Since the Supreme Court overturned Roe V. Wade in 2022, abortions have been limited, restricted, or banned in more than half the country.
Looking for an alternative, many people have turned to abortion pills for their medical care, either through a walk-in clinic or by mail order.
From 2012 to 2021, medication-induced abortions increased 137%, according to data from the Centers for Disease Control and Prevention, and accounted for 53% of all early medical abortions in 2021.
Outside of a doctor’s office, are these medications safe?
A new study, published in the journal JAMA Internal Medicine on May 13, followed women who were prescribed two mail-order abortion pills, mifepristone and misoprostol, and found that they are more than 97 percent effective at terminate the pregnancy without serious physical complications.
FDA approved mail order pills
Before 2021, the U.S. Food and Drug Administration required mifepristone to be administered in person at a medical clinic, according to the study.
When the COVID-19 pandemic limited the number of people who could enter doctors’ offices, clinics and hospitals, the FDA dropped that requirement and allowed the pill to be prescribed through telehealth appointments.
The change was later made permanent, increasing the number of qualified doctors who could now prescribe the pill to women who want to end their pregnancies, according to the study.
Starting in January 2020, a group of researchers from across the country followed 540 of these women to track their experience with the drug.
Participants from 11 clinics in seven states, all over the age of 15 and less than 63 days (nine weeks) pregnant, were enrolled in the study, according to the study.
Participants went through an in-person exam with a health care provider, then were prescribed mifepristone and misoprostol from an online pharmacy, the researchers said.
After receiving the prescription, the drugs arrived in the mail a few days later, and 506 people took the drug and then reported their experience to the researchers. Four participants had two miscarriages each and were counted twice, according to the study.
More than 97% effectiveness
Complete medication abortion occurred in 499 of 510 cases, including the 27 participants who took an additional dose of misoprostol, the study authors said.
This translates to an efficacy of 97.8%, slightly higher than the 97.4% reported on the label for mifepristone, according to the study.
The remaining participants either needed a vacuum aspiration to complete the abortion or chose to continue the pregnancy and gave birth to a healthy newborn, the researchers said.
According to the study, less than 5% of women needed additional medical attention after taking the pills for symptoms such as bleeding, pain, nausea, vomiting, infection or diarrhea.
Only 0.6 percent of study participants had serious adverse events, such as hospitalization, after taking the pills, the researchers said.
The psychological impacts of home abortions were not included in the study.
Overall, 91.2 percent said they were satisfied or very satisfied with the experience, the researchers said.
According to the study, this study adds to a growing body of literature showing that medication abortion can be provided safely and effectively through models of care that do not involve a physician dispensing mifepristone in person. … This body of research supports the FDA’s decision in 2021 to permanently eliminate the requirement for face-to-face dispensing of mifepristone.
How does medical abortion work?
According to Yale Medicine, medication-assisted abortions work by blocking progesterone, a hormone critical to the early days of pregnancy, in the body.
First, the person takes mifepristone, which blocks progesterone, then, up to 48 hours later, the person takes misoprostol, which expels the pregnancy tissue over the course of 12 to 24 hours, Yale Medicine says.
The drugs are FDA-approved for use during the first 70 days or 10 weeks of pregnancy.
According to the FDA, the drugs are not available over the counter and require a prescription from a certified medical provider.
Using the medication to terminate a pregnancy will not affect your ability to get pregnant again in the future, the FDA says.
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