Are Abortion Pills Safe?

How do they work?

Understanding the process for terminating an early pregnancy at home with pills will give you knowledge and confidence to make the decision that’s right for you.

The process and the risks...

Finding and taking abortion pills to end a pregnancy without the help of a doctor or nurse is called “self-managed abortion” (which some people call an “abortion at-home”). Research shows that self-managing an abortion with abortion pills (mifepristone and misoprostol) is a safe and effective way to end a pregnancy for Women who:

  • Usually have regular periods and are fairly sure of the first day of their last period.
  • Are 10 weeks or less from the first day of their last period.
  • Have access to good information about how to take the pills.
  • Don’t have medical reasons why they shouldn’t use the pills (like inherited bleeding disorders).0
  • Live within a 1hr drive of a hospital in the unlikely event emergency medical care is needed.

Medication abortion was approved in the U.S. by the FDA in 2000 [read here] to end pregnancies up to 10 weeks. Today, nearly 40% of all abortions in the U.S. are done with medications. This simple treatment involves taking two medicines at home over a 2 day period. The first medicine you’ll take is mifepristone. This blocks the pregnancy hormone (progesterone) which stops the pregnancy from growing. Then, 24-48 hours later you’ll take a second medicine, called misoprostol. This causes the uterus to contract, like a miscarriage, to empty the uterus.

You can expect bleeding like a heavy period. Taken together, these two pills work up to 98 out of 100 times to end an early pregnancy.

After you take mifepristone (the first medication), you must complete the abortion. If treatment with medication does not work the first time, you may have the option to repeat the medicines or you will need an in-clinic procedural abortion. But again this is less than 2% of the time.

Are abortions safe? What are the risks?

The World Health Organization (WHO) reports that Women in the first trimester (up to 12 weeks pregnant) can self-administer Abortion Pills (Mifepristone and Misoprostol) to terminate an early pregnancy at home without direct supervision of a health-care provider. An abortion with pills is actually safer than childbirth and safer than plastic surgery.

As published in the March issue of Women’s Health in 2008 a medical abortion does not need to take place in a hospital or urgent care center. The risks of a medical abortion are the same as those of a miscarriage. About 15% of all pregnancies end in a miscarriage. These miscarriages more often occur at home than in a hospital. Most women only go to a hospital for issues such as heavy bleeding or fever. A medical abortion causes a miscarriage. The medicines can be taken safely at home for pregnancies 10 weeks duration or less and if the Woman lives within one hour of medical help in the case of emergency.

Scientific research in the British Medical Journal, May 2017 studied 1000 women in the Republic of Ireland and Northern Ireland who secured an abortion with pills online from 2010-2012. Findings showed a medical abortion at home is safe and acceptable with support services. Additionally, the World Health Organization reports 40% of Pregnancies are unplanned and 73 Million abortions take place worldwide each year. In a 2015 study, abortions induced by Mifepristone and Misoprostol (conducted within 63 days) were shown to be 98% effective, with very few complications [read here]. Mifepristone and Misoprostol are so widely accepted the World Health Organization has included them on their list of essential medicines since 2005.

In summary, abortions are very safe under modern protocols, regardless of which kind you have. When done properly complications occur in less than 0.4% of people for medication abortion, and less than 1% for in-clinic procedural abortion.

There are a lot of rumors about abortion which aren’t true. Abortion does not lower your chances of getting or staying pregnant in the future. Abortion does not cause infertility, birth defects or have adverse effects on a future pregnancy. In fact, you can get pregnant almost immediately after having an abortion.

Having an abortion does not increase your risk for breast cancer and does not generally lead to depression or mental health issues.

Do I need an ultrasound test?
New data shows that medication abortion patients generally don’t need an ultrasound. The first date of your last menstrual period can be used to determine your gestational age. The age of your fetus is critical to predict the safety and efficacy of an abortion with pills. If an ectopic pregnancy is thought to exist an Ultrasound test is used to confirm or rule out.

Ectopic pregnancies and the risks involved:
An ectopic pregnancy is a pregnancy that grows outside of the uterus, often in the fallopian tube. Ectopic pregnancies are very rare occurring in 1-2% of all pregnancies. Risk factors for having an ectopic pregnancy include:

1) Having had one in the past.
2) Having an IUD in place when you became pregnant.
3) A previous pelvic surgery or tubal ligation (ie: having your tubes tied).

You can make 100% sure your pregnancy is inside the uterus by having an ultrasound test. If you have a medication abortion without having an ultrasound first, there is a small chance you could have an undetected ectopic pregnancy. Medication abortion will not end an ectopic pregnancy, so if you don’t pass tissue and blood after taking the misoprostol (the 2nd medicine), you might have an ectopic pregnancy. In this rare case professional medical care is needed. This is why its important to be within a 1 hr drive of emergency medical care when performing an abortion with pills.

Ectopic pregnancies can be a life-threatening situation if left untreated because the pregnancy could grow large enough to rupture your fallopian tube, which can cause severe bleeding. There are instances in which deaths have been reported. You should seek immediate medical care if, after taking the meds, you have worsening abdominal pain 24 hours later, if you have no bleeding within 24hrs or if you believe you still might be pregnant after 7 days. But again, the chances of this happening are 1-2%.

Ectopic pregnancies are treated everywhere in the World even in places where abortion is restricted. The treatment is the same as reporting to urgent care with a miscarriage- a common occurrence.

Serious complications: when to contact a medical provider

Serious complications from the Mifepristone/Misoprostol treatment are rare, and most side effects can be managed from home. If you experience any of the following however you should visit your nearest emergency care department. Remember, abortions from medication and miscarriages look the same, so if a patient needs to go to the hospital because of complications, you can tell the doctors you think you had a miscarriage.

If you have any of the following symptoms at any time:

• You soak more than 2 maxi pads an hour for more than 2 hours in a row
• Belly pain or cramps that don’t get better with pain medicine or a heating pad
• Dizziness or vomiting lasting more than 4 hours
• Weakness, nausea, or diarrhea lasting more than 24 hours

If you have any of these symptoms 24 hours after taking the misoprostol pills in Step 2:

• Cramping or bleeding is not getting better
• You have a fever of 101 F or higher that lasts for more than 4 hours. Fever is common in the first 24 hours (always use a thermometer).
• Your bleeding is not as heavy as a period
• Worsening belly pain
• You begin to feel very ill after the heavy cramping and bleeding is over

One week after taking the pills, you have any of the following:
• You do not feel that you passed the pregnancy
• Your pregnancy symptoms (such as nausea and breast tenderness/soreness) are not getting better
• Cramping or bleeding is not getting better
• You have a fever of 101 F or higher (fever is common during the first 24 hours)
• Your belly pain is getting worse

How do I know the abortion pills worked?

1) You should have cramping and bleeding after taking the second medicine (misoprostol) to a level just as heavy or heavier than your regular period.

2) Your pregnancy symptoms, including nausea, breast soreness, etc should begin to dissipate within a week after using the pills. This is your body telling you you’re no longer pregnant.‍

Note: A pregnancy test will stay positive for about 4 weeks after treatment (even if you’re no longer pregnant), so it’s unnecessary to take one sooner.

In the rare event the treatment does not work, the abortion must be completed since misoprostol carries with it a risk for birth defects. Additionally, if your pregnancy has not ended after taking the medications, you may need to be evaluated at a healthcare facility to rule out the possibility of an ectopic pregnancy (a pregnancy outside the uterus).

What are the medical eligibility requirements
?
AbortDr.com is run by Doctors who want to protect your health. So before your order is accepted we’ll ask you some questions to ensure you meet accepted healthcare standards for a safe termination of your early pregnancy. This involves a brief medical screening and knowledge test to confirm you understand the process and risks involved. Read through our FAQs and watch the video to ensure your experience is safe, as it can be, under the circumstances. If for some reason you don’t meet our medical eligibility requirements, we may recommend you seek in-person care.