74. 

56. Kennedy CE, Yeh PT, Gholbzouri K, Narasimhan M.Self-testing for pregnancy: a systematic review and meta-analysis. BMJ Open. 2022 Feb 28;12(2):e054120. doi: 10.1136/bmjopen-2021-054120. PMID: 35228285; PMCID: PMC8886405.

57. Schmidt-Hansen M, Cameron S, Lohr PA, Hasler E. Follow-up strategies to confirm the success of medical abortion of pregnancies up to 10 weeks' gestation: a systematic review with meta-analyses. Am J Obstet Gynecol 2020;222(6):551-563.e513 Pubmed Journal

58. IPAS. (2007) Starting contraception after first-trimester medication abortion

59. FFPRHC Guidance (April 2017). Quick Starting Contraception. Faculty of Family Planning and Reproductive Health Care Clinical Effectiveness Unit.

60.  Feminist Women's Health Center. After-Care Instructions

61. Rocca C, Samari G, Fostera D, Goulda H, Kimport K, (2019). Emotions and decision rightness over five years following an abortion: An examination of decision difficulty and abortion stigma. Journal of Social Science & Medicine, Volume 248, March 2020, 112704.

62. Rocca C, Samari G, Fostera D, Goulda H, Kimport K, (2013). Women's Emotions One Week After Receiving or Being Denied an Abortion in the United States. Perspectives on Sexual and Reproductive Health. Volume 45, Issue 3. September 2013.

63. Diana Greene Foster, The Turnaway Study, (2020). Scribner.

64. Heidi Moseson, Jessica Shaw et all. (June 2019)  Contextualizing medication abortion in seven African nations: A literature review. Health care for Women International.

65. World Health Organization. Towards a supportive law and policy environment for quality abortion care: evidence brief. 2022.



66. Kaunitz, AM. (2008) Clinical practice. Hormonal contraception in women of older reproductive age. N Engl J Med. 2008 Mar 20;358(12):1262-70. 

67. Farley TM, Meirik O, Collins J. (1999) Cardiovascular disease and combined oral contraceptives: reviewing the evidence and balancing the risks. Hum Reprod Update. Nov-Dec 5:721–35.

68. Grimes DA.(1993) Over-the-counter oral contraceptives—an immodest proposal? Am J Public Health 1993;83:1092–

69. Grossman D.(2013) Moving oral contraceptives over the counter as a strategy to reduce unintended pregnancy. Ann Intern Med.  June 4;158(11):839-40.

70. McIntosh J, Rafie S, Wasik M, et al. (2011) Changing oral contraceptives from prescription to over-the-counter status: an opinion statement of the Women’s Health Practice and Research Network of the American College of Clinical Pharmacy. Pharmacotherapy. 2011;31(4):424–437.

71. World Health Organization Department of Reproductive Health and Research, and Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs (2022) Family planning: A global handbook for providers (2011 update). Baltimore and Geneva, Switzerland: CCP and WHO.

72. FSRH Clinical Guideline: Combined Hormonal Contraception.  (January 2019, Amended October 2023).

73.  The Reproductive Health Access Project (RHAP). Medical Eligibility for Initiating Contraception: Absolute and Relative Contraindications.

74. Rice CF, Killick SR, Dieben T, Coelingh Bennink H. (1999). A comparison of the inhibition of ovulation achieved by desogestrel 75 micrograms and levonorgestrel 30 micrograms daily. Hum Reprod; 14:982–985.

75. FSRH (Faculty of Sexual and Reproductive Healthcare). Clinical Guideline: Progestogen-only Pills (August 2022, Amended July 2023).

76. EC Princeton (updated July 2014). How does emergency contraception prevent pregnancy?

77. EC Princeton (updated July 2014). How effective is emergency contraception? 

78. FSRH CEU Guidance: Recommended Actions after incorrect Use of Combined Hormonal Contraception (e.g. late or missed pills, ring and patch) (March 2020, amended July 2021) Faculty of Family Planning and Reproductive Health Care Clinical Effectiveness Unit.

79. Merck Manual (Reviewed/Revised Apr 2022 | Modified Sep 2022). Female Internal Genital Organs