“Medication abortion plays a crucial role in providing access to safe, effective and acceptable abortion care.” World Health Organization. Medical Management of Abortion, Geneva, 2018, p. 54 (World Health Organization) https://www.who.int/reproductivehealth/publications/medical-management-abortion/en/.
Medication abortion also referred to as medical abortion is the use of medicines to induce an abortion. Often referred to as the “abortion pill”, the U.S. Food and Drug Administration (FDA) has approved a regimen of two medicines, mifeprex (generic version is mifepristone ) and misoprostol for medical abortion up to 70 days gestation. The first pill, mifeprex is taken orally, and then 24 to 48 hours later, misoprostol is applied buccally. If mifeprex is unavailable then misoprostol alone is dispensed. Mifeprex (mifepristone) is subject to the FDA’s Risk Evaluation and Mitigation Strategy (REMS) which imposes a series of requirements for administering the medicine to individuals seeking a medication abortion. For example, mifeprex must be “…ordered, prescribed and dispensed by or under the supervision of a healthcare provider….” and “…may only be dispensed in clinics, medical offices, and hospitals by or under the supervision of a certified health care provider.” U.S. Food and Drug Administration (FDA). Mifreprex (mifepristone) Information. U.S. Food and Drug Administration, https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/mifeprex-mifepristone-information
American College of Obstetricians and Gynecologists, Society for Family Planning. “Medication Abortion Up to 70 Days Gestation.” ACOG Practice Bulletin, vol. 136, no. 225, no. 4, 2020. American College of Obstetricians and Gynecologists, https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2020/10/medication-abortion-up-to-70-days-of-gestation.
Advancing New Standards in Reproductive Health (ANSIRH). “Medication Abortion.” University of California at San Francisco (UCSF), https://www.ansirh.org/abortion/medication-abortion.
U.S. Food and Drug Administration (FDA). Questions and Answers on Mifeprex. U.S. Food and Drug Administration, https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/mifeprex-mifepristone-information.
“Federal and state-level regulations have effectively limited the use of mifepristone, particularly in underserved areas without a nearby clinic. Studies show providers of medication abortion are mostly concentrated where surgical abortion is already available.” The Availability and Use of Medication Abortion, Women’s Health Policy, Kaiser Family Foundation. June 2021. KFF https://www.kff.org/womens-health-policy/fact-sheet/the-availability-and-use-of-medication-abortion/.
Grossman, Daniel et al,. “Continuing pregnancy after mifepristone and “reversal” of first-trimester medical abortion: a systematic review.” Contraception, vol. 92, 2015, pp. 206-2011. Advancing New Standards in Reproductive Health, https://www.ansirh.org/sites/default/files/publications/files/grossman-sep15-continuing_pregnancy_after_mifepristone.pdf.
Medication Abortion Up to 70 Days of Gestation, ACOG Practice Bulletin, American College of Obstetricians and Gynecologists, Society for Family Planning, Number 225, Vol. 136, No. 4, October 2020 at: https://www.acog.org/-/media/project/acog/acogorg/clinical/files/practice-bulletin/articles/2020/10/medication-abortion-up-to-70-days-gestation.pdf; World Health Organization (WHO), Self-management of medical abo
World Health Organization, Self-management of medical abortion, Sexual and reproductive health, 2021, https://www.who.int/reproductivehealth/self-care-interventions/medical-abortion/en/
According to The Centers for Disease Control (CDC) 2018 Surveillance Reporting for Abortions in the U.S., 38.6% of individuals had medical abortions at or before 9 weeks gestation while only 1.4% had medical abortions later than 9 weeks gestation.
Kortsmit K, Jatlaoui TC, Mandel MG, et al. Abortion Surveillane—United States 2018. MMWR Sruveill Summ 2020; 69 (No. SS-7): 1-29/ DOI: http://dx.doi.org/10.15585/mmwr.ss6907a1