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Discontinuation of the drug is common. The mechanism is as follows

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The Associated Press

Associated Press

Lindsey Tanner And Matthew Perrone

Even before the Supreme Court overturned the Roe v. Wade case, drug abortion has become the preferred way to end pregnancy in the United States. became. These include taking prescription medications at home or in the clinic every two days.

Abortion procedures are an invasive medical technique that emptys the uterus. It does not include surgery, but it is sometimes called an abortion.

Tablet abortions include the drugs mifepristone and misoprostol. Demand for pills is expected to increase as more states seek restrictions on abortion.

How the medicine works

Take mifepristone first and swallow it in your mouth. The drug dilates the cervix and blocks the effects of progesterone, a hormone needed to maintain pregnancy.

Misoprostol, which is also used to treat gastric ulcers, should be taken 24-48 hours later. The pill is designed to dissolve when placed between the gums and teeth or in the vagina. The uterus cramps and contracts, causing bleeding and drainage of pregnant tissue.

How to use the drug

The abortion drug is approved for use up to the 10th week of pregnancy.

Pills may be taken at the clinic or clinic. In this case, the patient may have an ultrasound or clinical examination in advance. Some providers also provide tablets through telemedicine visits and then mail the drug to the patient.

The use of pills has increased in recent years. As of 2020, it will account for 54% of all abortions in the United States, according to preliminary data from the Guttmacher Institute. A final quote for the group is scheduled for later this year.

Side effects

Studies and evidence of actual use show that tablets are safe and up to 99% effective when taken together. Side effects include nausea, vomiting, and diarrhea.

Bleeding is normal. Very severe bleeding (soaking more than one pad in an hour for more than 2 hours) is rare but requires medical attention.

Dr. Stephanie Rand, a gynecologist in New York and a specialist in the Physicians for Reproductive Health, a group advocating abortion, determines whether a drug-induced abortion was successful due to pregnancy hormones. Because of the fact that pregnancy tests should not be used immediately. It may remain in the body for several weeks. Bleeding with blood clots, including light-colored tissue, is a sign of success, she said.

Serious complications are extremely rare. According to the Food and Drug Administration, more than 3.7 million US women have used mifepristone since it was approved more than 20 years ago. The agency has received 26 reports of the death of a woman taking the drug, including two, including an ectopic pregnancy that grows outside the womb.

This drug is not recommended for certain patients, such as those with suspected ectopic pregnancy or those with an intrauterine device.


Costs vary from location to location, but are similar to abortion procedures and can exceed $ 500 in total. Health insurance covers a wide range, with some plans to make tablets free or low cost, while others do not cover them at all.

Mifepristone is branded under the Mifeprex brand and misoprostol is marketed under the Cytotec brand, but both pills are available as generics.

Federal Regulations

The FDA has approved Mifepristone to end pregnancy in 2000 when used in combination with misoprostol. At that time, it imposed some restrictions on the method of prescribing and dispensing medicines.

In December, authorities lifted the biggest restrictions. It is a requirement that the patient take the medicine directly. The FDA has shown that scientific reviews of the drug's use, including during a pandemic of COVID-19, show that women can safely receive the drug by mail after online consultation without increasing side effects or complications. Said that.

This decision allows postal delivery of pills nationwide. This is a long-sought change by medical professional groups and abortion advocates.

Still, due to state law patchwork that covers abortion, especially abortion, millions of women will have difficulty accessing abortion. About half of the states in the United States are expected to ban or significantly limit abortion.

Legal Conflict

Legal experts go to Pill to bring test cases to challenge state restrictions by supporters of abortion rights Foresee a long-standing legal battle over access to.

There is little certainty as to which side is dominant, but experts point out that there is strong debate and precedent on both sides.

The Biden administration's Justice Department has already shown plans to challenge state restrictions on drug abortion. Federal lawyers may also include outside parties, such as abortion groups such as Planned Parenthood and companies that manufacture pills.

The main argument against the restriction of tablets may be the long-standing principle that federal law, including the FDA's decision, takes precedence over state law. In fact, few states have tried to ban FDA-approved drugs altogether because of past decisions in favor of the FDA.

Still, states where abortion is totally banned may be interpreted as banning abortion drugs. Many laws do not distinguish between abortion procedures and drug-induced abortions.

"In the short term, banning abortions assumes that their ban also includes drug abortions, which will be banned," said a university assisted reproductive technology specialist. Said professor Glia Donley. Pittsburgh Glow School.

State Law on Pills

Even if you succeed in challenging the comprehensive ban, more than 30 states have laws that specifically restrict access to abortion pills. For example, in 19 states, the clinician needs to be physically present when administering the drug.

These laws can withstand court objections. The state has long had authority over how doctors, pharmacists, and other healthcare providers practice healthcare.

The state also sets rules for telemedicine counseling used to prescribe medications. In general, this means that state healthcare providers with restrictions on abortion medications may face penalties such as fines and suspension of licenses if they try to send the medication by mail.

Women have already crossed state borders to locations with easy access to abortion medications. That trend is expected to increase.

On the other hand, some women take medicines through online pharmacies in Canada and abroad and often receive telemedicine consultations from foreign doctors. This practice is technically illegal, but it is not enforced in nature, and supporters believe that as more states ban abortions, women will increasingly choose this method.

"Anti-abortion countries will do everything they can to limit abortion by drugs, but in reality people are through emails from international pharmacies. I have had access to abortion. I expect it to continue.

One important issue is how to decide when and when the State Supreme Court will take up these cases. Rejected the constitutional right to abortion, but conservative judges also generally postponed the FDA's dominance over drug decisions.


AP Communications' Health Sciences Department is supported by the Science Education Department of Howard Hughes Medical Institute. AP is solely responsible for all content.