Why do you only need 4 tablets of Misoprostol after taking Mifepristone?

Why do we also recommend taking one extra dose of 2 Misoprostol 3-4 hours after the first dose?

Scientific research has shown that an abortion with the combination of Mifepristone and Misoprostol is safe and effective for home use up to 12 weeks of pregnancy.

For pregnancies up to 10 weeks gestation, research shows that taking 1 tablet of Mifepristone (200 mg) and 4 tablets of Misoprostol (200 mcg each) under the tongue 24 hours later, is a safe and effective way to take the medication, without the repeated doses of Misoprostol. Recent research on telemedical abortion, however, also indicates that even in early pregnancies of less than 10 weeks, an extra dose of 2 Misoprostol, used 3 to 4 hours after the first dose results in less ongoing pregnancies and less incomplete abortions.

Women on Web follows the World Health Organisation Guidelines on Safe Medical Abortion. Most packages contain 1 tablet of Mifepristone and up to 8 tablets of Misoprostol 200 mcg for women who are expected to be less than 10 weeks pregnant when they do the abortion with pills.  This way, the second dose of Misoprostol is part of the standard regimen. An extra dose of 2 Misoprostol 200 mcg can also be used for treatment of heavy bleeding or incomplete abortion.

Individuals who are longer than 10 weeks pregnant will receive 1 tablet of Mifepristone (200 mg) and 12 tablets of Misoprostol (200mcg) which should be used in repeated doses. In this case, the person will receive an email with detailed information on how to use the extra tablets of Misoprostol.

In some countries, Misoprostol is available only in tablets of 400 mcg. When these pills are used for medical abortion, the dosage of Misoprostol used should be halved.