For Nicole, taking the abortion pill was like getting through “an extremely painful poop.” It hurt—a lot—and then it was done. She was bartending at the time, light-years away from thinking about motherhood, and decided on medication abortion. At $585, it was cheaper than a surgical abortion. Plus, Nicole wanted do it in the privacy of her own home. Two pills, four days, and several pairs of bloody underwear later (“It was basically like an extra heavy period for a week,” she says), she went back to work at the bar.
Medication abortion, or the “abortion pill” is a legal way to end a pregnancy—one that women like Nicole increasingly prefer over surgical abortion for a variety of reasons. According to data from the Guttmacher Institute, medication abortions now account for more than half of all abortions in the United States.
Over the last few years, in-person restrictions have resulted in a growing number of people choosing the abortion pill. With reproductive rights under attack now more so than ever before, the idea of taking an abortion pill on your own terms and in your own home is increasingly appealing. However, the process is shrouded in mystery and misinformation. Here’s everything you need to know.
What is the abortion pill?
Also called a “medication abortion,” the abortion pill is a way to stop the progress of a pregnancy and then help the body expel it. The FDA first approved medication abortion in 2000, and the pills have grown in use over the years. The process involves taking two separate pills in the first 10 weeks of pregnancy. The first is mifepristone, which blocks progesterone and prevents the pregnancy from proceeding. The second is misoprostol, which ends the pregnancy. Planned Parenthood describes it “like having a really heavy, cramp-y period, and the process is very similar to an early miscarriage.” You should take misoprostol 24 to 48 hours after taking mifepristone, and Planned Parenthood suggests calling a nurse or doctor if you don’t experience bleeding after a day.
It is not the “morning after” pill.
They are two very different things. The so-called “morning after” pill, branded as Plan B, helps prevent pregnancy; the abortion pill helps end pregnancy.
Is it safe?
As with any medical procedure or medication, there is some risk associated with medication abortion—including blood clots, excessive bleeding, and infection. But overall, medication abortion is widely believed to be safe and effective.
Just how effective is the abortion pill?
Very effective. Planned Parenthood has the stats to back that up:
For people who are 8 weeks pregnant or less, it works about 94-98 out of 100 times.
For people who are 8-9 weeks pregnant, it works about 94-96 out of 100 times.
For people who are 9-10 weeks pregnant, it works about 91-93 out of 100 times.
Where can you get it?
Before the pandemic, the most common way to get the abortion pill was at a health center or through a clinician providing abortion care. Now that the FDA is allowing women to receive telehealth abortions, you can receive the abortion pill by mail.
Can you get in trouble for buying it online?
Even with the FDA’s decision, states are already moving to prohibit medication abortion. Depending on where you live, there may be restrictions. Planned Parenthood has more information on where you can get the abortion pill here. Abortion Finder also has more information about where and how to get it. And the National Abortion Federation has a list of clinics searchable by state.
Plan C, an organization established to provide women more information about medication abortion, outlines the legal risks of the abortion pill. Check out their “Can I get in trouble?” guide.
What does the future look like for the abortion pill?
Access to abortion pills via by mail could bring about major change at a time when abortion rights are under serious threat in this country. Last year, the Supreme Court overturned Roe v. Wade, ending the constitutional right to abortion in the United States and reversing nearly 50 years of precedent. The decision essentially gave states the authority to decide whether to ban or protect abortion access.
A conservative group in Texas has filed a lawsuit that seeks to overturn the FDA’s approval of mifepristone, which could undo government approval of a key abortion drug that would be applicable nationwide. The suit alleges that the FDA did not adequately evaluate mifepristone’s safety in 2000, arguing that it should not be accessible via telehealth. It is perhaps the most important abortion case to reach the Supreme court since Roe v. Wade was overturned. The suit, which has garnered national attention and sparked protests, could permanently alter the way women seek maternal healthcare in America. We will update this post accordingly as litigation in Texas continues.
Rose is a Senior Editor at ELLE overseeing features and projects about women's issues. She is an accomplished and compassionate storyteller and editor who excels in obtaining exclusive interviews and unearthing compelling features.
