Medication Abortion Increases: What and Where Women Get It

Taking a pill to end a pregnancy contributes to an increase in the number of abortions in the United States, legal and not. If the Supreme Court overturns Roe v. Wade as expected, drug abortion will play a major role, especially among women who lose access to abortion clinics.

It is a type of pill that women can take at home, a method that is increasingly used worldwide.

The protocol approved for use in the United States consists of two drugs. The first, mifepristone, inhibits a hormone called progesterone which is essential for pregnancy to continue. The second, misoprostol, causes uterine contractions.

The Food and Drug Administration has approved abortion for up to 10 weeks of gestation. The World Health Organization guidelines say it can be used up to 12 weeks at home, and after 12 weeks in a medical office.

Yes for both calculations.

In US studies, the combination of these pills results in complete abortion for more than 99 percent of patients, and is as safe as the traditional abortion procedure administered by a physician. Various studies have found that abortion abortions have lower rates of adverse events, and recent Lancet studies have found that patients are generally satisfied with it. Increasing evidence from overseas suggests that abortion pills are safe even among women who do not have a doctor to consult them.

“Some people still think we’re talking about something dangerous or done in despair, but this information is becoming more and more common,” said Abigail RA Aiken, an assistant professor at the University of Texas at Austin who leads the research group above. medical abortion.

About half of all legal abortions occur in the United States (and three quarters in Europe). During the epidemic, medical abortion became more widespread because patients wanted to avoid going to private clinics, and changes in federal law made it easier for them to get prescriptions via telemedicine.

It usually depends on the personal preferences of the patients, said Dr. Maria Isabel Rodriguez, associate professor of obstetrics and gynecology at Oregon University of Health and Science, who has worked on abortion research and policy formulation. “Some people like surgery, because it’s too late, they can get numb, and it is completed on time,” he said. “The drug may feel more private, some want it in their own home, some say it feels more natural to them, and some say it feels more possible to deal with the loss.”

Medicinal abortions are also used illegally by those living in an area that prohibits legal abortions or by those who do not have access to clinics. The rate of abortion in the United States is higher than officially reported by doctors, the evidence suggests, because people are prescribing pills online. That invisible abortion rate could increase if more states ban abortion – the ban will apply to surgical and medical abortion.

Physicians with special registration required by the FDA

But it recently abolished laws that required a personal appointment. That means more providers are aborting medication through telemedicine. The doctor and the patient meet online, then the doctor sends the pills to the patient’s home via mail. (Some brick and mortar stores have been approved to fill out prescription tablets, but this is still not uncommon.)

New startups who specialize in mobile abortion, such as Hey Jane and Just the Pill, have begun offering the service in the states that allow it. But 19 states prohibit pills from being prescribed by telemedicine or delivered by mail. In those areas, patients still need to see a doctor face-to-face to pick up pills. Some states ban medical abortion after a certain number of weeks.

If Roe is overthrown, about half of the states are expected to ban abortion altogether. Those rules will affect all forms of abortion, including systemic abortions and pills.

Online pharmacies abroad sell pills. Aid Access provides women in all 50 states with advice and instructions from European doctors before shipping the pill from India. These illegal methods are becoming increasingly popular as abortions are increasingly difficult to obtain in some states. After Texas enacted a law in September banning abortion after about six weeks, Aid Access requests for abortion pills tripled.

The FDA has demanded that these groups suspend the sale of these drugs in the United States, saying they are evading US drug safety protocols. But researchers who have analyzed the tablets in the laboratory have found that the pills prescribed for these services are generally true.

The second of two drugs in the official regimen, misoprostol, can also be terminated if used alone. It is suitable for 80 percent alone, although sometimes it should be taken more than once. The pill is also used to treat ulcers, and is available over the counter in many countries, including Mexico. But the only way the FDA approved in the United States is to use both tablets.

No. It is illegal to sell prescription drugs to Americans without a prescription from a licensed physician in the United States. But the practice of overseas service providers has become more common, as is the case with other drugs that Americans import from abroad. And sales will be hard to stop because medicines generally come in unmarked packages on mail.

“I’m not there, so I don’t have any legal risks,” said Dr. Rebecca Gomperts, a Dutch doctor who runs Aid Access, and says she has lawyers advising her, at home and in the United States. “I know from where I am, I follow the rules.”

In general, recent state laws do not punish women for abortion, but focus on enforcement for abortions. Except for the old laws in South Carolina, Oklahoma and Nevada. That could change if Roe was abolished and if illegal drug abortions became more common. In recent months, some states have moved to increase criminal penalties by ordering, issuing or issuing tablets.

“It is not a crime to control abortion” in all three states except the three states, said Farah Diaz-Tello, attorney general and legal director of If / When / How, a reproductive rights policy and advocacy group. “But it is not legal for a person to seek medication without a doctor’s prescription.”

The first pill, mifepristone, usually has no visible effect on patients. Second, misoprostol, taken 24 to 48 hours later, causes stress and bleeding that increases with intensity, Drs. Rodriguez said.

The process takes about six to eight hours, and is extremely intense for an hour. He recommends that patients stay at home, with no other responsibilities. Ibuprofen with a heat pad is also recommended, because the pain may be intense and the bleeding is heavier than for a period. After pregnancy, constipation and freezing stop, although women generally bleed, similar to the menstrual cycle, for about a week.

In rare cases, less than 1 percent of the time, the patient has a heavier-than-expected blood and needs medical attention. Similarly rarely, abortion is incomplete and needs to be followed by another dose or surgical abortion. Women who have these problems can be treated by a doctor who is experienced in treating pregnancy; The symptoms and treatment are the same. Once a medical abortion begins, it cannot be stopped.

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