Medical Abortion 101 | Autostraddle

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Today is a heavy and unprecedented day. Everything you feel today is valid and I hope you give yourself space to take care of yourself this weekend. My “day job” is to work as an activist in a gender justice organization where we have been preparing for this moment for months and preparing to fight back and identify opportunities to help those most affected . In my “day job” I focus on fighting misinformation and misogyny online and have learned that one of the best ways to fight fake news is to share the truth. So I’m here to bring a small ray of hope and accurate medical information (although I’m not a doctor, just a reproductive rights activist) on medical abortion.

Medication abortion is safe, effective and fully FDA approved and it is accessible by mail, which means it will remain an option in states that ban or even criminalize abortion, but with some risk in states where it is criminalized. Here’s everything I know about medical abortion so you can access the care you need, share it with a friend, or save it for just in case.


What is medical abortion?

Medical abortion is a non-invasive combination of two drugs, mifepristone and misoprostol, which work together to end an early pregnancy. It is FDA-approved for the first 10 weeks of pregnancy, but some providers will prescribe it off-label later in pregnancy.

He has a 95% success rate and less than 0.5% of patients have serious complications. Most abortions in the United States are already practiced by medical abortion and this number is likely to continue to increase.

How does medical abortion work?

Mifepristone stops pregnancy growth by blocking the hormone progesterone. Progesterone helps the uterus grow in early pregnancy and prevents it from contracting. Mifepristone therefore helps to counteract these effects. Misoprostol, taken later, causes the uterus to contract. Patients take Mifepristone to start the process followed by Misoprostol a day or two later.

Is it the same as plan B?

No, Plan B is over-the-counter emergency contraception that helps stop a pregnancy before it happens, medical abortion is a prescription regimen of multiple pills to stop an early pregnancy.

Is medical abortion safe?

Yes, mifepristone and misoprostol have a long history of safe use. They were FDA approved for over 20 years and approved in France, Sweden and the UK since at least the early 1990s. Mifepristone actually has a better safety record than penicillin, Viagra, and even Tylenol.

These drugs are also regularly used to treat other medical conditions. Mifepristone can treat high blood sugar in people with Cushing’s syndrome and Misoprostol helps prevent stomach ulcers.

What is the legal situation now?

In this new post-Roe world, things are unfortunately complicated but that doesn’t mean there aren’t options.

In 2021, the FDA removed the requirement to administer misoprostol in person in a medical setting and made it available to patients by mail. Of course, this means that in response, a host of laws have been passed imposing unnecessary restrictions and barriers to accessing what should be a simple FDA-approved prescription. Today’s decision has further complicated matters; this means that there are now many states that ban abortion and a few states where abortion is criminalized.

Fortunately, there are a few reliable websites (see below) that have done all the research and have state-by-state information on how to access these pills within your state’s legal boundaries. In some places, that can mean diving into legal gray areas, like using mail forwarding. I’m not a lawyer and I’m not recommending that you do anything that will get you in legal trouble, but as Mahatma Gandhi wrote in Non-violence in Peace and War “An unjust law is itself a kind of violence.”

How can I access it?

There are a few websites you can try out and see which has the best options for you in your state. I’m especially a fan of Plan C because it lists the resources and options available in places like Texas and Oklahoma, including things like getting a prescriber in the Netherlands and using mail forwarding.

What should I expect if I take it?

According to Planned Parenthood, the second medication, misoprostol will likely cause fatigue for a few days, tender breasts if you have breasts, chills, fever, and nausea, and you can expect cramping and bleeding.

Can I store it and keep it just in case?

In theory, both of these drugs are shelf stable and could be acquired now and stored for a few years for a time of need and it’s likely to become a more popular underground option. Again, I’m not a lawyer or a doctor, so I can’t tell you how to make this decision. I can tell you that you will need a prescriber to get the medicine in the first place and that Mifepristone has a shelf life of five years and misoprostol has a shelf life of two years.

I heard you could reverse it, right?

Abortion cancellation refers to an experimental and dangerous procedure that has been promoted by anti-choice activists and doctors. They claim that by taking a large amount of progesterone – the hormones that mifepristone blocks – and skipping misoprostol, it is possible to “reverse” an abortion.

There was only one medical study ever attempted on this process and it was stopped early because it was deemed too dangerous to continue. Three people in the study were sent to the emergency room due to dangerous bleeding. The American Medical Association and the American College of Obstetricians and Gynecologists have denounced the cancellation of medical abortion.


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