Abortion has become an increasingly common medical procedure over the past few decades. While surgical abortion is still the most prevalent method, medical or medication abortion using specific drugs has grown in popularity as well. Let’s take a closer look at how abortion drugs work and the factors involved in their use.
Types of Abortion Drugs
There are currently two main types of abortion drugs approved for use in the United States – mifepristone and misoprostol. Mifepristone, also known as RU-486, is taken first to block the hormone progesterone. Without progesterone, the lining of the uterus breaks down and the pregnancy cannot be sustained. Misoprostol is then taken 24-48 hours later to induce contractions of the uterus and expel its contents. Together, these two drugs are over 90% effective in terminating pregnancies up to 10 weeks.
Mifepristone was approved by the FDA in 2000 while misoprostol has been used off-label for abortions prior to the approval. Mifepristone can only be prescribed by certified healthcare providers and is not available over the counter. Misoprostol is also sometimes used on its own for early medical abortions but has a lower success rate than when used along with mifepristone. No other abortion drugs have been approved for use in the U.S. so far.
Effectiveness of Medical Abortion
Studies have shown medical Abortion Drugs using mifepristone and misoprostol to be around 93-95% effective for terminating pregnancies up to 9 weeks. The effectiveness declines slightly to around 88% for pregnancies between 9-10 weeks. Failure rates tend to be higher for women with certain medical conditions like obesity. Incomplete abortions requiring surgical intervention also occur in about 5% of cases. Overall, medical abortion has similar safety outcomes as surgical abortion when performed according to recommended protocols.
Process of a Medical Abortion
The typical process for a medication abortion involves an initial counseling session with a doctor or other healthcare provider to determine gestational age and medical eligibility. A baseline ultrasound may also be performed. If it is determined the pregnancy is less than 10 weeks, the patient is prescribed mifepristone to take at the clinic followed by misoprostol tablets to take at home 24-48 hours later. Common side effects include abdominal pain, cramping, nausea, diarrhea, vomiting, and headache.
Bleeding and passage of pregnancy tissue typically occur over the next few hours after taking misoprostol. Patients are advised to monitor for heavy bleeding and advised when to seek medical help. A follow-up visit is scheduled in 2 weeks to confirm the abortion completion through an ultrasound. In rare cases where the pregnancy continues, a surgical abortion may be needed instead. Overall, the whole process takes about 2-3 weeks from start to finish.
Restrictions and Bans on Abortion Drugs
Access to medication abortion using mifepristone and misoprostol has unfortunately become politicized. Over the years, some states have passed laws severely limiting their use and imposing unnecessary restrictions. For example, many states require the drugs to be administered in-person rather than allowing telemedicine options. Other laws mandate medically unnecessary ultrasounds or lengthy waiting periods between drug doses. Some states have gone as far as entirely banning medication abortion by outlawing the off-label use of misoprostol without mifepristone.
However, proponents argue these restrictions are not evidence-based and only make abortions riskier by delaying or denying care. Federal courts have struck down some of the harshest restrictions in several states. In December 2021, the FDA permanently lifted their Risk Evaluation and Mitigation Strategy that required mifepristone to be dispensed in-person. But the political battles over medication abortion are sure to continue in the years ahead with the Supreme Court’s ruling on abortion looming.
Future of Abortion Drugs
Research into new and improved medical abortion options is actively ongoing. Some future possibilities include pills that only require taking one drug instead of two sequential doses. Longer-lasting versions that don’t require follow-up confirmation also hold promise. New drug combinations and formulations may expand the window of use to earlier and later in pregnancy than current regimens allow.
TelAbortion or telemedicine medication abortion is also expected to become more widespread. This involves examining and consulting with patients remotely via telehealth and mailing the abortion drugs directly to them. Increased access this provides could potentially help bypass many existing state restrictions on abortion. Only time will tell if political realities allow such innovations to reach those seeking a non-surgical abortion option without barriers.
Abortion using medications mifepristone and misoprostol has provided women with an additional choice for terminating early pregnancies in a safe and effective manner. However, ongoing efforts by abortion opponents to limit medication abortion through unnecessary restrictions are concerning and should be avoided. Continued research leading to improved drugs may someday offer even greater options. The future of abortion drugs remains influenced as much by medical science as political activism on both sides. Overall access and standards of care should be guided primarily by evidence, not ideology.
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it