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Everything to Know About the Abortion Pill

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, light years 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. In 2017, medication abortions accounted for more than one-third of all abortions in the United States, according to the Guttmacher Institute.

Over the last year and a half, in-person restrictions have resulted in a growing number of people turning to the abortion pill. Back in April, a landmark decision from the FDA ruled that during the pandemic, anyone seeking the abortion pill was no longer required to visit a doctor’s office or a clinic. That meant that women could have an abortion without ever having to leave home.

Since Texas lawmakers instituted a controversial ban on abortions after six weeks of pregnancy earlier this month, access to medication abortion has become a major focus. 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 a “medication abortion,” the abortion pill is a way to stop the progress of a pregnancy and then help the body expel it. The FDA first approved medication abortion in 2000, and the pills have grown in use over the years. The process involves taking two separate pills in the first 10 weeks of pregnancy. The first is mifepristone, which blocks progesterone and prevents the pregnancy from proceeding. 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 mifepristone, 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 so-called “morning after” pill, branded as Plan B, helps prevent pregnancy and the abortion pill helps ends pregnancy.

Is it safe?

As with any medical procedure or medication, there is some risk associated with medication abortion. Those can include blood clots, excessive bleeding, and infection. Overall, medication abortion is safe and effective.

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How effective is the abortion pill?

Very, and Planned Parenthood has the 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?

Before the pandemic, the most common way to get the abortion pill was at a health center or through a clinician providing abortion care. Now that the FDA is allowing women to receive telehealth abortions (at least for the duration of the coronavirus pandemic), you can receive the abortion pill by mail.

Is it safe to buy the abortion pill online?

In short, yes. Acting FDA Commissioner Dr. Janet Woodcock wrote in a letter to the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine that overall findings from studies conducted during the pandemic “do not appear to show increases in serious safety concerns (such as hemorrhage, ectopic pregnancy, or surgical interventions) occurring with medical abortion as a result of modifying the in-person dispensing requirement during the COVID-19 pandemic.”

Can you get in trouble for buying it online?

Even with the FDA’s decision in April, 19 states already have laws that effectively prohibit medication abortion. That means that taking the pills in states where it is outlawed could potentially be legally risky. Planned Parenthood has more information on where you can get the abortion pill here. The National Abortion Federation also has a list of clinics searchable by state.

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, an organization established to provide women more information about medication abortion, 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 does the future look like for the abortion pill?

Telemedicine abortion has gained new momentum during the COVID-19 pandemic, with health care advocates “expanding its geographical reach and streamlining protocols, so as to minimize in-person clinic visits.”

It is unclear how the FDA will handle abortion pills delivered by mail in the future, but some experts believe the pandemic could bring about a major change in the world of telehealth. “If we learn through research that there are simplified ways to provide services that are still equally effective and acceptable to the patient, then that’s how the medical process changes,” Melissa Grant, chief operations officer of Carafem, a network of reproductive health clinics that offers telemedicine abortions, told ELLE.com.

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