Mail-order abortion medication is safe and effective, study shows

Cancer is one of several conditions for which mifepristone is a potentially effective treatment. | Anna Moneymaker/Getty Images)

Ahead of the U.S. Supreme Court’s impending ruling on an abortion pill case, a study published Monday found that medication abortion after in-person screening is safe and effective.

JAMA Internal Medicine published research that examined the prescription of abortion drugs from January 2020 to May 2022, before the Supreme Court overturned Roe v. Wade.

Researchers scoped surveys from roughly 500 patients who sought medication abortions through 11 clinics in seven states — California, Colorado, Delaware, Georgia, New York, Pennsylvania and Rhode Island.

The patients had to terminate their pregnancies at 63 days — seven weeks of pregnancy — or earlier. (Medication abortion is allowed in the U.S. within 70 days of gestation. Authors wanted to account for possible shipping delays with the 63-day limit.)

After a consultation with a health care provider, about 86% of patients received their pills in the mail within three days, and 99% received their package within one week, according to the study.

Most patients said they were satisfied with their level of care and noted that some improvements could be made in the shipping of the pills and how to track the package. Out of 510 people, 11 had an incomplete medication abortion, which had to be completed via a procedure, but one patient decided to remain pregnant. Twenty-four adverse events were reported, but none of the issues were associated with the mail-order dispensing.

“The study provides additional evidence that the abortion medication mifepristone should be treated like every other medication and can be easily dispensed by pharmacists, including through a mail-order pharmacy,” said Dr. Daniel Grossman, the study’s lead author and director of Advancing New Standards in Reproductive Health at the University of California, San Francisco, in a statement.

Grossman and his team’s findings also back the U.S. Food and Drug Administration’s decision in December 2021 to permanently remove in-person dispensing requirements for mifepristone, one of two drugs used to terminate pregnancies up to 10 weeks along. Misoprostol, the second drug in the regimen, is less regulated.

Despite a multitude of research proving the safety of abortion pills, the drugs have become increasingly politicized since the Dobbs v. Jackson Women’s Health Organization decision.

Mifepristone is the subject of an abortion case before the Supreme Court this term that is expected to be decided in June. A group of doctors who oppose abortion sued the U.S. Food and Drug Administration in November 2022 over its decades-old approval of mifepristone, arguing that the agency rushed in approving the medication, which they frame as a danger to women and girls.

“Any attempt to restrict it is not based on science,” Grossman said.

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