The procedure with methotrexate is similar to the one using RU 486, though administered by an intramuscular injection instead of a pill.

This drug approved by the FDA in 1953 was designed to treat certain cancers. Methotrexate has the potential for serious toxicity in high doses.[1] Since the time of its approval, medical researchers have discovered other uses for the drug including its use to end unintended pregnancies.[2]

• HOW IT WORKS: As with the medical abortion brought about by mifepristone several office visits are required for counsel, obtaining past medical history and ultrasounds.  Methotrexate stops embryonic or fetal cells from dividing.  Once these cells can no longer divide, the pregnancy stops growing.[3] Five to seven days after the methotrexate injection, the woman either returns to the doctor’s office for insertion of a misoprostol suppository or she takes an oral dose of the drug misoprostol as prescribed by her doctor at home.[4] This drug is a prostaglandin and causes uterine cramping and softening of the cervix resulting in expulsion of the embryo.  Generally within two days of the suppository insertion or oral ingestion of the misoprostol, the woman aborts.[5] In most cases, it takes 7 to 10 days from the start of drug treatment for the abortion to be completed.

•  FAILURE RATE: According to one study of 178 women 68% successfully aborted after the combination drug treatment of methotrexate and misoprostol.[6] Some women who fail to abort with the first doses (see above) may need a second dose of the misoprostol, and the few who fail to abort after that are given a mini-suction abortion.[7]

• SIDE EFFECTS: Nausea, vomiting, diarrhea, abdominal pain and cramping have all been reported.[8]

• EFFECTS ON THE DEVELOPING EMBRYO/BABY: Methotrexate is a known teratogen and women who take this drug will often deliver a child with a congenital anomaly; the most frequent are bone and limb deformities.[9]

• The manufacturer warns in the package insert that while methotrexate has shown itself useful in treating certain types of cancer and severe cases of arthritis and psoriasis, "deaths have been reported with the use of methotrexate," and recommends that its use be limited to "physicians whose knowledge and experience includes the use of antimetabolite therapy."  Though researchers performing methotrexate abortions have dismissed such concerns because of the low dosage used,  other doctors in the abortion trade have disagreed, and the package insert clearly warns that "toxic effects may be related in frequency and severity to dose or frequency of administration but have been seen at all doses" (emphasis added).