What You Need to Know About Abortion Pills, and How You Can Order Them Online

Korin Miller
·6 min read
What You Need to Know About Abortion Pills, and How You Can Order Them Online

News broke this morning that the Supreme Court has voted to overturn the landmark Roe v. Wade legislation that makes abortion legal in the U.S. This ruling came a month after the initial draft majority opinion obtained by Politico and written by Justice Samuel Alito said that “Roe was egregiously wrong from the start,” and that the issue of abortion should be left to states to decide.

Alito, in the final opinion issued Friday, wrote that Roe and Planned Parenthood v. Casey, the 1992 decision that reaffirmed the right to abortion, were wrong the day they were decided and must be overturned. Alito’s reasoning for the overturning is that “the Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision.”

Since the initial draft opinion was leaked, online searches for abortion pills and how to access them online have increased significantly, and are expected to rise much more in the wake of today’s ruling.

With all of this, it’s understandable to have questions about the abortion pill and how it works. Here’s what you need to know, whether you’re in need of an abortion and are concerned about your access to care, or are just curious.

What is the abortion pill, exactly?

There are actually several drugs that are used for medical abortions. “The abortion ‘pill’ is actually two medications—mifepristone, also known as RU-486, and misoprostol,” says Jamie Alan, Pharm.D., Ph.D., associate professor of pharmacology at Michigan State University.

There is another medication that can be given earlier in pregnancy called methotrexate, Alan says, but the combination of mifepristone and misoprostol is the most common.

What is the shelf life of abortion pills?

The optimal shelf life for mifepristone and misoprostol tablets is about two years, according to the International Federation of Gynecology and Obstetrics. For the drugs to be effective when used, the active ingredient in each tablet must be 90–110% of the labeled content (LC). The USAID Global Health Supply Chain Program says the shelf life can vary from brand to brand, but two to three years is usually a safe bet. Be sure to check the individual brand’s packaging as generic mifepristone has a three-year expiration date and the brand name Mifeprex has a five-year expiration date, according to the Reproductive Health Access Project.

How can you access the abortion pill online?

As of right now, the abortion pill can be accessed in many states (depending on state law) by visiting your ob/gyn or gynecologist for a prescription, says Mary Jane Minkin, M.D., a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School. “If a woman doesn't have a regular gynecological provider, she should find the nearest Planned Parenthood for advice,” Dr. Minkin says.

You can also access the abortion pill online by contacting Planned Parenthood and scheduling a virtual visit. However, you must have an address in one of the following states listed:

“This is significant change in care over the past few years, as medical abortions require much fewer surgical interventions and have fewer complications,” Dr. Minkin says.

Stephanie Toti, senior counsel and project director at The Lawyering Project, notes that, with Roe v. Wade, overturned, it will be considered illegal to order medication for an abortion “if you live in a state where abortion is outlawed.”

Only three states—South Dakota, Louisiana and Kentucky—have laws that immediately ban most abortions. Oklahoma has already completely eliminated abortion access.

Most states with so-called trigger laws require the attorney general, governor or state legislature to certify that the court’s opinion does, indeed, overturn Roe, include a delay of up to 30 days before they take effect. In other states, court action will likely be necessary to determine whether states’ pre-Roe abortion bans can take effect. This legal process could take up to several weeks or months.

How does the abortion pill work?

The medications used for an abortion work in a few different ways. Mifepristone “stops the pregnancy from growing by blocking progesterone, a hormone that maintains pregnancy,” says women’s health expert Jessica Shepherd, M.D., founder of Sanctum Med + Wellness in Dallas, Texas. “Misoprostol is taken after and causes the uterus to cramp in order to help the body remove the contents of the endometrial cavity,” she says.

How do you use the abortion pill?

The abortion pill is obtained by a prescription after consulting a healthcare provider, Dr. Shepherd explains.

Then, both medications are usually taken by mouth. Mifepristone is ideally taken about 56 days (or eight weeks) after a patient’s last menstrual period, Dr. Minkin says. But, she adds, “officially it can be used up until 70 days after the last period.”

Misoprostol “is usually administered 24 hours later,” Dr. Minkin says.

“The misoprostol tablet can also be placed in the vagina directly against the cervix to cause cervical opening and uterine contraction,” Alan says.

What can women expect after they take the abortion pill?

Alan says that people can generally expect “abdominal discomfort,” bleeding, and cramps. “The misoprostol can also cause diarrhea,” she adds.

In general, Dr. Minkin says, “women will start bleeding some time after taking the first pill, but times vary significantly.” She adds, “They will usually start cramping and passing tissue some time after taking the second pill.”

How safe is it to take the abortion pill?

Medical abortions are “very safe” and “have been done for years,” Dr. Shepherd points out. Worth noting: The FDA approved the use of mifepristone and misoprostol in 2000.

“The major risk is heavy bleeding but it is unusual—experienced by less than 1% of women who take it—and women are counseled if they start bleeding very heavily, to call their provider,” Dr. Minkin says.

Medication-induced abortions have grown in popularity. A report from the Guttmacher Institute released earlier this year found that these abortions account for more than 50% of abortions in the U.S. That’s a big jump from a 2017 report that found that medication-induced abortions were responsible for 39% of abortions in the country.

How much does the abortion pill typically cost?

It depends. A medication-induced abortion can cost up to $750, according to Planned Parenthood, but it’s usually less. (Costs vary by factors like your state, health center, and whether you can use insurance.)

However, you can get mifepristone from GoodRx for $30 and misoprostol for $8—you just need a prescription.

If you’re in need of an abortion, but live in a state where abortion may become illegal, check to see what the abortion laws mean in your state right now, according to the map provided by Planned Parenthood on their site.

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