The FDA Has Approved Abortion Pills by Mail

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. 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. A new landmark decision from the FDA ruled that anyone seeking the abortion pill will no longer be required to visit a doctor’s office or a clinic. This means that women can 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; 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.

How effective is the abortion pill?

Very, and Planned Parenthood has the stats to back that up:

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, 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, 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?

The FDA’s decision allowing abortion pills to be delivered by mail could bring about major change at a time when abortion rights are under serious threat in this country. “The FDA’s decision eliminating its unnecessary in-person requirement did not come a moment too soon, as politicians emboldened by the Supreme Court’s shameful decision in Texas race to impose ever more barriers and burdens on people seeking to end a pregnancy, with outsized harm to communities of color,” Julia Kaye, staff attorney with the ACLU Reproductive Freedom Project, said in a statement.

“With states banning abortion at earlier and earlier points in pregnancy, it is all the more essential that the FDA remove medically unnecessary restrictions that reduce where and how patients can safely fill their mifepristone prescription—and today’s decision is critical progress, though far from complete. We will continue to fight every day for a world where we can all control our reproductive destinies, regardless of where we live, how much money we make, or the color of our skin.”

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