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for patients interested in a medication abortion the first drug given is mephaprystone a progesterone receptor antagonist progesterone plays an essential role in early pregnancy and preparing the uterine wall for implantation and supporting the developing embryo progesterone works in two main ways first it promotes the growth of the decidua the inner lining of the uterus into which the embryo implants and second it calms the myometrium or the uterine muscle to keep it from prematurely expelling the growing pregnancy mifapristone when administered in the first 10 weeks of pregnancy blocks the action of progesterone that is needed to maintain a pregnancy in several ways it causes decidual necrosis which leads to detachment of the pregnancy it acts on the endometrial vessels to disrupt the pregnancys blood supply it promotes uterine contractions by increasing the excitability of myometrial cells and their sensitivity to exogenous prostaglandins it increases the local release of prostagla