6 things to know about abortion pills


More than half of recent abortions in the United States have been performed by medical abortion. The Food and Drug Administration permanently allowed patients to obtain abortion pills via telehealth and mail delivery in December 2021, but accessibility still depends on the state in which the patient lives. If the Supreme Court decides to overturn the landmark Roe v. Wade right on abortion, medical abortions are expected to increase even more if access to abortion clinics is threatened. To help offer guidance on medical abortion, Yahoo News spoke with Ushma Upadhyay, associate professor of obstetrics, gynecology, and reproductive sciences at the University of California, San Francisco.

Video transcript


A medical abortion is the use of two types of drugs. The first is mifepristone, which prevents a pregnancy from developing, and the second is misoprostol, which allows the uterus to contract and empty the contents of the uterus. It takes up to 11 weeks of pregnancy and the process usually takes place at home and takes place over 24 hours. And the bleeding lasts up to a few weeks.

A person taking a medical abortion can expect to have severe cramping and bleeding for the first 24 hours. Some people experience nausea and vomiting, and sometimes diarrhea during this early phase of the abortion. Medical abortions are now the most common type of abortion. Our most recent data available is from 2020 and we learned that medical abortion accounts for 54% of all abortions.

A medical abortion is different from Plan B, which is emergency contraception. Emergency contraception is taken within the first 72 hours after sex, then medical abortion is used after a person is already pregnant, which happens a few weeks later.

The FDA approved mifepristone and misoprostol, the two medications in medical abortion, in the year 2000. They recently updated those approvals in 2016, and they are continually updating the protocols to provide them. Medical abortion is extremely safe. We analyzed data from over 11,000 medical abortions and followed people over time and found a complication rate of less than a third of 1%. It therefore has a safety rating of over 99%. This safety rating is even better than that of Tylenol and Viagra, which means it is safer than Tylenol, Viagra, and many other over-the-counter medications.

The safety profile of abortion pills is so safe that research is currently being conducted to determine if they might eventually become available over the counter. And our preliminary research suggests it definitely has the potential to go over-the-counter one day.

Patients do not have to go to a specialized clinic to obtain abortion pills. They could ask their primary care providers now that it’s available by prescription and at online pharmacies. So, to get a medical abortion, a patient can either have a telehealth visit or an in-person visit. In many states — around 22 right now — someone can get it through telehealth services, which means they don’t even have to make an in-person visit. And they can receive the drugs by mail. There is a clinician who will attend to the patient, but this is done remotely using telehealth technologies.

Providers will assess a patient’s gestational age or if she is eligible, if she is in the first 11 weeks by asking the date of her last menstrual period or other questions to make sure she is in this range. eligibility window. But other than that, there is no other requirement for an ultrasound or test before a patient can receive these drugs.

Then the in-clinic option is when a patient will walk into the clinic and speak to a clinician face-to-face. Many clinics no longer require an ultrasound before abortion. All it takes is one consultation and you can take the pills and take them home.

Not everyone can receive these FDA-approved drugs by mail. People in 19 states can’t because of state laws that ban telehealth for abortion. And these laws are not based on any medical evidence that they are necessary. In our research following abortion telehealth patients, some patients living in states where telehealth is restricted, they were able to order the pills and have them delivered to a friend or family member living in a state where that is authorized. And then that friend or family member sends the pills to the patient.

So it’s not necessarily legal, there could be legal risks associated with this option, but we have documents indicating that some patients try this method. Legal risk is actually greater than any type of medical risk.

If Roe v. Wade is overturned, states will be able to determine when in pregnancy they can prohibit abortion. And so some states will completely ban abortion, but others will do what Texas did and have a limit of about six weeks or seven weeks. So in these states people can get access to a medical abortion faster than they can get an appointment for a procedural abortion.

So, as abortion becomes more and more restricted by law, I think abortion pills will play a bigger role in getting people to medical abortion care as soon as possible.


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