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5 Key Facts About Medication Abortion

Expanding access to safe abortion in whatever ways possible is more critical than ever—and a central way of doing so is to make medication abortion more easily accessible.

The U.S. Supreme Court building
The U.S. Supreme Court is seen behind fences in Washington, on May 11, 2022. (Getty/Stefani Reynolds/AFP)

A draft Supreme Court opinion released last week strongly suggests that a majority of the court is ready to overturn Roe v. Wade, the nearly 50-year-old precedent recognizing the constitutional right to abortion. Consequently, expanding access to safe abortion in whatever ways possible is more critical than ever—and a central way of doing so is to make medication abortion more easily accessible. A medication abortion involves two different medications approved by the U.S. Food and Drug Administration (FDA)—mifepristone and then misoprostol, taken orally, 24 hours to 48 hours apart from one another. The FDA currently approves use of medication abortion for up to 10 weeks after pregnancy.

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Here are five key things to know about medication abortion.

1. Medication abortion is extremely safe and common

Research has established medication abortion as both highly effective and exceptionally safe; it has fewer serious risks than Tylenol. It is also common. Since the FDA approved it more than two decades ago, medication abortion with mifepristone and misoprostol has been used by more than 4 million women in the United States. In 2020, more than half of abortions in the United States were medication abortions.

2. Medication abortion pills can be obtained through the mail

The FDA thoroughly reviewed the pills’ safety and allows them to be prescribed over the phone or online, as well as for people to receive the medications through the mail. Clinicians can dispense the drug directly to patients, or an online pharmacy can mail the pills to them.

Telehealth—communication between patients and providers over the phone or using a digital platform—is a critical tool for expanding access to all care, including abortion, and is a boon for the many people of reproductive age in the United States without close access to an abortion clinic. Currently, almost 40 percent of all U.S. women live in a county without an abortion provider. For the many patients with child care obligations—the majority of those who seek abortion care are mothers—as well as work commitments and/or strained finances, the costs of traveling long distances for abortion care can be insurmountable.

3. Medication abortion allows people to end their pregnancies earlier and more privately

Available with fewer scheduling complications, medication abortion may enable a person to have an abortion earlier in a pregnancy. Furthermore, given that people can take the medications at home, medication abortion allows patients to safely end their pregnancies in a setting where they are comfortable and can be supported by their loved ones.

Underscoring the safety of at-home medication abortion, the World Health Organization (WHO), supported by extensive research, has affirmed that with proper information, guidance, and support, medication abortion can be safely managed without clinician involvement; often called self-managed abortion, medication abortion occurs when laws limit people from accessing abortion through the traditional health care system.

4. Access to medication abortion is under attack

Despite medication abortion’s well-established safety and effectiveness, some states are overriding the FDA’s determination about how it can be used, enacting medically damaging, unnecessary laws that limit who can prescribe it, where it can be dispensed, and whether it can be mailed. So far, in 2022, some form of restriction on medication abortion has been introduced in 22 state legislatures. Already, 19 states prohibit medication abortion provision through telehealth. These restrictions fit within a broader pattern among anti-abortion lawmakers, who seem emboldened by the U.S. Supreme Court’s apparent openness to reconsidering Roe v. Wade as well as its willingness to allow Texas’ six-week ban—with a Constitution-defying vigilante enforcement scheme—to stand.

5. Policymakers can ensure that more people are able to access care

Despite these threats, progress is possible. Below are three of the critical areas in which policymakers should act now to expand and protect access to medication abortion.

Ensure care is affordable

Abortion is health care and should be covered as such. The federal Hyde Amendment prevents abortion care from being covered in federal health insurance programs such as Medicaid. It also prohibits abortions for those in the military, Peace Corps, and employed in the federal government except when pregnancy is due to rape, incest, or poses a threat to the pregnant person’s life. The Hyde Amendment must be abolished, but while it is still law, states must fulfill their legal obligation to cover Hyde-permissible abortions.

For people who are privately insured, insurance coverage also must be improved to enable access to abortion. Eleven states currently prohibit abortion coverage in private insurance plans, and 25 states limit coverage in marketplace health plans. Only 16 states permit the use of state Medicaid plans to cover medically necessary abortions; nine of these 16 do so only under court order.

Ensure people aren’t prosecuted for having an abortion

In some states, women have been arrested and criminally charged after being suspected of self-managing their abortions. Perhaps the most recent example of this arose out of Texas, where a 26-year-old woman was arrested, charged with murder, and held on a $500,000 bond for an abortion. The charges were thankfully dropped after it became clear that officials didn’t have the legal authority to prosecute the woman, but the fact that the arrest occurred at all speaks to the likelihood of individuals being charged in the future—particularly as legal standards continue to shift in the states and cause confusion on the ground. This risk of criminalization falls disproportionately on people of color and low-income people. No one should be prosecuted for their health care decisions or pregnancy outcomes.

Ensure politicians cannot override science and medical best practices

The FDA undertakes an extensive review process, and its approval stands as a definitive federal assessment of a medication’s fitness for the intended public’s use. Anti-abortion politicians should not be able to disregard scientific evidence or impose burdensome requirements that are contrary to the FDA’s analysis.

As the U.S. Supreme Court seems poised to cede its responsibility to protect the constitutional right to abortion, policymakers’ obligations to do so increase.

The positions of American Progress, and our policy experts, are independent, and the findings and conclusions presented are those of American Progress alone. A full list of supporters is available here. American Progress would like to acknowledge the many generous supporters who make our work possible.

Authors

Elyssa Spitzer

Senior Policy Analyst

Maggie Jo Buchanan

Senior Director, Women's Initiative

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