5 fast facts about medical abortion, backed by doctors who know their stuff
“Abortion using medications is very safe,” one physician says. “This has been very well studied and really millions of patients have now used it in the US.”
If the Supreme Court overturns Roe v. Wade as the unprecedented leaked draft opinion by Justice Samuel Alito indicates could happen as soon as next month, abortion pills may be the last safe resort for people seeking to terminate their pregnancy.
As anti-abortion activists work with state legislatures to restrict access to or outright ban medication abortion, it may be helpful to ground yourself in the science of abortion pills in the face of rising tensions and rampant misinformation.
Below are five facts about medical abortion, backed by doctors who know their stuff.
1. Medical abortions are effective.
The most commonly used regimen for medication abortion in the US involves two medications: mifepristone followed by misoprostol, which are approved by the Food and Drug Administration for up to ten weeks of pregnancy. But Dr. Daniel Grossman, director of Advancing New Standards in Reproductive Health and professor in the department of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco, explains that there is evidence about its safe use up until about 11 or even 12 weeks.
As for their effectiveness: Dr. Goodman says 97 percent of all medication abortions are successful, with the remaining three percent of people who take the pills requiring a vacuum aspiration or a procedural abortion to complete the termination.
2. The physical effects of medication are short-term.
Dr. Claire Brindis, founding director of the Bixby Center for Global Reproductive Health, University of California, San Francisco, advises that the physical effects of using these medications are only around the time of the abortion.
“And they’re not long-lasting in the women’s body,” she said. “The physical ailments may be additional bleeding [and] cramping, but no further and long-term consequences of using these medications.”
Dr. Goodman pointed to studies that found the maximum pain level that people report on a scale from zero to 10 can be seven to eight with some people experiencing higher levels of pain.
“There are no risks to fertility in the future or risks of complications of a future pregnancy,” he added. “These medications are very safe, and we have a great deal of experience with them now.”
3. Complications from medication abortion are uncommon.
Dr. Brandis estimates less than one percent, 0.4 percent of women to be exact, experience any type of complications. The most common complications — heavier bleeding, low-grade fevers and some additional pelvic pain — are eliminated over time.
“Like any procedure in medicine, there are complications with medication abortion. I would say they’re extremely rare, Dr. Lauren Elizabeth Owens, a fellow at the American College of Obstetricians and Gynecologists and assistant professor of obstetrics and gynecology at the University of Michigan Medical School, said.
“Abortion using medications is very safe,” Dr. Grossman said. “This has been very well studied and really millions of patients have now used it in the US.”
4. Telehealth medication abortions are equivalent to those performed in a clinical setting.
Dr. Brindis explains that an ironic outcome of COVID has been the rise in telemedicine for services like medical abortion with a cost-effective and patient-centered approach. The result: Women can receive counseling, other types of advice following the procedure and attention that may have been unavailable when they were just going to their doctors’ offices for their medications or surgical abortion.
Dr. Goodman agrees that the pandemic has enabled deep learning about the accessibility of telehealth services.
“Telehealth has expanded in really every area of medicine, including for providing medication abortion,” he said. And there are now several published studies, both from the United Kingdom and now from the United States, showing that safety and effectiveness outcomes are really pretty much identical with medication abortion provided by telehealth compared to in-person provision.”
Dr. Owens said the option to receive telemedicine abortion care is especially meaningful to people in rural areas who have more barriers to care than other people.
5. Medication abortions are safe when performed at home without medical supervision too.
Dr. Goodman reminds us that people have been self-managing their abortions for hundreds, if not thousands, of years. The difference now, over the past few decades
“One thing that is very important to recognize is that many of these women are savvy consumers of knowledge and information,” Dr. Brinidis said. “They will seek out advice either from friends who’ve already had one or from other internet resources that help them prepare for what to expect, first, before, during, and after.”
For Dr. Owens, medication abortion exists on a spectrum.
“So when we think about an — in quote — in-clinic medication abortion, folks are frequently getting a first pill in clinic and then taking the second pills at home. So even though that’s clinically done at the start, really the procedure is completed at home,” she said. “When folks are self-sourcing medication abortion, there are many ways to do that, but there are some really great data with almost 3,000 folks showing that there are really similar outcomes with success as far as completion of medication abortion.”
The legal risks that patients may take do concern Dr. Goodman though.
“We know that a number of people, more than 20, have been arrested or prosecuted or even imprisoned for allegedly attempting to self-manage their abortion or for helping someone else self-manage their abortion.”
Further reading: “Can pill prescriptions overcome US state abortion bans?” (Nate Raymond / Reuters) • “Abortion pills stand to become the next battleground in a post-Roe America” (Pam Belluck and Sheryl Gay Stolberg / NYT) • “Abortion pills by mail pose challenge for officials in red states” (Christopher Rowland, Laurie McGinley and Jacob Bogage / WaPo)