How Abortion Pills and Medical Abortions Work

The U.S. has a rapidly shrinking bortion access. The U.S. Supreme Court has ruled in favor of bortion access. Roe Vs. WadeExperts believe that women will be more likely to seek medical abortion (also called a medication abortion) in their own homes. Abortion pills, which account for 54% of all abortions in America in 2020, are the best way to end your pregnancy.

Here’s what to know about the safety and efficacy of abortion pills.

What is an abortion pill?

Two drugs are taken at the same time to induce an abortion. These medications can be approved by the U.S. Food and Drug Administration up until the 10th weeks of pregnancy. The first, RU 486 (or mifepristone), blocks progesterone, which stops pregnancy progressing. Misoprostol causes bleeding and contractions that drain the uterus.

Is it safe to have an abortion by medication?

It is very safe. “We have a great deal of safety data,” says Dr. Daniel Grossman, an ob-gyn and researcher at the University of California, San Francisco. Serious complications that require hospitalizations are “incredibly rare—less than half a percent.”

Dr. Lauren Owens, an ob-gyn at the University of Michigan, adds that “medical abortion has been historically really tightly regulated because of abortion stigma, but not because of medical necessity.”

What will happen to abortion pills if they are legalized? Roe Vs. WadeIt has been rescinded?

While it might be harder to access the pills in some cases, there may still be ways around this. There may still be access to abortions by telehealth or mail-order. This is because these services depend on pharmacies and doctors overseas to circumvent U.S. regulations. The aid access organization helps Americans and others around the globe get medical abortion pills. Patients must answer some questions and pay a fee (usually $200-$300). They can also receive medical advice via email from international doctors. It can take as long as two weeks for the pills to reach you.

However, 19 states have restrictions regarding medication abortion. These state laws require that the physician present at medication administration. Many states also prohibit mail-ordering of pills for residents.

Learn More: Meet the Pharmacist Expanding Access for Abortion Pills across the U.S.

Advocates and doctors expect self-managed abortions—when someone ends a pregnancy without physician support—to increase significantly post-Roe. You can get prescriptions online from pharmacies, rather than a telehealth provider or from friends in other states. This method has more risk. Robin Tucker, Aid Access’ nurse practitioner, advises that people verify the legitimacy of the company or individual sending them the pills. Plan C is a website that lists trusted abortion-pill vendors in every state. Plan C can also perform quality checks on the pill itself.

Tucker advises people to call the Miscarriage and Abortion hotline if they need any medical advice. It is confidential and private and can be reached by clinician volunteers.

Is there a chance medication abortion won’t work?

Yes, but it’s small. Research has shown that medical abortion can be used to end a pregnancy in 95-99% of cases. This is before the ninth week. As the pregnancy progresses, abortion pills become less effective.

What is the best way to know whether abortion pills worked?

For a test of the effectiveness of the drugs, women must wait four to five weeks. Many people are unable to have medical abortions because of this timing. A woman who has experienced heavy bleeding, and is unable to pass any tissue, is unlikely she’s still pregnant. But in some rare cases, the pregnancy will continue; medication abortion won’t terminate an ectopic pregnancy, for example. If someone doesn’t experience any symptoms and thinks they might still be pregnant, even after medication abortion, experts recommend that they seek medical attention and possibly have an ultrasound.

Continue reading: Within the Campaign to Promote Abortion Pills in a Post Roe America

If you think you’re still pregnant, can you do another medical abortion?

Grossman states that it’s reasonable to believe this will work. Tucker also says that she’s witnessed some people achieve success after only one attempt. Tucker says that the people need to be able to access and take the second set of pills within the timeframe of 10 weeks.

Are you going to get into trouble if your doctor orders you to have a medication aborted?

Abortion restrictions were traditionally aimed at providers rather than patients. Aid Access is a case in which providers are not within the country, and thus do not face prosecution. But that doesn’t necessarily mean that pregnant people aren’t legally vulnerable. Greer Doley, an assistant professor at University Pittsburgh Law School says that states don’t have the same protections available for people who are trying to abort. If a hospital suspects that a patient is having an abortion, she worries about the possibility of reporting them to police. “People are going to be scrutinized if they’re not displaying the appropriate grief response that people expect; if they are poor women of color, they are much more likely to get targeted,” she says.

Dr. Debora Bartz, an ob-gyn at Brigham and Women’s Hospital in Boston, stresses that people don’t need to tell their doctors if they did a medication abortion. “There is no way for a health care professional to be able to distinguish between a natural miscarriage or a medication abortion if the patient herself doesn’t disclose that she took these medications,” Bartz says—a point on which Grossman and Tucker both agree.

If you are concerned about your legal risk, people can call the confidential and free Repro Legal Helpline. It is operated by If/When/How. This advocacy and support group is committed to protecting reproductive rights. This hotline is staffed with lawyers that can offer free legal advice to anyone who is concerned about their risks.

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