Medication Abortion 101

Today is a heavy and unprecedented day. Whatever you are feeling today is valid and I hope you allow yourself space to take care of yourself this weekend. My “day job” is working as a campaigner at a gender justice advocacy organization where we have been prepping for this moment for months and preparing to fight back and identify opportunities to help those most impacted. In my “day job,” I focus on fighting online disinformation and misogyny online and I’ve learned that one of the best ways to fight false information is through sharing the truth.So I’m here to provide a small ray of hope and accurate medical information (though I am not a doctor, just a reproductive rights activist) about medication abortion.

Medication abortion is safe, effective and fully FDA approved and it can be accessed by mail, which means it will remain an option in states that now ban or even criminalize abortion, albeit with some risk attached in the states where it is criminalized. Here is everything I know about medication abortion so that you can access the care you need, share it with a friend, or save it for that just-in-case moment.


What Is Medication Abortion?

Medication abortion is a non-invasive combination of two medications, Mifepristone and Misoprostol, that work together to end an early pregnancy. It is FDA approved for the first 10 weeks of pregnancy but some providers will prescribe it off-label later in pregnancy.

It has a 95% success rate, and less than 0.5% of patients experience serious complications. Most abortions in the United States are already done through medication abortion and that number is likely to continue rising.

How Does Medication Abortion Work?

Mifepristone stops pregnancy growth by blocking the hormone progesterone. Progesterone helps the uterus grow in early pregnancy and keeps it from contracting so Mifepristone helps counter these effects. Misoprostol, taken at a later time, makes the uterus contract. Patients take Mifepristone to start the process followed by Misoprostol one or two days later.

Is This the Same as Plan B?

No, Plan B is over-the-counter emergency contraception that helps stop a pregnancy before it takes hold, medication abortion is a prescription regimen of multiple pills to stop an early pregnancy.

Is Medication Abortion Safe?

Yes, Mifepristone and Misoprostol have a long record of safe use. They have been approved by the FDA for more than 20 years and have been approved in France, Sweden, and the United Kingdom since at least the early 1990s. Mifepristone actually has a better safety record than penicillin, Viagra, and even Tylenol.

These medications are also regularly used to treat other medical conditions. Mifepristone can treat high blood sugar in people with Cushing’s Syndrome and Misoprostol helps prevent stomach ulcers.

What’s the Legal Situation Now?

In this new post-Roe world, things are unfortunately complicated but that’s not to say there aren’t options.

In 2021, the FDA removed the requirement for Misoprostol to be given in person in a medical setting and made it so that patients could access it via mail. Of course, that means in reaction, a bunch of laws were passed placing unnecessary restrictions and hoops in the way of accessing what should be a straightforward FDA-approved prescription. Today’s ruling complicated things even further; it means there are now many states with abortion bans and a few states where abortion is criminalized.

Thankfully, there are a few reliable websites (see below) that have done all of the research and have state-by-state information on how to access these pills within the legal confines of your state. In some places that may mean delving into legal grey areas, like using mail forwarding. I am not a lawyer and I’m not recommending you do something that will get you into legal trouble but as Mahatma Gandhi wrote in Non-violence in Peace and War “An unjust law is itself a species of violence.”

How Can I Access It?

There are a few websites you can try and see what has the best options for you in your state. I am a particular fan of Plan C because it lists resources and options available in places like Texas and Oklahoma, including things like getting a prescriber in the Netherlands and using mail forwarding.

What Should I Expect if I Take It?

According to Planned Parenthood the second medication, Misoprostol will likely cause fatigue for a few days, tender breasts if you have breasts, chills, fever, and nausea and you can expect to experience cramping and bleeding.

Can I Stock Up and Save It Just in Case?

In theory, these two medications are shelf-stable and could be acquired now and saved for a few years for a moment of need and it’s likely this will become a more popular, underground option. Again, I’m not a lawyer or a doctor so I can’t tell you how to make that decision. I can tell you that you will need a prescriber to get the medication in the first place and that Mifepristone has a shelf life of five years and Misoprostol has a shelf life of two years.

I Heard You Can Reverse It Is That True?

Abortion reversal refers to an experimental and dangerous procedure that has been promoted by anti-choice activists and physicians. They claim that by taking a large amount of progesterone — the hormones that Mifepristone blocks — and skipping the Misoprostol, it is possible to “reverse” an abortion.

There has only been one medical study ever attempted on this process and it was stopped early because it was deemed too unsafe to continue. Three people in the study were sent to the emergency room because of dangerous hemorrhaging. Both the American Medical Association and the American College of Obstetricians and Gynecologists have denounced medication abortion reversal.


Before you go! Did you like what you just read? We keep Autostraddle majority free-to-read, but it isn't free to create! And yet most readers don't support this indie queer site. Will you be one of the people who do? A+ membership starts at just $4/month or $30/year and they literally keep us from closing. Will you join?

Join A+

Katie Reilly

Katie is a disabled queer writer, creator, and activist who spends her days fighting online misogyny, hate, and disinfo and her evening playing with her dog, designing for her Etsy, reading 5 books at once, or collecting too many kinds of tea. Find her across social media at @imkatiereilly.

Katie has written 7 articles for us.

13 Comments

  1. Is that last sentence right, or is it meant to read “denounced medication abortion reversal”?

    I was surprised to read “Both the American Medical Association and the American College of Obstetricians and Gynecologists have denounced medication abortion,” and it seems at odds with the sentences before it denouncing reversal as dangerous.

    Thank you for publishing this important information, I am certain it will help many.

  2. I had a medical abortion a few years ago, luckily I live in a country where abortions are accessed very easily and don’t cost anything. I found out very early (4 or 5 weeks), and immediately called a clinic. The worst part was when they told me I had to wait a week for an appointment, it really freaked me out. I started crying and asking the woman on the phone if I couldn’t just go somewhere the next day and get it taken care of! She very kindly explained that I just had to wait. That night I drank beer and ate sushi just to fuck over my devil spawn and then felt super guilty. The next week was a fucking roller coaster, I started thinking about what it would be like to actually keep it and love it…. it was a total mind fuck to be honest. Finally, I got the medication I needed, and spent the day and night with my friend. We had a wierd, kinda fucked up sleepover where we watched the Simpsons and played monopoly waiting for the meds to start working. All in all it wasn’t a particularly pleasant experience to say the least, but I am so fucking fortunate to have been able to access those services so easily, and to have people I could talk to, and a manager who gave me 3 days paid off work as “special leave” to go through it and make sure I was OK after. The only thing I had to worry about was the physical and emotional effects of the process (which honestly weren’t that bad… I’m fine now). It sucks that you guys in the US, a supposedly developed nation, have to worry about how to even access an abortion in the first place. Fuck Donald Trump, fuck the Supreme Court and fuck the United States of America 🇺🇸

  3. Any info on how weight factors into effectiveness of these pills? I know that with Plan B, after a certain weight (in the 160 lb range?) the effectiveness goes down. But these are different medications with different uses, so I thought I would ask. Weight stigma is so hard to grapple with in medical settings.

Contribute to the conversation...

Yay! You've decided to leave a comment. That's fantastic. Please keep in mind that comments are moderated by the guidelines laid out in our comment policy. Let's have a personal and meaningful conversation and thanks for stopping by!