What are abortion pills and are they safe?
The bottom line
Pills used for medication abortions are generally safe and effective; however, they should not be given in some circumstances and must be used with appropriate supervision in case of complications.
Prevention Tips
Do not take abortion pills without adequate medical supervision.
Do not take herbal abortion pills or remedies. Do not take pills that do not come from a legitimate pharmacy or clinic.
Talk to your doctor to make sure you are not at risk for an ectopic pregnancy before taking abortion pills.
Tell your doctor when the date of your last period was to make sure you are not too far along for abortion pills.
Tell your doctor if you have a history of bleeding or adrenal problems or if you are on long term steroid treatment.
Seek immediate medical care if you have severe pain or bleeding, cannot keep down fluids, or are having pain.
This Really Happened
Case 1: A teenager took an overdose of misoprostol to end her pregnancy. A day later, she started vomiting blood. She developed organ failure and underwent an operation where doctors discovered severe damage to her stomach. Despite aggressive treatment, her heart stopped and she died.
Case 2: A 25-year-old woman took an overdose of misoprostol by swallowing tablets and putting them in her vagina. She developed a fever and became confused. Uterine contractions caused a miscarriage, but the woman made a full recovery.
Case 3: A 42-year-old woman took RU-486 and misoprostol for a medical abortion. She experienced severe cramping and bleeding and fainted in the bathroom. She was taken to the emergency department where she continued to have significant bleeding and additional fainting episodes. She received a blood transfusion and needed a surgical procedure but made a full recovery.
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What is a medication abortion?
A medication abortion is one that is performed by taking medications to end a pregnancy as opposed to getting a surgical procedure. Medication abortions can generally be performed up to the 10th week of pregnancy. Currently, over 50% of abortions performed in the U.S. are medication abortions.
What are abortion pills?
The most common regimen used for medication abortions includes a combination of 2 different medications, mifepristone (RU-486) and misoprostol (Cytotec), taken under the supervision of a physician. Sometimes when patients cannot afford or have a reason they cannot take RU-486, misoprostol is used alone.
How do abortion pills work and how are they taken?
Once the decision is made to proceed with a medication abortion, the woman takes a single dose of RU-486. This medication works by blocking the hormone progesterone, which is important in maintaining pregnancy. Up to 24 hours later, a dose of misoprostol is taken. This medication works to end the pregnancy by softening the cervix (the opening to the uterus or womb) and causing the uterus to contract. If this process is not effective, a second dose of misoprostol may be taken. Misoprostol can be given under the tongue, in the cheek, or in the vagina.
Do I need to see a doctor before taking abortion pills?
Prior to taking abortion pills, pregnant women should be evaluated by a doctor to make sure that an ectopic (tubal) pregnancy is not present and to confirm that the abortion pills can be safely used. Medication abortion may not be safe in women with long-term steroid use, adrenal problems, or bleeding disorders. In addition, medication abortion is safer and more effective in early pregnancy (before 10 weeks) than later. Abortion pills do not treat ectopic pregnancy and should not be used for this condition.
Do abortion pills have side effects?
The most common adverse effects associated with abortion pills are gastrointestinal upset (nausea, vomiting, diarrhea, stomach pain), pelvic cramping, and bleeding. Occasionally, dehydration and loss of electrolytes can occur if vomiting and diarrhea are severe. This can be treated with oral or intravenous fluids and nausea medications. Sometimes women have very heavy bleeding with a medication abortion and may require a blood transfusion or even a surgical procedure. Women with adrenal problems and those on long-term steroids may experience low blood pressure when taking RU-486.
Are abortion pills effective?
While medication abortion is generally effective, it may be incomplete in some women, meaning that some tissue may still remain in the uterus. This can lead to severe bleeding and infection that requires immediate medical attention. In addition, sometimes women who undergo medication abortion may have an unrecognized ectopic pregnancy, which is a life-threatening condition that also needs immediate treatment.
Are abortion pills legal in states that have banned abortion?
The legality of abortion pills in a state that has banned abortions is a subject of much controversy. Abortion pills are approved by the US Food and Drug Administration and it is unclear at this time if states can ban the use of an approved medication or if they can prohibit mailing of these medications into states with abortion restrictions.
What is the difference between the morning after pill and an abortion pill?
Abortion pills are used to end a pregnancy up to 10 weeks. The morning after pill (Plan B®, Ella®) is used to prevent pregnancy after unprotected sexual intercourse. The morning after pill is not effective for medication abortion.
For an adverse reaction to an abortion pill, contact a healthcare provider and seek medical care. If severe pain, bleeding, or fevers develop, call 911 for immediate assistance. Use the webPOISONCONTROL online tool to get immediate help, or call your poison center at 1-800-222-1222. Whether online or by phone, expert guidance is always free, confidential, and available 24 hours a day.
