How Abortion Pills and Medical Abortion Work

Onereach in the US is rapidly shrinking. Now The US Supreme Court overturned Roe vs. Wade, experts predict that people will increasingly seek to end their pregnancy at home with a medical abortion (also known as a medical abortion or abortion pill). Abortion pills were The most popular way to end a pregnancy in the US, accounting for 54% of abortions in 2020, and this number is expected to grow.

Here’s what to know about the safety and effectiveness of the abortion pill.

What are abortion pills?

Medical abortions are approved by the U.S. Food and Drug Administration until the 10th week of pregnancy, where two medications must be taken 24 to 48 hours apart. The first, called RU 486 or mifepristone, is a hormone that blocks progesterone and stops a pregnancy from progressing; the second, misoprostol, causes contractions and bleeding that empty the uterus.

How safe is medical abortion?

Very safe. “We have a lot of data on safety,” said Dr. Daniel Grossman, an ob-gyn and researcher at the University of California, San Francisco. Serious complications requiring hospitalization are “extremely rare – less than half”.

Dr. Lauren Owens, a physician in charge at the University of Michigan, added that “medical abortion has historically been really tightly regulated because of abortion stigma, but not because of medical necessity. “

Is the abortion pill still legal? Roe vs. Wade was overturned?

Buying medicine can become more difficult, but there is a workaround. People still have access to medical abortion services through telehealth and mail-order pharmacies, which rely on doctors and pharmacies abroad to follow US regulations. Aid Access, an organization that helps people in the United States and around the world gain access to medical abortion pills, sends the pills after a patient answers some questions on a health screening questionnaire and provides a payment. payment (usually from $200 to $300); The group also provides medical guidance with international doctors via email. It took up to two weeks for the medicine to be available.

However, there are currently restrictions on medical abortion in 19 states that require a clinician to be present while administering the medication. Some states also have especially outlaw mailing drugs for residents of those states.

Read more: Meet pharmacists expanding access to abortion pills across the US

Advocates and doctors expect self-administered abortion – when someone ends a pregnancy without a doctor’s support – to increase dramatically after-Roe. Examples include getting prescriptions from online pharmacies (instead of telemedicine providers) or through friends from other states. There are more risks with this method, and Robin Tucker, a nurse practicing with Aid Access, cautions people to carefully check that the organization, company, or sender of the medication is legit and vetted. are not. She recommends checking out the site OLD plan, which lists trusted providers of the abortion pill in each state. Plan C also conducts some quality checks on the pills themselves.

If people need medical advice during the procedure, Tucker advises them to call Miscarriage and Abortion Hotline: a confidential, private and secure phone line staffed by medical volunteers who can answer questions.

Is there a chance that a medical abortion won’t work?

Yes, but it’s small. Learn Studies have shown that medical abortion is effective at terminating a pregnancy from 95-99% before the 9th week of pregnancy. Abortion pill gradually become less effective as the pregnancy progresses.

How do I know if the abortion pill has worked?

People have to wait four to five weeks for a pregnancy test to make sure the pill is working. This moment causes many people to skip the medical abortion window. If a woman is bleeding heavily and has some tissue removed, she is most likely still pregnant. But in rare cases, the pregnancy will continue; For example, a medical abortion will not end an ectopic pregnancy. If someone isn’t experiencing any symptoms and thinks they might still be pregnant, even after a medical abortion, experts recommend seeing a doctor and possibly having an ultrasound.

Read more: Inside an effort to promote abortion pills for a postpartum America

If you think you are still pregnant, can you perform another medical abortion?

Grossman says it makes sense to think this would work, and Tucker says she’s seen some people succeed on the second attempt. But people will need to buy and take a second pill within 10 weeks, Tucker said.

Will you be in trouble if you have to go to the doctor for a medical abortion?

Traditionally, abortion restrictions targeted service providers, not patients. In the case of Access to Aid, the suppliers are overseas and therefore are not at risk of prosecution. But that doesn’t necessarily mean pregnant people aren’t legally vulnerable. Greer Donley, an assistant professor at the University of Pittsburgh School of Law, says that not all states have protections for patients who try to have an abortion. She worries that the patient could be reported to the authorities at the hospital, for example, if a healthcare provider suspects an abortion. “People will be scrutinized if they don’t show the appropriate grieving response that people expect; if they are poor women of color, they are more likely to be targeted,” she said.

Dr. Debora Bartz, a physician at Brigham and Women’s Hospital in Boston, stresses that people do not need to tell their doctor if they have had a medical abortion. “There is no way for a health care professional to be able to distinguish between a spontaneous miscarriage or a medical abortion if the patient herself does not disclose that she has taken these drugs,” says Bartz — a point which both Grossman and Tucker agree. .

If people are concerned about their legal risk, they can contact the toll-free and confidential hotline called Repro Legal Helplinerun by If / When / How, an organization that advocates and supports commitment to reproductive rights. This team has a team of lawyers who can provide free legal advice to those concerned about their risk.

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