For Nicole, taking the abortion pill was like getting through “an extremely painful poop.” It hurt, a lot, and then it was done. She was bartending at the time, lightyears away from thinking about motherhood, and decided on medication abortion. At $585, it was cheaper than a surgical abortion. Plus, Nicole wanted do it in the privacy of her own home. Two pills, four days, and several pairs of bloody underwear later (“it was basically like an extra heavy period for a week,” she says), she went back to work at the bar.
Medication abortion or the “abortion pill” is a legal way to end a pregnancy—one that women like Nicole increasingly prefer over surgical abortion for a variety of reasons. It now accounts for more than one-third of all clinic abortions in the United States, according to the Guttmacher Institute.
With reproductive rights under attack in this country, the idea of an abortion pill taken on your own terms and in the safety of your own home, is increasingly appealing. Since 2011, medication abortions have risen in popularity by nearly 25 percent. The process, however, is shrouded in mystery and misinformation. Here’s everything you need to know.
What is the abortion pill?
Also called “medication abortion,” the abortion pill is a way to stop the progress of a pregnancy and then help the body expel it. It involves taking two separate pills in the first 10 weeks of pregnancy. The first is mifepristone, which blocks progesterone and prevents the pregnancy from furthering. The second is misoprostol, which ends the pregnancy. Planned Parenthood describes it “like having a really heavy, cramp-y period, and the process is very similar to an early miscarriage.” You should take misoprostol 24 to 48 hours after taking misoprostol, and Planned Parenthood suggests calling a nurse or doctor if you don’t experience bleeding after a day.
It is not the morning after pill.
They are two very different things. The morning after pill helps prevent pregnancy and the abortion pill helps ends pregnancy.
Is it safe?
Like any medical procedure, medication abortion has some risks. Those can include blood clots, excessive bleeding, and infection. A full list of possible complications can be found here.
How effective is the abortion pill?
Very, and Planned Parenthood has stats to back that up:
For people who are 8 weeks pregnant or less, it works about 94-98 out of 100 times.
For people who are 8-9 weeks pregnant, it works about 94-96 out of 100 times.
For people who are 9-10 weeks pregnant, it works about 91-93 out of 100 times.
Where can you get it?
This gets tricky depending on where you live. The most common way to get the abortion pill is at a health center or through a clinician who provides abortion care and meets certain qualifications. According to the FDA: “It is only available to be dispensed in certain healthcare settings, specifically, clinics, medical offices, and hospitals, by or under the supervision of a certified prescriber. It is not available in retail pharmacies, and it is not legally available over the Internet.”
However, because we live in an age where everything is online, you’ll also find them available via telemedicine. This means a practitioner can prescribe the pill through videoconference, and then send it by mail. According to Wired, “The mailing part is a little tricky, not because of medical outcomes—this procedure’s so safe that some folks argue it should be over-the-counter—but because of regulations. The drugs have to be mailed to an address in the state where the provider is licensed.”
Laws about medication abortion and how it can be administered via tele-health vary state to state. A complete breakdown of which states require prescribing clinicians to be in the physical presence of a patient are listed here.
Is it safe to buy the abortion pill from an online pharmacy?
Some people in the U.S. choose to self-manage their abortions by ordering the abortion pill through non FDA-approved websites. Plan C, an organization established to provide women more information about medication abortion, has developed a “report card” guide showing how authentic these unregulated sites are. It includes detailed information on quality of product, price, and shipping time.
Can you get in trouble for buying it online?
If you’ve been prescribed the abortion pill by a doctor (either in person or via telemedicine), you’re in the clear. However, according to Plan C, if you purchase the pill on your own (without a prescription or without the supervision of a healthcare professional) the legal risk is unclear. Check out their guide “Can I get in trouble?” here.
What’s the future look like for the abortion pill?
The abortion pill is currently subject to the FDA-imposed Risk Evaluation and Mitigation Strategy (REMS), which limits its distribution to registered providers in clinics, hospitals, and medical offices. More information on REMS can be found here. However, reproductive rights activists believe the abortion pill should be readily accessible in the U.S.—some argue it should be over-the-counter. Several organizations, including Plan C, are working to get the REMS requirements lifted.