NRL News

Off-Label Abortion Pills being Sold at Flea Markets

by | Jul 17, 2013

By Randall K. O’Bannon, Ph.D., NRL-ETF Director of Education & Research

Randall K. O'Bannon, Ph.D.

Randall K. O’Bannon, Ph.D.

When many people think of abortion pills, they think of RU-486, the abortion drug developed in France in the 1980s and sold in the U.S. since 2000. But there is another drug, misoprostol, a prostaglandin normally used in conjunction with RU-486, that is being increasingly promoted and used by itself as a standalone abortifacient.

And word is that misoprostol is now being sold at border town flea markets in Texas.

After all these years, many people do not know that “RU-486” is actually a two-drug abortion technique. RU-486 (generic name mifepristone) is a drug that causes a baby’s life support system to shut down, essentially starving the child to death. But to complete the abortion, another drug, a prostaglandin is used, to stimulate powerful uterine contractions to expel the tiny corpse.

Somewhere along the line, someone figured out that a pregnant woman could try skipping the RU-486 and just take the prostaglandin, initiating a violent labor that forcefully aborts the child. But it is a much riskier proposition than most women know—for both the child and herself—which we will detail later in this story.

Why do it then? For two reasons. First, because it is considerably cheaper than RU-486. Second, misoprostol has legitimate medical uses and is therefore easier to obtain.

RU-486 pills have been priced at about $90 a pill while misoprostol costs only maybe a couple of dollars a pill. Available on the black market for $10 a pill, misoprostol is still a bargain over the higher priced mifepristone. And while RU-486, in the U.S., is only available directly from the distributor, misoprostol is sold at regular pharmacies all across the country.

Unlike RU-486, which is only officially marketed as an abortifacient, misoprostol, under the trade name Cytotec, is a mainstream drug with a genuinely therapeutic application. It helps those have to regularly take non-steroidal anti-inflammatory drugs to stave off gastric ulcers.

Searle, the manufacturer of Cytotec, has specifically said that it does not want its drug used for abortion, and instructions sent out with bottle specifically indicate that it is not to be used by pregnant women. However once a prescription is filled by the pharmacy or a shipment is sent to a doctor’s office, there is little control over how it is used. And it does not help matters that the U.S. Food and Drug Administration (FDA) specifically mandated its use in tandem with RU-486 when approving that drug in September of 2000.

Which is long way of explaining exactly how we got to the situation where misoprostol is being sold in Texas flea markets.

Bloomberg News, in a July 11, 2013, article, reports that though the misoprostol pills are not officially advertised or on display, they can be obtained at open air flea markets like the one Bloomberg visited outside McAllen, Texas, a city of about 133,000 near the southern tip of Texas, just across the border from Mexico.

It is unclear what prompted Bloomberg to investigate the flea market abortifacient sales. But the story is built on the basis of what the news service identifies as interviews with “a dozen area residents and doctors” against the backdrop of recent legislative battles in Texas over abortion and state funding of “family planning” groups (like abortion giant Planned Parenthood).

Bloomberg tries to argue that if the state, through its laws, “makes legal abortion unavailable in Texas, more women may turn to markets such as the one near McAllen…”

It is worth noting, though, that the primary incentive for women going the black market route seems to have been cost, rather than availability. There is an abortion clinic there in McAllen, and a long-time abortionist there was one of those interviewed for the story.

At the “nearest legal provider”–which would seem to be that McAllen clinic– a “pharmaceutical” abortion costs $550. Erlinda Dasquez, a 29-year-old mother of four, got and took some of the pills she bought from a woman who had smuggled some pills across the border. Interviewed for the article, Dasquez told Bloomberg that three years ago she paid $40 for four pills she got in a clear plastic bag from the woman who sold them to her out of her living room.

According to Bloomberg, though abortion is illegal in Mexico (at least outside the capitol, Mexico City), pharmacies on the Mexican side of the border can legally sell misoprostol without a prescription. So the supply is relatively easy to come by if someone can bring them across the border.

Women who don’t want to cross the border themselves now can simply go to the flea market. The pills aren’t sitting out on the tables, but people told Bloomberg that all one has to do is ask.

Dasquez says she knows 12 to 20 people have gotten the pills, including a cousin she said “went to the flea market a few months ago.” These abortions are described as “clandestino.”


These pills, used alone, often don’t work. Consequently, the woman buys more pills, pursues more expensive surgical abortions, or gives birth later to a child that could have had his or her development impaired by the arduous but unsuccessful process.

In our June and July 1998 issues of NRL News, we wrote on studies of babies with disabilities born in Brazil after unsuccessful misoprostol abortion attempts. There are sometimes children born months later with missing or webbed toes, fingers, clubbed feet, partial facial paralysis or other developmental malformations. There are more difficulties which we discuss in a moment

The drug can initiate a lengthy period of bleeding. Dasquez told Bloomberg she bled for at least a month. William West, the abortionist at Whole Women’s Health in McAllen, told Bloomberg that he sees patients daily who have taken the black-market abortion drugs, many of them bleeding or still pregnant.

Instructions given at the Mexican pharmacy are scant; Bloomberg recounts the man behind the counter telling the woman to take two pills orally and one vaginally, followed by two pills every hour “until something happens.” It is unclear what sort of directions and warnings are given to women at the flea markets.

The most recent official FDA label for Cytotec (11/2012), states that the drug “should be taken only according to the directions given by a physician” and indicates that “caution should be employed” when administering Cytotec to patients with pre-existing cardio-vascular disease. In addition to repeated warnings that it is not to be used by pregnant women because of its abortifacient effects, the FDA notes that misoprostol has been associated with uterine ruptures when used for abortion beyond the eighth week of pregnancy.

The label also reminds people that the drug falls in the FDA’s Pregnancy Category X (meaning that because of studies showing risk to the baby, the FDA has determined that risks clearly outweigh the benefits of the pregnant woman’s use) and says that “Congenital anomalies sometimes associated with fetal death have been reported subsequent to the unsuccessful use of misoprostol as an abortifacient…”

Given the abortion industry’s energetic, all-out push of chemical abortifacients, this is not the first time we have heard of the black market sale of these drugs, nor is it likely to be the last. In September of 2000, NRL News reported on a story appearing in the August 30- September 5, 2000, edition of the Village Voice indicating that a sizeable black market had grown up, especially in New York City’s Latino community, around Cytotec.

Often referred to as “the star pill” on the streets because of its five-sided shape, the drug had put a number of women into hospital emergency rooms hemorrhaging or dealing with the effects of an incomplete abortion, the Village Voice reported.

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“Women on Waves,” the notorious people associated with the “abortion ship” that anchored off the coasts of Ireland, Portugal, and Poland in the early 2000s, have in recent years been promoting abortion hotlines where “Women with unwanted pregnancies who need help can get information about the best use of misoprostol for a safe abortion.” Many, if not most of these campaigns, are in countries where abortion is not legal.

With the abortion industry nearly always soft-pedaling the risks, women are led to believe that these pills are safe and easy to use, that anyone can just pick up a couple of spare pills from a friend or that they could be purchased at the back of the booth at the flea market.

Nothing could be further from the truth. These pills are dangerous for both the mother and the child. Women picking up these pills at their local flea markets may end up getting a lot more than they bargained for.

Categories: Abortion Risks