The Science Behind the “Abortion Pill”

Legal or not, more American women are opting for abortion by medication. We asked doctors: How safe is it?

Roe v. Wade may have legalized abortion in America 45 years ago, but the fight it ignited is far from over. While abortion is still legal, many states have since passed laws that restrict access to abortion to varying degrees—making it more expensive, difficult or even illegal in specific circumstances to terminate a pregnancy. Today abortion clinics are disappearing at a record pace, and Medicaid payouts to Planned Parenthood are in jeopardy.

As a result, many women do not have access to a safe clinical abortion.

“The fact that a clinic exists in her state doesn’t help a woman who lives far away from that clinic and has no way to get there,” says Susan Yanow, a reproductive health consultant for the international nonprofit Women Help Women (WHW). Seven states—Kentucky, North Dakota, South Dakota, Missouri, Mississippi, Wyoming and West Virginia—currently have only one abortion provider, and Kentucky may soon be the only state with none.

Now some women are once again taking the procedure outside the doctor’s office, outside the law, and into their own hands. While the days of the infamous wire coat hanger aren’t quite over, many women are turning to a safer method made possible by modern medicine: the “abortion pill.”

For those with access to a clinic, the abortion pill has become an increasingly popular way to legally terminate an early pregnancy. The Food and Drug Administration mandates that medication can only be prescribed by a healthcare provider “who meets certain qualifications”; 19 states also require that a physician be there physically to supervise the procedure.

Anti-abortion activists argue against the safety of using this method outside a doctor’s office and have even argued that states should require stricter medical supervision for abortion medication. “These drugs are dangerous. They are deadly. If they are mishandled, they result in serious injury,” Kristi Hamrick, spokeswoman for the antiabortion group Americans United for Life, recently told The Washington Post. (Hamrick is not a physician.)

But women who can’t get the medication legally can and do buy it illegally, either online or in Mexico. In fact, this is fast becoming the primary option for women who lack others: In 2015, more than 700,000 Google users in the U.S. typed in queries about self-induced abortions, including “buy abortion pills online” and “free abortion pills,” according to the New York Times. In May 2016, Glamour magazine chronicled the stories of women seeking these pills in “The Rise of the DIY Abortion.” 

That’s why, in April, WHW launched its first website to assist American women undergoing medical abortions on their own. “The new Trump administration and anti-abortion legislatures in many states are moving swiftly to push abortion out of reach,” said Kinga Jelinska, the group’s executive director, in a statement announcing the move. The new website,, provides women with confidential, one-on-one counselling on how to safely use their abortion medication—regardless of where they may have obtained it.

It isn’t clear just how many women are seeking abortion medication outside of a clinic. To protect its clients, WHW does not disclose how many inquiries its trained counsellors receive. But in the past several years, many women have been charged for buying or taking it illegally, with several facing felony charges and jail time. As the use of the abortion pill spreads outside the doctor’s office and into murky legal waters, we asked: How does this procedure work? And how safe is it?

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