As Republicans create ever higher barriers to abortion that push abortion seekers later into pregnancy, U.S.-based activists are learning from Latin American feminists who have developed protocols to make second-trimester medication abortion easier and safe: using a double-dose mifepristone protocol for pregnancies 17 weeks of gestation and longer.

For second-trimester abortions, taking two mifepristone means needing less misoprostol, which eases painful contractions and shortens the time to uterine expulsion.

Whereas mifepristone’s side effects are mild—mainly headaches and some nausea that can be treated with medications—misoprostol causes diarrhea, chills and vomiting, which are much harder to experience. Using two mifepristone also significantly reduces the period of painful contractions—from 15 to 18 hours, to often less than six hours, which is critical for women who have to work or care for children or relatives.

Supported women have expressed great satisfaction with the process.

People seek abortion care later in pregnancy for the same reasons they do early in pregnancy, said Erika Christensen, cofounder of Patient Forward, which works to eliminate barriers to abortion care later in pregnancy and provides resources on how find later abortion care—but many are not able to access care as soon as they would like. “This could be because they learned a piece of new information later in their pregnancy, like a health threat to themselves or to the fetus, a new extenuating life circumstance, or it could be the new information could be that they’re pregnant.”