Even before the U.S. Supreme Court reversed its ruling, Law vs Wadeinterest in medical abortion soared.
Immediately after the draft opinion Dobbs v. Jackson Women’s Health Organization Internet searches for “abortion pill” surged 162% after a decision to overturn the constitutional right to abortion was leaked in May 2022. study published in June in JAMA Internal MedicineNonprofit Abortion Access Provider Just the Pill When aid access reports a spike in calls from women asking for more information about the pill.
at the same time, Kaiser Family Foundation Poll Less than a third (27%) of U.S. adults have even heard of medical abortion, according to a survey released in June, but women aged 18 to 49 (40%) are not familiar with it. I’m here. In contrast, while most U.S. adults (91%) have heard of emergency contraception, 73% of them said the so-called Plan B pill can terminate a pregnancy early in pregnancy. I erroneously believe that
AAMC News To clear up misconceptions about abortion pills and emergency contraception, we spoke with several reproductive health professionals to explain how each works and how doctors provide treatment. Did Dobbs decision.
What is medical abortion?
Medical abortion is the process of terminating a pregnancy with medicine. There are two types of drugs that are taken continuously. The first, mifepristone, terminates pregnancy, and the second, misoprostol, induces uterine contractions, allowing the body to expel the pregnant tissue.medical abortion was used 54% of all abortions performed in the United States in 2020according to the Guttmacher Institute, a nonprofit organization dedicated to sexual and reproductive health research and policy.
How are the tablets taken?
The first drug, Mifepristone, comes in 1 tablet and can be taken at the doctor’s office or at home. The second drug, misoprostol, was placed in her mouth (dissolved between her cheeks and teeth) or vaginally in a series of her four tablets, which she took 24 to 48 hours after the first. increase. If the pregnancy is over her nine weeks, some doctors will prescribe her a second dose of misoprostol to be taken four hours after her first round, he said. Sirapanth Nippita, M.D., Director of Humanities Family Planning Division, said. New York Health.
What are the side effects?
Most people will experience bleeding and cramping the day they take their second dose. Lauren Thaxton, MD, MBA, Assistant Professor of Women’s Health at the University of Texas at Austin Dell Medical School. “Each person is a little different, but most people have the most bleeding and most cramping on the day they take misoprostol,” she says.
Some pregnant women also experience stomach cramps, diarrhea, and other gastrointestinal problems, so doctors may advise patients to take misoprostol vaginally.
Either way, the patient may experience irregular bleeding for the next few weeks, after which they may return to their normal menstrual cycle.
A follow-up visit with the provider is recommended to ensure that the abortion is fully completed.
Are medical abortions safe and effective?
The Food and Drug Administration (FDA) has approved the use of mifepristone and misoprostol to terminate pregnancies up to 10 weeks, but clinical guidance allows use up to 11 weeks. “The evidence-based recommendation for when to prescribe a medical abortion is between his 10 weeks and his 11 weeks,” Thaxton said. “After that, we tend to recommend abortions where abortions are possible.”
a Meta-analysis of 87 clinical trials Medical abortion is safe, showing that less than 0.3% of patients develop serious complications requiring hospitalization (vaginal bleeding, pelvic pain, or infections). Approximately 0.1% of patients required blood transfusions. sign Urgent medical attention may be needed for prolonged heavy bleeding, severe abdominal or back pain, fever lasting more than 24 hours, and foul-smelling discharge.
The pill is also very effective and there are now reported pregnancies. 1.1% of patients.
During the COVID-19 pandemic, many providers prescribed telemedicine medical abortions.a study It was published in the magazine contraception They then found that telemedicine-prescribed tablets were as safe and effective as those prescribed in hospitals, with 0.7% requiring hospitalization and 0.4% requiring blood transfusions. The study also found that 99% of his patients were satisfied with their care.
Are medical abortion drugs used for reproductive health procedures other than abortion?
“These are two drugs that are exactly the same evidence-based medicine for use in miscarriage management,” says Thaxton. No discharge.
“People are a little nervous and a little scared about prescribing these drugs because they can be considered abortions, even for the purpose of treating a miscarriage,” Thaxton says. I went to medical school, I didn’t go to law school, and I think that’s what a lot of obstetricians and gynecologists are feeling right now: we’re really committed to providing evidence-based medicine. I’m just trying to do what I’ve researched.”
Are there risks for people who obtain abortion pills via telemedicine or mail?
“Research shows that people who have access to accurate information about how to manage their abortions can safely perform them on their own,” says an obstetrician-gynecologist and a summarized gynecologist at the American College of Obstetricians. means To all obstetricians and gynecologists Dobbs decision. But, Villavicencio said, “state law may regulate where abortion pills can be taken and if and how someone can obtain them.”
Where is medical abortion prohibited?
Abortion is now prohibited We have launched initiatives in 10 states: Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, South Dakota, Texas and Wisconsin. The ban is set to go into effect in Idaho and Tennessee at the end of August. Five states—Arizona, North Dakota, Utah, West Virginia, and Wyoming—have banned abortion, but courts have blocked the ban from taking effect. there is Florida bans abortions after the 15th week of pregnancy, and Ohio, South Carolina, and Georgia ban abortions after the 6th week, before most people realize they’re pregnant. In many cases, providers of abortions, including medical abortions, are subject to criminal penalties.
“There’s certainly a lot of uncertainty and a lot of worry about how we’ll be able to provide this care to our patients,” adds Nippita, who works for Planned Parenthood. “We have been training for years to provide care, so the fact that it is so politicized is incredibly discouraging.”
What is emergency contraception?
Emergency contraception, also called the morning after pill, is a drug that prevents or delays ovulation. It can be used after unprotected sex or when primary methods of contraception have failed, and is most effective when taken as soon as possible after unprotected sex.
There are two types of FDA-approved emergency contraception. Plan B is an over-the-counter drug available at many drug stores, and Ella (Ulipristal Acetate) is a prescription drug.
“Ella is more effective than Plan B,” Thaxton says. Thaxton often prescribes the drug to patients who may not yet be sexually active, but want to be prepared should the need arise. “It can also be used a little further away from unprotected sex than Plan B.”
Once a person becomes pregnant, emergency contraception cannot stop the pregnancy.
What is the difference between emergency contraception and medical abortion?
“The main difference between emergency contraception and medical abortion is that emergency contraception prevents pregnancy, whereas medical abortion terminates a pregnancy,” says Villavicencio.
“For that, [emergency contraception] It should not be subject to laws against abortion,” she adds. “The impact of abortion bans on emergency contraception is a misuse of the law and a misunderstanding of medicine.”
