As legislatures across the United States impose greater restrictions on abortion care, more people are choosing medication abortion.
This method involves taking pills that can end a pregnancy, often without requiring an office visit or an appointment with a provider.
Medication abortion is safe and effective, and it’s been used around the world for decades.
Although Americans lost the constitutional right to abortion with the overturning of Roe v. Wade in June 2022, Attorney General Merrick Garland has since said that states can’t ban abortion pills that are approved by the Food and Drug Administration (FDA).
However, there are still plenty of misconceptions surrounding medical abortion’s legality and use, and misinformation can make it difficult to understand and access this care.
On June 24, 2022, the Supreme Court of the United States overturned Roe v. Wade, the landmark 1973 ruling that secured a person’s constitutional right to an abortion.
This means that individual states are now able to decide their own abortion laws. Many states will ban or severely restrict abortion access, and more states may follow suit.
The information in this article was accurate and up to date at the time of publication, but it’s possible the information has changed since. To learn more about your legal rights, you can message the Repro Legal Helpline via a secure online form or call 844-868-2812.
Medication abortion involves taking pills that terminate a pregnancy. A person usually takes one medication called mifepristone followed by another medication called misoprostol.
These medications stop the pregnancy from continuing to develop and cause the uterus to empty itself, ending the pregnancy.
You can access abortion pills by visiting a provider’s office or provider-staffed telehealth platform (known as a “clinician-supported” abortion) or by ordering them online and taking them at home (called a “self-managed” abortion), depending on where you live.
Medication abortion is common around the world
Medication abortion became legally available in the United States in 2000, when the FDA approved it to induce abortion early in a pregnancy.
Abortion pills are FDA-approved for ending a pregnancy up to 10 weeks, but they’re also used off-label later than this in some states.
Medication abortion has
In some countries within Latin America, people have had legal access to misoprostol to self-manage their abortions
Is medication abortion different from emergency contraception like Plan B?
Yes, medication abortion is different from emergency contraception like Plan B One-Step and ella, known as “morning-after pills.”
Emergency contraception pills are taken within 3 to 5 days after having unprotected penis-in-vagina sex. These medications help prevent a pregnancy before it begins — they don’t end an existing pregnancy.
Medication abortion, on the other hand, ends a pregnancy.
Most medication abortions involve taking two different medications: mifepristone followed by misoprostol. However, you can also complete a medication abortion by using misoprostol on its own.
Mifepristone stops a pregnancy from growing, and misoprostol causes the uterus to shed its lining and empty itself.
Since progesterone helps the uterus grow and sustain a pregnancy, stopping progesterone’s activity can help end a pregnancy.
Mifepristone can also soften the uterus and encourage it to contract.
Misoprostol softens the cervix, too. The combination of the uterus and cervix softening, the antiprogestin activity, and the uterine contractions cause your body to expel the embryonic tissue, ending the pregnancy.
The abortion itself may feel like a very heavy period with cramping and bleeding. You may also pass large blood clots.
The process is usually complete within 4–5 hours of taking the second medication, but some milder cramping and bleeding or spotting may continue for 1–2 days or up to a few weeks.
If someone doesn’t have access to mifepristone, misoprostol can be used on its own to induce an abortion, though it may be less effective than the combination of both pills.
Medication abortion is a highly effective way to end a pregnancy. However, medication abortion becomes less effective the longer someone has been pregnant. Effectiveness appears to start waning after 12 weeks.
Rarely, if medication abortion isn’t completely effective, some pregnancy tissue will remain in the body. This is known as an “incomplete abortion.”
People who experience an incomplete abortion may need another dose of misoprostol or surgical intervention to complete the process.
Combination of mifepristone and misoprostol
If you’ve been pregnant for 9 weeks or fewer, self-managing an abortion using both pills is
Very few people
Misoprostol alone is effective, and people who can’t obtain mifepristone can take misoprostol on its own to end their pregnancy.
Another review also reported a success rate of around 80%.
On the other hand,
Medication abortion is considered very safe. It’s estimated that
Plus, most people
Potential risks and complications
Serious complications of medication abortion are rare. It’s typical to experience pain, bleeding, low fever, and gastrointestinal upset for a few days following your abortion — especially during the first 24 hours.
Other risks, though uncommon, may include:
- incomplete abortion
- blood clots in the uterus
- diarrhea and digestive pain
- allergic reactions to the medications
Some incomplete abortions can be treated with another dose of misoprostol. Others may require surgical intervention.
Reach out to a healthcare professional or seek emergency care if you:
- experience no bleeding at all within 24 hours of taking misoprostol
- have extremely heavy bleeding (soaking through more than 2 regular maxi pads in an hour) for 2 or more hours in a row
- pass blood clots the size of, or larger than, a lemon for more than 2 hours
- experience other side effects like fever, nausea, vomiting, or diarrhea for more than a day after taking misoprostol
If you experience complications and are in an abortion-hostile state, you should still seek medical care.
Healthcare professionals can’t distinguish a medication abortion from a miscarriage, and you don’t have to disclose that you induced the abortion using pills.
You can say that you’re experiencing heavy menstrual bleeding or suspect that you’re having a miscarriage. These conditions are treated the same way.
Are abortion pills ordered online safe?
Some people may be uncomfortable with the idea of ordering mifepristone and misoprostol online without a physician’s prescription.
Depending on where you live, a physician or abortion provider may be able to prescribe you the medication, and you can take your medication in their office. However, pills ordered online appear just as safe as those administered in person.
One United States-based
Prioritize your privacy
There are legal risks to self-managed at-home medication abortion. Some states restrict access to telehealth abortion or receiving abortion pills by mail.
This means discretion and privacy are absolutely paramount.
If at all possible, tell as few people as you deem necessary about your pregnancy and your decision to terminate the pregnancy.
Clear any internet search, private message, or phone call history that might connect this to you.
Trying to make sense of the limitations in your state? Our state-by-state guide to abortion restrictions can help.
Are there mental health concerns surrounding abortion?
Abortion is not associated with poorer mental health. People who have had abortions are
Research shows that the vast majority of people do not regret their abortions. Many people experience relief, joy, and a greater sense of autonomy after accessing an abortion.
A recent study including 667 people who had abortions found that while more than half had a hard time deciding whether abortion was right for them, 97.5% said that having an abortion was the right choice one week later.
Five years later, study participants were even more likely to say that getting an abortion was right for them, at 99%.
It appears that, for many participants, the toughest part of getting an abortion was the stigma or judgment they received from others — not an inherent sense of regret or sadness.
There are studies that link abortion to mental health conditions. However, according to the American Psychological Association (APA), many of these are flawed in design.
Often, they don’t account for participants’ existing mental health conditions prior to getting abortions. The studies attribute the development of the conditions to abortions themselves, even though participants had the conditions beforehand.
The APA affirms that the ability to access safe, legal abortion actually supports mental health and well-being.
That doesn’t mean it’s unusual to feel a complex set of emotions after having an abortion.
One week after their abortions, 17% of the aforementioned study participants reported feeling mostly negative emotions, while 12% reported a mix of negative and positive emotions.
However, negative feelings decreased significantly within 1–3 years post-abortion.
Feel empowered to speak with an abortion-informed mental health professional or consider joining a support group if you need help navigating your feelings after having an abortion.
Most people who are up to 12 weeks pregnant are eligible to end a pregnancy using pills. However, medication abortion may be unsafe for people with certain health conditions.
- an ectopic pregnancy (a non-viable pregnancy that is attempting to develop outside of the uterus)
- blood clotting disorders or anemia
- chronic adrenal failure
- long-term use of steroid medicines
- inherited porphyrias (rare blood disorders)
- intolerance or allergy to mifepristone or misoprostol
People with these conditions still have options for terminating their pregnancies. It’s a good idea to speak with a qualified abortion provider or another abortion-informed healthcare professional to discuss your next steps.
If you’re experiencing symptoms of an ectopic pregnancy, you should seek immediate medical attention.
Many states restrict abortion access, including abortion pills. That means the way you access this care might depend on where you live.
Some limitations on legal medication abortion include:
- medication abortion providers have to be physicians (32 states)
- medication abortion can’t be used past a certain point in pregnancy (2 states)
- people must take abortion pills in the presence of a physician, meaning telemedicine can’t be used (19 states)
In some states, people can’t legally access any kind of abortion after they’ve been pregnant for a certain number of weeks.
The language and ever-changing nature of abortion access can be confusing. That’s especially true now that the Supreme Court has overturned Roe v. Wade, the case that upheld the right to legal abortion in the United States.
The landscape of abortion rights has already shifted dramatically and is expected to continue. However, medication abortion is still legal, and you can order pills online.
In the meantime, resources for accessing medication abortion by mail include:
You can visit in-person abortion providers in your area as well, whether you’re seeking a surgical or medication abortion.
Resources like the National Abortion Federation’s U.S. Abortion Clinic Locator and Planned Parenthood’s Health Center database can help you find providers.
The National Abortion Federation also operates a hotline that can help you find an abortion provider or financial support for your abortion.
Watch out for crisis pregnancy centers (CPCs)
While some CPCs offer limited healthcare services like pregnancy tests or ultrasounds, they do not provide abortions or support accessing abortions.
CPC workers are known to shame and mislead people into believing that abortion is unsafe or harmful.
Medication abortion can be expensive, but financial assistance is available.
According to Planned Parenthood, abortion pills can cost up to $750 — though it varies by state.
Does insurance cover medication abortion?
Some health insurance plans will cover some or all of the cost of medication abortion, though some government health insurance plans only cover abortions in certain states or if you’re seeking an abortion for specific reasons.
That means it may be a good idea to contact an abortion provider ahead of time if you’re unsure about your coverage.
Can abortion funds pay for a medication abortion?
Abortion funds are organizations that help people pay for abortion care. They can help you find abortion providers and arrange appointments, too.
Many abortion funds also offer financial assistance for logistical concerns associated with abortion, like transportation, lodging, child care, and medication.
Some abortion funds you can contact for help include:
- Indigenous Women Rising
- Access Reproductive Care Southeast
- Yellowhammer Fund
- Lilith Fund
- Northwest Abortion Access Fund
- Access Reproductive Justice
- Utah Abortion Fund
- Florida Access Network
- Holler Health Justice
- Kentucky Health Justice Network
- Midwest Access Coalition
The above list is far from complete, as many local and regional communities have abortion funds. The National Network of Abortion Funds can connect you with local organizations serving your area.
After an abortion, it’s best to take a day or two off work, school, or other activities if possible.
You may experience painful cramping and bleeding, as well as nausea and diarrhea or vomiting.
It’s best to avoid heavy lifting or intense exercise for at least a week after an abortion.
Instead, try to rest, and consider taking warm baths or using a heating pad on your abdomen to help relieve any pain.
You may not need to visit an abortion provider for a follow-up appointment, but you may want to if you have any questions or concerns.
It might be a good idea to take a pregnancy test or receive an ultrasound to confirm that the abortion is complete.
The most important thing to know right now? That you have options. Whoever you are and wherever you live, you can end your pregnancy if you want or need to.
Medication abortion is one way to end a pregnancy, and studies show that it is extremely safe and effective.
If you choose to pursue medication abortion, you can either do it with the support of a clinician or manage it on your own.
You can receive prescribed medication from an abortion provider or access pills yourself online. Remember, self-managed abortions do not appear to be less effective or less safe than clinician-supported abortions.
Be sure that you understand the laws and restrictions in your state, and prioritize your privacy when navigating abortion care, whether clinician-supported or self-managed.
Rose Thorne is an associate editor at Healthline Nutrition. A 2021 graduate of Mercer University with a degree in journalism and women’s & gender studies, Rose has bylines for Business Insider, The Washington Post, The Lily, Georgia Public Broadcasting, and more. Rose’s proudest professional accomplishments include being a college newspaper editor-in-chief and working at Fair Fight Action, the national voting rights organization. Rose covers the intersections of gender, sexuality, and health, and is a member of The Association of LGBTQ+ Journalists and the Trans Journalists Association. You can find Rose on Twitter.