Myths about medical abortion and abortion pills

As of 2020, the most common way to terminate a pregnancy in the United States is through medication rather than surgery, according to the Guttmacher Institute. This trend has accelerated further since the COVID-19 pandemic and the growing number of abortion restrictions in many states since the June 2022 reversal. Roe vs. Wade.

Known as medical abortion, medical abortion, or the abortion pill, the process usually involves a combination of two drugs. Mifepristone, which was approved in 2000 by the US Food and Drug Administration (FDA), prevents pregnancy cells from growing and replicating. This pill is followed a day or two later by misoprostol, a drug that causes severe cramps that push tissue out of the uterus.

Medical abortions “are extremely safe and effective,” says Elisa Wells, MPH, co-founder of abortion information site Plan C.

But myths and misconceptions about medical abortions are widespread.

Here are eight misconceptions about the abortion pill and the correct facts that everyone should know.

Myth 1: Surgery is needed to terminate a pregnancy

When we think of abortion, many of us visualize a “surgical” or procedural abortion, which is done in a sterile clinical setting.

A surgical abortion, according to MedlinePlus, typically involves dilating the opening of the uterus, known as the cervix, and using suction to remove the fetus and other tissue from the cervix. pregnancy. Sedatives are often used to help a person relax during the procedure. After the procedure, medication may be given to contract the bleeding from the uterus and stalk, as well as an antibiotic to reduce the chances of infection.

It was once the most popular method of abortion, but in 2020 medical abortions have overtaken surgical procedures for the first time, according to the Guttmacher Institute. This represents a significant increase from the group’s previous research, when medical abortions accounted for 39%, in 2017.

This trend of more medical abortions was further heightened during the COVID-19 pandemic, when surgeries were limited or delayed and people started looking for other options.

Myth 2: Medical abortions are not super effective

Medical abortion has proven to be extremely effective and safe over the two decades it has been used. When the National Academies of Sciences, Engineering, and Medicine conducted a comprehensive review of the science of abortion care, they concluded that medical abortions do indeed end teenage pregnancies with extremely low rates of serious complications. .

According to Planned Parenthood, the pills work best when taken at 8 weeks pregnant or earlier. But medical abortion still works more than 90% of the time for women 9 to 10 weeks pregnant and about 87% of the time for people up to 11 weeks.

Even when it’s less effective in the last weeks of the first trimester, people can be given an extra pill and then the abortion is almost always complete, says Planned Parenthood.

Another option in these rare cases is to undergo in-clinic surgery to complete the abortion.

Myth 3: Medical abortions are also called plan B

Many people confuse the abortion pill with another medication known as Plan B.

Plan B is called emergency contraception. This medicine is taken soon after unprotected sex to prevent you from getting pregnant.

Plan B is a drugstore pill that contains the hormone levonorgestrel, a synthetic progestogen similar to progesterone that the body naturally makes to regulate the menstrual cycle. The hormone inhibits or delays ovulation.

“Plan B can be used within 72 hours of having sex,” says Sherry Ross, MD, gynecologist and author of She-ology and She-ology, youhe She-what. “It’s most effective when taken within 24 hours of having sex,” she notes.

In contrast, abortion pills work through a completely different mechanism, inhibiting the growth of pregnancy tissue rather than delaying ovulation. One prevents a pregnancy and the other terminates it.

Myth 4: You need to see a doctor in his office or clinic to get abortion pills

In fact, you may not need it.

First, a doctor need not be involved. Many states allow non-physician healthcare professionals, such as physician assistants and advanced practice nurses, to prescribe the pills. Some states, however, have laws requiring the person administering the medical abortion to be a licensed physician.

Second, during the pandemic, an increasing number of telehealth medical abortion providers have become available in various states. With telehealth abortions, says Wells of Plan C, “you can have this safe and effective procedure without needing to take time off work, find daycare, etc.”

Telehealth abortions allow for more privacy, since women don’t have to go to an abortion clinic — or fight their way past protesters, Wells adds. And in parts of the country that are rural or underserved by providers, telehealth medical abortions can save a patient hundreds of miles of travel, according to the nonprofit Guttmacher Institute.

Plan C lists a number of such telehealth abortion sites that operate in various states. They include Hey Jane, Just the Pill, Choice, Forward Midwifery and Aid Access. You can search for telehealth providers available in your state on the Plan C website.

Telehealth abortions were the subject of a study published in August 2021 in Obstetrics and Gynecology. Researchers at the University of California, San Francisco followed 110 Choice telehealth patients and found that 95% had completed abortions with the pills. The 5% who required additional medical attention is similar to the rate of in-person medical abortions, the study authors note. And no patient reported any adverse effects.

Myth 5: Abortion pills must be taken in a doctor’s office or clinic

Women who receive the abortion pills after a telehealth consultation or who order them online take the pills from the comfort of their homes.

Even women who go to a practice or clinic for a medical abortion usually take pills at home. They can take the first pill, mifepristone, in the medical setting and take the second drug home to take later. Or both drugs can be taken after the patient returns home.

Because it takes time for the drugs to work, a medical abortion is almost always done in the person’s home or another comfortable place.

Myth 6: You must have a prescription to get abortion pills

It was the case before, but it is no longer the case.

For a long time, mifepristone was regulated under a special FDA provision that required it to be administered in a clinic, hospital, or under the direct supervision of a certified medical provider, known as “in-person delivery requirement”.

This prevented it from being delivered by mail or readily available at retail pharmacies.

But during the pandemic, the FDA changed that requirement to remove the in-person specification and added a requirement that all dispensing pharmacies must be certified. In December 2021, he made the changes permanent.

Although the FDA advises people against buying the drugs over the Internet, “because you’ll bypass important safeguards designed to protect your health,” many health experts say buying from reputable sites is okay.

The growth of online pharmacies is allowing more women to “self-manage” their abortions, Wells says. They simply order abortion pills directly from certain websites, without a medical professional prescribing them.

Plan C lists a number of pharmacies they claim are safe to order from, which vary depending on the state you live in. These include Secure Abortion Pills, Abortion Privacy and Medside 24.

Myth 7: Medical abortions are not covered by insurance

According to Planned Parenthood, many health insurance plans actually cover abortions, making the procedure free or inexpensive for people with that insurance. (Check directly with your insurer to see if your insurance falls into this category.) Note that in several states, laws prohibit private insurers from covering abortion.

People on Medicaid may or may not have their abortion pills covered. “Some…plans in some states cover abortion, while others don’t. Some plans only cover abortion in certain cases,” advises Planned Parenthood.

If your insurance doesn’t cover the cost of a medical abortion, which can cost hundreds of dollars, you can still get help. A number of organizations provide funds to help pay for abortions. You can find some of these groups through the National Network of Abortion Funds.

Myth 8: If abortion isn’t legal in your state, you can’t get a medical abortion

Medical abortions are still legal in states that have not banned or strictly restricted abortions.

In states that have severe restrictions on abortion, determining whether a medical abortion is legal can be complex.

According to the Guttmacher Institute, the outright ban on medical abortion has been deemed unconstitutional. But he notes that other state-level restrictions have been allowed to go into effect.

For example, South Dakota has approved regulations that require patients to visit a clinic four times in order to obtain a medical abortion, although this has been stalled pending the outcome of litigation. Other states have banned the use of telehealth abortions.

Abortion advocates say some women circumvent state bans by having the drugs mailed to another state where abortion pills are explicitly legal. This could be a friend’s address or a “general delivery” mailbox at a post office in that state, where the person then goes to pick up the pills.

Of course, there is a legal risk of being sued in some states that prohibit medical abortions or sending pills. You can learn more about the possible legal repercussions from the Repro Legal Helpline, a free site designed to educate women about their legal rights to obtain their desired abortion.

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