Medication abortions currently make up the majority of abortion procedures in the US, accounting for around 54% of all procedures. But abortion pills, such as Mifeprex (mifepristone) and Cytotec (misoprostol), have been difficult to access in some states since the Supreme Court issued a ruling in Dobbs against Jackson in June 2022. In that decision, the Court took a further step toward reversal Roe v. Wadewhich has championed a woman’s right to an abortion for nearly 50 years.
As a result, many states had trigger bans in place that went into effect immediately, making abortion illegal within their borders. In other states, new restrictions were created, such as banning access to abortion pills.
Just this week, the The Supreme Court declared that it will hear a case challenging the Food and Drug Administration’s (FDA) approval of a commonly used abortion pill, which could significantly affect access. More than 5 million women in the US have used mifepristone to end their pregnancies, and dozens of other countries have approved the drug, The New York Times reports.
When health care providers are prohibited from providing access to safe abortions, many women will be forced to carry their pregnancies to term and potentially face new health risks. Here’s what to know about medication abortion, sometimes called Plan C.
What is abortion medicine or Plan C?
Plan A is birth control to prevent pregnancy, Plan B is emergency contraception (to prevent pregnancy after sex) and Plan C are abortion pills.
Note: The FDA has also recently moved to clarify the labeling of Plan B pills it does not cause abortionthereby distinguishing emergency contraceptives from medical abortion pills.
Also called a medication abortion, Plan C is an option for safe and effective end of pregnancy The drug used is a combination of mifepristone and misoprostol (or misoprostol can be used alone, if mifepristone is not available). The entire process can be self-managed at home.
Mifepristone is also sometimes used to treat a missed miscarriage.
According to ACOG, medication abortion is most effective if used before 10 weeks of pregnancyup to 70 days from the first day of your last normal period, but in some cases, it can also be used with more advanced pregnancy.
Related: Here’s the thing: Many women don’t know they’re pregnant at 6 weeks
Are abortion pills legal?
In short, it’s complicated. Abortion pills are approved by the FDA at the federal level, but access may be restricted at the state level depending on where you live.
In a statement, Attorney General Merrick Garland insists that access to abortion pills and other reproductive care will be protected by the Justice Department.
“States may not ban Mifepristone based on disagreement with the FDA’s expert judgment regarding its safety and effectiveness,” Garland wrote.
Related: Resources for safe abortion access and reproductive rights
Even state laws can make it illegal or very difficult for clinicians to prescribe and for patients to access the pills. Even half of the states have enacted regulations restricting abortion care through medication or telemedicine, which means people living in those states who take the pill could face legal consequences.
The new FDA decision (updated herewith websitealthough no announcement has been made), it is outlined that retail pharmacies will have to meet certain requirements in order to dispense the drug, i.e. the designation of a specific employee to ensure compliance, along with additional duties – administrative.
The FDA previously required that one of the drugs used in abortion pills, mifepristone, be administered in person. But in December 2021, permanently removed that requirementalso paves the way for telehealth platforms to regulate safe access to abortion care.
The Guttmacher Institute has a list of regulations of each stateand Plan C offers FAQs on access to abortion drug resources.
Are abortion pills safe?
Yes. Abortion pills are safe and effective. Abortion pills currently make up the majority of abortion procedures in the US.
The protocol of taking mifepristone first (which blocks progesterone, a hormone needed to maintain the possibility of pregnancy), followed 24 to 48 hours later by misoprostol (which causes your uterus to crack and contract , emptying it) is approved by the Food and Drug Administration (FDA).
Plan C pills are considered by The American College of Obstetricians and Gynecologists (ACOG) to be a safe and effective regimen for medication abortion or early pregnancy loss.
Related: 10 facts about the state of abortion in America today
The organization supports the use and expanded access to mifepristone for these indications and defies restrictions such as on-site dispensing requirements and mandatory personal exams before and after abortion medication.”
The protocol is also recommended by Planned Parenthood.
This medication abortion method is low risk (less than 1% of women who used abortion medication reported serious adverse effects such as infection or bleeding), highly effective (95% to 98% of abortions are successful)and it has the least side effects.
Studies show that medication abortions tend to take longer and you have to monitor yourself at home, compared to a surgical abortion, known as uterine aspiration, which is usually performed by a clinician during an office visit. While no medical procedure is without risk, the risks of a medical abortion are most serious if you have one an IUD or an ectopic pregnancy. One small 2021 cohort study reviewed the safety record of telehealth-administered medication abortion care, and found it to be “feasible, safe and effective.”
What is the shelf life of the abortion pill?
If you’re wondering if abortion pills expire, the answer is yes, even though they have a long shelf life. Both misoprostol and mifespristone tablets carry a shelf life of about two years, according to the International Federation of Gynecology and Obstetrics (FIGO). Some sources say that mifepristone can last as long Five years. If used after their expiration date, the pills may still work, but you risk a higher failure rate.
Abortion medicine makes abortion easier to obtain
In some European countries, such as Finland, abortion drugs are the cause up to 90% of all abortion procedures. Many health care providers recommend medication abortions to their patients seeking this type of care—as it may be preferable to a uterine aspiration in some cases.
Add to that, Plan C pills offer additional benefits: they’re more accessible, more affordable (pills can cost $40-$105; pills typically cost upwards of $500 ) and can be self-administered at home. That self-governance factor is crucial, considering we now live in a post-Roe world, where abortion clinics across the country have been forced to shutter.
Related: How to take care of yourself after an abortion
Resources for finding abortion pills
Resources for finding abortion pills near you are available through Planned Parenthood, Choice Health (which offers virtual clinician services for California, Illinois and Colorado) and Plan C, where you can enter your location and determine the best way to get access to medication, whether it’s clinician-supported or self-managed. Some clinics may allow advance dispensing of abortion pills, where you can order pills for future use.
In some states, you can visit a clinic or seek support from an online clinician then take the pills at home, in other cases, you can order the pills for delivery to your home by not consulting a health care provider. Plan C also has a list of online resourcejust like The M+A Hotlinewhich is available for additional support.
Abortion care is health care. “Like all patients, women seeking abortions have the right to privacy, dignity, respect, and support,” writes The American College of Obstetricians and Gynecologists (ACOG). That’s all Plan C offers them.
A version of this story was published on December 3, 2021. It has been updated.
