Common abortifacients employed in medical abortions typically include mifepristone, which is usually administered alongside misoprostol in a sequential method.[3] Additionally, synthetic oxytocin is commonly applied to induce abortion during the second or third trimester, and is typically safe for use during term labor.[4]
For millennia, individuals across different cultures have documented and suggested herbal abortifacients for women seeking to terminate a pregnancy, though their usage may pose health risks to the woman.
Medications
Since ‘abortifacient’ encompasses a broad spectrum of drugs, numerous medications can be categorized as abortifacients or deemed to possess abortifacient characteristics.
The most frequently recommended medication protocol for intentionally inducing abortion typically involves the administration of mifepristone followed by misoprostol 1–2 days later.[5] Research indicates that these medications have been rigorously studied and have proven to be both effective and safe[6], with less than 0.4% of patients requiring hospitalization for infections or blood transfusions. This combination is authorized for use until 10 weeks’ gestation (70 days post the last menstrual period).[7]
Other pharmaceuticals with abortifacient properties are often used for multiple purposes. Synthetic oxytocin (Pitocin) and dinoprostone (Cervidil, Prepidil) are routinely utilized during healthy term labor. Pitocin is used to stimulate and enhance contractions,[8] while Cervidil helps prepare the cervix for labor by inducing the softening and widening of this passage to the uterus.[9] When used in these contexts, neither drug is classified as an abortifacient. However, they can also be applied to induce abortion, especially after 12 weeks of pregnancy.[4][10] Misoprostol (as mentioned earlier) is additionally utilized to treat peptic ulcers[11] for patients experiencing gastric or intestinal damage resulting from NSAID use. Its availability for ulcer treatment sometimes allows misoprostol to be used for self-induced abortions in regions where legal abortion is not accessible or feasible.[12]
Not all agents labeled as abortifacients are intended for the purpose of terminating pregnancy. For instance, methotrexate, commonly prescribed for the management of rheumatoid arthritis, can induce abortion. Consequently, the use of contraception is generally recommended while managing a chronic condition with methotrexate.[13]
In some cases, herbal remedies are sought in efforts to trigger abortion. Generally, a dosage sufficient to achieve this effect poses risks to the mother due to possible liver and kidney complications; unsuccessful attempts may necessitate subsequent clinical abortion procedures if the uterus fails to expel completely.[14][15]
Some substances that do not function as abortifacients, like levonorgestrel,[16] are mistakenly categorized as such.[17]
History
The medical writings of classical antiquity frequently address pharmacological methods of abortion; various texts by Aristotle, Caelius Aurelianus, Celsus, Dioscorides, Galen, Hippocrates, Oribasius, Paul of Aegina, Pliny, Theodorus Priscianus, Soranus of Ephesus, and others outline the use of abortifacients in detail.[18]
In ancient Babylonian literature, scholars have examined several written prescriptions and techniques for terminating pregnancies. Some instructions explicitly delineated methods for consuming ingredients intended to end a pregnancy, while other cuneiform texts addressed the intake of substances to restore a missed menstrual cycle, often serving as historical euphemisms for abortion.
The ancient Greek colony of Cyrene once boasted an economy heavily reliant on the cultivation and exportation of silphium, a plant utilized for purposes ranging from food to treating feral dog bites. It was also revered as a potent abortifacient employed to “purge the uterus.”[20] Silphium played a significant role in…The wealth of Cyrene is evident in the depiction of the plant Silphium on coins minted in the region.
In Biblical literature, scholars and commentators interpret the ordeal of bitter water, which is prescribed for a woman suspected of infidelity (known as a *sotah*), as a reference to the administration of abortifacients to end her pregnancy. The woman consumes “water of bitterness,” and if found guilty, it results in the termination of the pregnancy she may be carrying. However, the Biblical scholar Tikva Frymer-Kensky has challenged this interpretation, arguing that the ordeal does not pertain to the use of abortifacients.
Ibn Sina, a physician of the medieval Islamic world, recorded various methods of birth control and mentioned rue as an abortifacient. Similarly, 11th-century physician Constantine the African cataloged several abortifacient herbs, categorizing them according to their potency, from those with milder effects to the most powerful ones.
Carl Linnaeus, celebrated as the “father of botany,” identified five abortifacients in his 1749 work *Materia medica*. Historian Londa Schiebinger notes that during the 17th and 18th centuries, a wide variety of sources—such as herbals, midwifery texts, court records, *Pharmacopoeia*, and *Materia medica*—indicate that physicians, midwives, and women possessed extensive knowledge of herbs capable of inducing abortion. She also observed that European expeditions in the West Indies uncovered around a dozen known abortifacients.
For Aboriginal peoples in Australia, certain plants like giant boat-lip orchid (*Cymbidium madidum*), quinine bush (*Petalostigma pubescens*), and blue-leaved mallee (*Eucalyptus gamophylla*) were used for ingestion, insertion, or smoking alongside Cooktown ironwood (*Erythrophleum chlorostachys*).
In eastern Canada, First Nations people traditionally utilized *Sanguinaria canadensis* (bloodwort) and *Juniperus virginiana* for inducing abortions. Historian Virgil Vogel recorded that the Ojibwe people employed blue cohosh (*Caulophyllum thalictroides*) for this purpose, while the Quinault used thistle. His work also lists additional abortifacient plants used by various North American tribes, including red cedar (*Juniperus virginiana*), American pennyroyal (*Hedeoma pulegioides*), tansy, and Canada wild ginger (*Asarum canadense*). Anthropologist Daniel Moerman reported that calamus (*Acorus calamus*), a common medicinal plant in Native American societies, was used for abortion by tribes such as the Lenape, Cree, and Sioux, among others, and he cataloged over a hundred abortifacient substances utilized by Indigenous peoples.
Continuing a tradition found in European and English literature, Benjamin Franklin advised colonial Americans to be precise in their measurements for an abortifacient recipe he included in a mathematics book meant to teach various practical skills.
Historian Angus McLaren highlights the practices of Canadian women from 1870 to 1920, indicating that a woman would often start by consuming an infusion of traditional abortifacients, including tansy, quinine, pennyroyal, rue, black hellebore, ergot of rye, sabin, or cotton root.
During the period of American slavery in the 18th and 19th centuries, cotton root bark was commonly used in folk remedies to facilitate miscarriage.
In the late 19th century, women in both the UK and the US increasingly turned to lead intake as a method for inducing abortions, frequently through pills containing diachylon or lead plaster, often leading to severe illness or even death.
The 19th-century figure Madame Restell operated a business facilitating mail-order abortifacients and surgical abortions for women in New York.
Early 20th-century newspaper ads contained euphemistic solicitations for abortifacients marketed to address menstrual “irregularities.” Between 1919 and 1934, the U.S. Department of Agriculture imposed restrictions on fifty-seven “feminine hygiene products,” including items like “Blair’s Female Tablets” and “Madame LeRoy’s Regulative Pills.”
Historically, terminating a pregnancy before “quickening” (the point at which a pregnant woman senses fetal movement) did not carry the legal and social stigma it is associated with today. Early medieval laws did not address abortion prior to quickening, and early teachings of the Catholic Church posited that human life began at “ensoulment,” which correlated with the moment of quickening, continuing Roman practices regarding the use of abortifacients before this point.
Under English law, abortion was not criminalized until 1803. Women seeking to terminate pregnancies before quickening would often refer to their actions as “restoring the menses” or “bringing on a period.” After quickening, however, abortion was punishable by death—a penalty that was revoked in 1837 while the legal distinction of quickening was eliminated.
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