What You Should Know About Abortion Pills Post-Roe

Abortion availability in the United States is rapidly dwindling. Experts believe that now that the United States Supreme Court has overruled Roe vs Wade, people may attempt to end pregnancies in their homes through pharmaceutical abortion (also known as a medical abortion or abortion pills). Abortion pills are now the most prevalent method of terminating a pregnancy in the United States, accounting for 54% of abortions in 2020, and that figure is anticipated to rise.

At Dr. Franz Theards Womens Reproductive Clinic in Santa Teresa, New Mexico, doses of Mifepristone, the abortion pill, and Misoprostol, which is taken the next day to produce cramping and bleeding to empty the uterus, are shown.

Here’s everything you need to know about the safety and effectiveness of abortion pills.

What are abortion pills?

Medication abortions which are legal in the United States until the tenth week of pregnancy, require taking two medications 24 to 48 hours apart. The first, known as RU 486 or mifepristone, is a hormone that inhibits progesterone and hence prevents pregnancy progression; the second, misoprostol, produces contractions and bleeding that empty the uterus.

How safe is medication abortion?

Very secure. “We have a lot of safety data,” Dr. Daniel Grossman, an ob-gyn and researcher at the University of California, San Francisco, adds. Serious consequences that necessitate hospitalization are “very rare—less than half of the time.”

According to Dr. Lauren Owens, an ob-gyn at the University of Michigan, “medical abortion has historically been fairly heavily controlled because of abortion stigma, but not because of medical need.”

Will abortion pills remain legal now that Roe vs. Wade has been overturned?

The tablets’ availability may become more difficult, but there will be solutions. People may still be able to obtain medical abortions through telehealth services and mail-order pharmacies that use overseas physicians and pharmacies to avoid U.S. rules. Aid Access, an organization that assists people in the United States and around the world in obtaining medical abortion pills, sends the pills after patients answer a few questions on a health screening questionnaire and provide payment (usually between $200-$300); the group also provides medical guidance via email with international physicians. It might take up to two weeks for the tablets to arrive.

However, pharmaceutical abortion is now restricted in 19 states, requiring a doctor to be physically present when the medicine is delivered. Several states have also made it illegal to send medications to citizens of their states.

Self-managed abortions, which occur when a woman terminates a pregnancy without the assistance of a physician, are expected to skyrocket following Roe. Obtaining medications via internet pharmacies (rather than a telehealth provider) or through friends in distant states are two examples. There are additional hazards with this technique, and Robin Tucker, a nurse practitioner with Aid Access, advises individuals to double-check that the organization, corporation, or individual supplying the drugs is real and verified. She suggests visiting the website Plan C, which lists reputable abortion pill providers in each state. Plan C also does some quality checking on the tablets.

If clients require medical assistance during the procedure, Tucker advises calling the Miscarriage and Abortion hotline, which is a safe, private, and secure phone line manned by clinician volunteers who can answer questions.

Is there a chance medication abortion won’t work?

Yes, but it’s rather little. Medication abortion is successful in stopping a pregnancy 95-99 percent of the time before the 9th week of pregnancy, according to studies. As the pregnancy continues, abortion medications become less effective.

How do you know if abortion pills have worked?

To ensure that the tablets worked, people must wait four to five weeks before doing a pregnancy test. Because of the date, many patients have missed the opportunity for medical abortion. If a woman has significant bleeding and passes some tissue, it is quite improbable that she is still pregnant. However, in certain rare situations, the pregnancy will continue; for example, pharmaceutical abortion will not terminate an ectopic pregnancy. If a woman does not have any symptoms and suspects she is still pregnant, even after a medication abortion, she should seek medical assistance and maybe undergo an ultrasound.

Can you get another medical abortion if you believe you are still pregnant?

Grossman believes it is realistic to believe this might work, and Tucker has seen some individuals succeed on the second try. People would, however, need to procure and consume the second batch of tablets within the 10-week interval, according to Tucker.

Will you face consequences if you need medical attention during a medication abortion?

Historically, abortion regulations have targeted physicians rather than patients. In the case of Aid Access, suppliers are located outside of the nation and hence are not subject to prosecution. However, this does not mean that pregnant women are not legally susceptible. According to Greer Donley, an associate professor at the University of Pittsburgh Law School, not all states provide safeguards for patients who try abortion. She is concerned that people may be reported to hospital authorities if a health care worker suspects an abortion. “People will be inspected if they do not exhibit the acceptable grieving reaction that people anticipate; poor women of color are considerably more likely to be targeted,” she adds.

Dr. Debora Bartz, an ob-gyn at Brigham and Women’s Hospital in Boston, emphasizes that patients are not required to inform their doctors if they have had a medication abortion. “There is no way for a health care provider to tell the difference between a natural miscarriage and a pharmaceutical abortion if the patient herself does not reveal that she took these pills,” Bartz adds, and Grossman and Tucker concur.

If people are concerned about their legal risk, they can call the Repro Legal Helpline, a free and confidential service offered by If/When/How, an advocacy and support group dedicated to reproductive rights. The is staffed by attorneys who may offer free legal advice to anyone who is worried about their risk.

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