The Abortion Pill – Know the Facts

Mifepristone. The abortion pill. It seems as if every news channel and media outlet is talking about this medication these days. And for now, the U.S. Supreme Court has decided this medication will remain accessible to Americans. So what is all the fuss about? Let’s break it down.

How Does the Abortion Pill Work?

Mifepristone is a pill that was approved by the Food and Drug Administration in 2000 to end pregnancies at 7 weeks gestation or less when used in combination with a separate medication known as misoprostol. Mifepristone works to block the hormone receptors in the uterus that sustain a pregnancy. As a result, the pregnancy becomes less firmly attached to the uterus. The second medication, misoprostol, causes uterine cramping and allows the body to pass the pregnancy.

Is the Pill Safe and Effective?

Since 2000, we have learned a lot about the safety and efficacy of mifepristone.

• There are few side effects, including mild nausea, cramping and heavy bleeding.
• There are no long-term effects of the medication, and it has no impact on a person’s ability to become pregnant or stay pregnant in the future.
• This medication is highly effective. In fact, since its initial approval, we have learned through clinical trials and direct experience that medication abortion using a regimen of mifepristone and misoprostol has a greater than 95% success rate at ending pregnancies up to 11 weeks gestation.
• Mifepristone and misoprostol effectively treat early pregnancy loss (commonly called “miscarriage”) up to 12 weeks gestation, ending the bleeding quicker and helping patients avoid surgery and pass the pregnancy in the comfort of their own homes. Before mifepristone, patients desiring medication to manage their miscarriages used misoprostol alone. While also safe, patients using misoprostol were more likely to incompletely pass their pregnancies and require surgery to complete their miscarriages. They were also more likely to have severe vaginal bleeding requiring emergency care. The addition of mifepristone has made miscarriage care safer and more effective.

As with many medications, serious complications are possible, although very rare. These include failure to pass the pregnancy, severe vaginal bleeding requiring emergency care and infection. These risks are similar to those associated with dilation and curettage (D and C), the procedure used for abortion or miscarriage.

How Does One Get This Medication and How Is It Given?

State law dictates how a patient receives the abortion pill. In Massachusetts, mifepristone is commonly given in a clinic visit by doctors or advance practice providers (e,g, nurse practitioners, physician assistants, certified nurse midwives). It can also be mailed to a patient after a telehealth visit or picked up at the pharmacy in the same way that misoprostol is issued. Other states require mifepristone to be given in the office by a physician only. Misoprostol is then administered by patients at home within 48 hours of taking mifepristone. Within several hours, bleeding and cramping starts. About 90% of pregnancies are passed within six hours of the start of bleeding. Within several weeks, ultrasounds and/or home pregnancy tests are used to confirm that the pregnancy has passed.

How Much Does the Abortion Pill Cost?

The cost of mifepristone varies by state. In Massachusetts, MassHealth and most private insurers cover the medication completely. In other states, abortion funding is often available. Learn more what services and funding are available in your area.

Why Is It So Controversial?

So now that you know about the basics of mifepristone, you may be wondering why it's controversial. Why is the availability of this medication being examined by the U.S. Supreme Court 24 years after FDA approval? Over the last decade, abortion has become increasingly controversial and laws limiting access to abortion have skyrocketed throughout the nation. Mifepristone is simply the latest target.