Are mail-order abortion pills safe to use at home? New study provides answers
Since the overturning of Roe V. Wade by the Supreme Court in 2022, abortions have become limited, restricted or banned in more than half of the country.
Seeking an alternative, many people have turned to abortion pills for their medical care, whether through an in-person clinic or by ordering them through the mail.
From 2012 to 2021, medication-induced abortions increased 137%, according to data from the Centers for Disease Control and Prevention, and accounted for 53% of all early medical abortions in 2021.
Outside of a doctor’s office, are these medications safe?
A new study, published in the journal JAMA Internal Medicine on May 13, followed women who were prescribed two mail-order abortion pills — mifepristone and misoprostol — and found they are more than 97% effective in ending pregnancies without serious physical complications.
Mail-order pills approved by FDA
Prior to 2021, the U.S. Food and Drug Administration required mifepristone to be administered in person at a medical clinic, according to the study.
When the COVID-19 pandemic limited how many people could enter doctor’s offices, walk-in clinics and hospitals, the FDA dropped this requirement and allowed the pill to be prescribed through telehealth appointments.
The change was later made permanent, increasing the number of qualified clinicians who could now prescribe the pill to women seeking to end their pregnancies, according to the study.
Beginning in January 2020, a group of researchers from across the country followed 540 of these women to track their experience with the drug.
Participants from 11 clinics across seven states enrolled in the study, all above the age of 15, and less than 63 days (nine weeks) pregnant, according to the study.
The participants went through an in-person examination with a healthcare provider, then were prescribed mifepristone and misoprostol from an online pharmacy, the researchers said.
After receiving the prescription, the drugs arrived in the mail a few days later and 506 people took the medication and then reported their experience back to the researchers. Four participants had two abortions each and were counted twice, according to the study.
More than 97% effective
“Complete medication abortion occurred for 499 of 510 cases, including for 27 participants who took an additional dose of misoprostol,” the study authors said.
This results in a 97.8% efficacy, slightly higher than the 97.4% reported on the mifepristone label, according to the study.
The remaining participants either required a vacuum aspiration to complete the abortion, or chose to continue the pregnancy and delivered a healthy newborn, the researchers said.
Less than 5% of the women needed additional medical care after taking the pills for symptoms like bleeding, pain, nausea, vomiting, infection or diarrhea, according to the study.
Only 0.6% of study participants had serious adverse events, such as hospitalization, after taking the pills, the researchers said.
Psychological impacts of the at-home abortions were not included in the study.
Overall, 91.2% said they were satisfied or very satisfied with the experience, the researchers said.
“This study adds to a growing body of literature demonstrating that medication abortion can be provided safely and effectively using models of care that do not involve a clinician dispensing mifepristone in person,” according to the study. “ ... This body of research supports the FDA decision in 2021 to permanently remove the in-person dispensing requirement for mifepristone.”
How does medicated abortion work?
Medication-assisted abortions work by blocking progesterone, a hormone critical to the early days of pregnancy, inside the body, according to Yale Medicine.
First, the person takes mifepristone which blocks progesterone, then up to 48 hours later, the person takes misoprostol which expels the pregnancy tissue over the course of 12 to 24 hours, Yale Medicine says.
The drugs are approved for use by the FDA during the first 70 days of pregnancy, or 10 weeks.
The medications are not available over-the-counter and require a prescription from a certified medical provider, according to the FDA.
Using the medication to terminate a pregnancy will not impact your ability to become pregnant again in the future, the FDA says.
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