What does “gynecological indications” mean?

There are two ways to have an abortion with pills. You can either use both Mifepristone and Misoprostol, or you can have an abortion with Misoprostol only.

Both Mifepristone and Misoprostol are on the WHO’s list of essential medicines.

Mifepristone currently has only one medical indication. It is used for abortion/ the treatment of miscarriage. For this reason, Mifepristone is often not registered by drug authorities in countries where restrictive abortion laws are in place.

Misoprostol; however, the other pill needed for a medical abortion, was originally produced to treat gastric ulcers and arthritis. In the 1980’s women from Brazil discovered its potential to induce and self-manage abortion. Because of the common use of Misoprostol for those other medical indications (gastric ulcers, arthritis, etc.), it is spread much more widely around the world, often including countries that have very restrictive laws around abortion. 

Depending on the country, a certain brand of Misoprostol might be openly registered for gynecological indications (such as birth, miscarriage treatment or abortion care etc.). In other cases Misoprostol is registered for other purposes (such as gastric ulcers, arthritis etc.). The medical indication a pill is registered for may vary from brand to brand and country to country. The common Misoprostol brand Cytotec for example is registered for gynecological indications in one country, and for other purposes in other countries.

The substance/active ingredient Misoprostol is always the same and can be used for an abortion regardless of the medical purpose it is registered for. In many countries it is common that doctors use Misoprostol “off-label”, meaning that they prescribe a product that is officially registered for other purposes for gynecological indications.

In countries with restrictive laws around abortion it may be easier to obtain Misoprostol in a pharmacy using a prescription to treat gastric ulcers or arthritis.