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 

Additional References:

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

During COVID-19 Emergency (currently in place) the FDA will not require a qualified healthcare provider to dispense mifepristone in-person but allow clinics to distribute the medicine via mail receipt (April 12, 2021) https://www.acog.org/news/news-releases/2021/04/acog-applauds-fda-action-on-mifepristone-access-during-covid-19-pandemic

See also, ACLU, FDA Respond to ACOG April 2021, https://www.aclu.org/letter/fda-response-acog-april-2021; D’Amrosio, A. “FDA Temporarily Lifts Restriction on Abortion Pill.” MEDPAGE TODAY, April 2021, https://www.medpagetoday.com/obgyn/generalobgyn/92077 

See also: 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/

TelAbortion (research project)

Since 2016, Gynuity Health Project TelAbortion Study is operating in 15 states and the District of Columbia. “The TelAbortion Study is a research project that aims to evaluate the use of telemedicine for providing a medical abortion to those who prefer to receive the abortion pills in the mail.”  The medications used are FDA approved. 

TelAbortion. “TelAbortion: About the Project.” Gynuity Health Projects,  https://telabortion.org/about.

To dispense medication abortion, 32 states require health care providers to be a physician.
Guttmacher Institute. Medication Abortion, State Laws and Policies. August 2021, https://www.guttmacher.org/state-policy/explore/medication-abortion 

Medication abortion is prohibited from being dispensed via telemedicine in 19 states. It requires clinicians to be physically present when providing pills to patients.
Guttmacher Institute. Medication Abortion, State Laws and Policies. August 2021, https://www.guttmacher.org/state-policy/explore/medication-abortion

Laws in ArkansasIdahoKentuckyNebraskaSouth Dakota, and Utah requiring providers to advise patients medication abortion may be reversed if given a high dose of progesterone after taking mifepristone are not based on scientific evidence. Similar bills were passed and blocked by courts in North Dakota, Oklahoma and Tennessee.
Guttmacher Institute. Counseling and Waiting Periods for Abortion. 2021. Guttmacher Institute, https://www.guttmacher.org/state-policy/explore/medication-abortion; American College of Obstetricians and Gynecologists, (ACOG). “Facts are Important: Medication Abortion Reversal is not Supported by Science.” American College of Obstetricians and Gynecologists, Advocacy, https://www.acog.org/advocacy/facts-are-important/medication-abortion-reversal-is-not-supported-by-science.

American College of Obstetricians and Gynecologists (ACOG). Improving Access to Mifepristone for Reproductive Health Indications, 2018, https://www.acog.org/clinical-information/policy-and-position-statements/position-statements/2018/improving-access-to-mifepristone-for-reproductive-health-indications.

American Bar Association, Resolution 107A, opposes criminal prosecution of any person having an abortion, or for experiencing a miscarriage, stillbirth, or other pregnancy outcome.
See Resolution and Report at: https://www.americanbar.org/content/dam/aba/directories/policy/midyear-2021/107a-midyear-2021.pdf


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