1. Risk of bias table for RoB 2 – including judgements.

Study, outcome	Bias arising from the randomization process	Bias due to deviations from intended intervention	Bias due to missing outcome data	Bias in measurement of the outcome	Bias in selection of the reported result	Overall
Avraham 2012   Pain scores at two hours post‐misoprostol administration	Low   Quote: "The 61 women were randomized at the time of misoprostol administration into two treatment groups by providing a sealed envelope, using a computer‐generated random list, with serial numbers from 1 to 61."	Low   Quote: "The 61 women were randomized at the time of misoprostol administration into two treatment groups by providing a sealed envelope, using a computer‐generated random list, with serial numbers from 1 to 61."	Low   Quote: "Two women, one in each group, did not show up for follow‐up, and data about the success of the abortion were not established. They were considered in our analysis as failure of the medical abortion."   Comment: missing outcome data between the two groups were similar in proportion and the reason for missing were similar.	Low   Quote: "this was a randomized, placebo‐controlled, double‐blind trial."    Comment: Using ROB2 tool, assessed as 'Probably No' for this domain therefore LOW risk.	Low   Comment: the study was analyzed and reported based on the authors plan	Low   Comment: No other sources of bias were identified
Friedlander 2018   Pain scores at multiple time points (immediately after misoprostol administration and then at 2, 6, 12, 24 and 72 hours later)	Low   Quote: "A researcher not involved in the conduct of the study used a computer‐generated randomization scheme of varied block sizes"	Low   Quote: "A researcher not involved in the conduct of the study ... placed the allocated study capsule in sequentially numbered bags identified only by study identification number so as to maintain blinding of participants and researchers."	Low   Comment: Using ROB2 tool: Domain 5.1 = Yes, 5.2 = No, 5.3 = No	Low   Comment: Using ROB2 tool: Domain 4.1 =No, 4.2 = No, 4.3 = No Information, 4.4 = No	Low    Comment: Study appears to have reported on all outcomes selected in analysis plan	Low   Comment: No other specific concerns regarding sources of bias
Livshits 2009   Pain scores at two hours post‐misoprostol administration	Low   Quote: "This was a prospective, double‐blind, randomized controlled trial.... We randomized the 120 women into two treatment groups by providing a sealed envelope by using a computer‐generated random list that included serial numbers from 1 to 120. The envelope was given by the nurse at the time at which the patient received the misoprostol tablets."	Low   Quote: "This was a prospective, double‐blind, randomized controlled trial....We randomized the 120 women into two treatment groups by providing a sealed envelope by using a computer‐generated random list that included serial numbers from 1 to 120. The envelope was given by the nurse at the time at which the patient received the misoprostol tablets...The ibuprofen and paracetamol tablets were identical in size, color, and shape."	Low   Quote: "We randomized the 120 women into two treatment groups by providing a sealed envelope by using a computer‐generated random list that included serial numbers from 1 to 120. The envelope was given by the nurse at the time at which the patient received the misoprostol tablets...The ibuprofen and paracetamol tablets were identical in size, color, and shape."	Low    Comment: Appears nurses were assessing outcomes and also blind to nature of trial medications	Low    Comment: ROB2 Tool Domain 5.1 = Probably Yes, 5.2 = No, 5.3 = Probably No. The authors listed all analyses for table 2 but only show the ones that were significant, but can infer from text that remaining were not significant.	Low   Comment: There did not appear to be any other significant sources of bias
Raymond 2013 Worst pain in the 24‐hour period following misoprostol	Low   Quote: "The one‐to‐one randomization scheme was stratified by site and used randomly permuted blocks with sizes of eight and 20 generated by computer by the study statistician before the start of enrollment."	Low   Quote: "If she was eligible, staff assigned her to either the prophylactic regimen group or the therapeutic regimen group by opening the next unused consecutively numbered opaque envelope containing a random assignment."	Low   Comment: Missing data accounted for and any sections missing identified in results tables. All variables analysed as ordinal ‐ nearly all data available.	High                 Comment: ROB2 tool questions 4.1 = No, 4.2 = No, 4.3 = Yes, 4.4 = Yes, 4.5 = Probably Yes.	Low   Comment: ROB2 tool questions 5.1 = Probably Yes, 5.2 = Probably No, 5.3 = Probably No	Some concerns   Comment: Recall scores of pain for those who did not complete diary will be affected by recall bias, however the number of participants doing this in both groups is small and so may not affect overall result, but cannot tell as results aggregated.