The use of medications like abortion pills to terminate a pregnancy at home without the supervision of a doctor or outside of a traditional health care facility is called self-directed abortion. Studies have proven the effectiveness of using home abortion pills, and these drugs have been recommended by organizations such as Doctors Without Borders and the World Health Organization.
Remember that as laws across the country continue to rapidly evolve, some ways to access medications may not remain legal indefinitely. Charm spoke with a reproductive rights leader and consulted peer-reviewed research to bring you everything you need to know about abortion pills.
About the pills:
Both mifepristone and misoprostol are FDA-approved medications that have been shown to be both safe and highly effective in causing miscarriage within 10 weeks of pregnancy. In the United States, they are usually prescribed in pairs when used for self-directed abortion. However, evidence shows that misoprostol, which is much cheaper and easier to obtain, is also effective for self-directed first trimester abortion when used alone. Misoprostol also has other common uses, such as for treating ulcers, which is part of why it’s so much more widely available.
How the pills work:
Mifepristone blocks the hormone progesterone, thus preventing the progression of pregnancy, while misoprostol induces uterine contractions to expel the pregnancy. It is not the same as Plan B or other morning after pills, which prevent pregnancy by preventing the egg from being released from the ovary or a fertilized egg from attaching to the uterus. Abortion pills essentially cause miscarriage, and in the 1% of cases where medical intervention becomes necessary, the treatment is the same.
Studies indicate that abortion pills successfully terminate a pregnancy without complications in approximately 95% of cases, while less than 1% of cases require medical intervention in the event of complications. In 2018, the FDA reported that the death rate of mifepristone was 0.35 in 100,000 deaths. For the scale, erectile dysfunction drugs like Viagra have a death rate of 4 in 100 000. The maternal mortality rate in the United States is 18 per 100,000 live births nationally and 40 per 100,000 for black women.
That said, abortion pills are not recommended for people taking blood thinners or showing signs of a possible ectopic pregnancy.
People who live in states where abortion is banned or strictly regulated – such as Alabama, Arkansas, Kentucky, Missouri, Ohio, South Dakota, Utah, Oklahoma or Texas, among others – can still get pills through various means. One resource is Plan C, a well-known abortion access advocacy organization. The site offers how-to guides and tools for obtaining abortion pills in all 50 states, including via telehealth.
Patients who are having difficulty accessing telehealth for abortion care in their own state can consult Plan C’s guide to find the closest state where telehealth is accessible. The organization also provides advice on how to order abortion drugs by mail or online.