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"Just Two Teeny-Tiny Pills": The Power of Medication Abortion

Let’s talk about medication abortion. It’s just two teeny, tiny pills, but the agency these pills grant is monumental, and every single person around the world should have access to this power if they need it.

Despite manufactured perceptions of abortion as an extremely invasive and traumatic procedure, medication abortion – which currently accounts for about 20 percent of US abortions – is a safe and straightforward process. A medication abortion consists of two pills: mifepristone and misoprostol. In the United States, a person seeking a medication abortion is administered the first pill, mifepristone, in an abortion clinic such as Planned Parenthood or a private doctor’s office. Mifepristone blocks the release of progesterone in the body, which effectively prevents the pregnancy from progressing. Then, 24-48 hours later, the second pill, misoprostol, is taken at home or any comfortable and safe location. Misoprostol empties the uterus, which causes cramping and bleeding for about 5 hours. Medical professionals are on call 24/7 if there are any concerns or complications during the expelling phase of the abortion, but for most people the process is smooth and similar to a heavy period. Medication abortion is an extremely safe medical procedure – only 1 in 100,000 people will die from a medication abortion. Compare that to the fact that in the U.S. approximately 14 in 100,000 people die in childbirth, and that number goes into the two-hundreds when averaged worldwide.

Medication abortions were first approved in the United States in 2000. However, regulations have recently changed – expanded access to the abortion pill in the US means the pill can be administered at up to 10 weeks instead of 9 and the dosage of misoprostol has been reduced by two thirds. These two specifications have made medication abortions much more accessible in the U.S. by decreasing costs for the procedure and increasing the number of people who can use it.

Needless to say, abortion access in the U.S. is constantly threatened by federal and state Republican legislators. However, there are many other countries in the world where abortion is either entirely illegal or severely restricted, and in these countries the abortion pills have created the possibility for a safe underground abortion network.

The international organization Women on Web sends the two abortion pills to people globally so that they can have abortions on their own. Only serving countries where abortion is extremely restricted or illegal, Women on Web conducts online medical consultations with those seeking abortions and if the procedure is approved, send the medication through the mail. Volunteers at the organization remain in constant digital contact with the patients during their medication abortion for support and to make sure everything is going well. If a patient were to experience a medical complication for any reason, they can go to an emergency room and say they had a miscarriage. The abortion pills mirror the biological process of a miscarriage, so there would be no way for the doctor to be able to tell if the patient is lying, and therefore the patient will not face backlash for the abortion laws in that country.

Wondering how this is legal? People are allowed to receive medication through the mail as long as it is only for personal use. Also, both mifepristone and misoprostol are on the World Health Organization’s list of essential medicines, and because they are not narcotics or controlled substances, no violation of customs regulations occur.

People around the world deserve the right to make their own choices about their own bodies. Abortion pills are a safe way to give people control over their lives, regardless of what country they live in. It is imperative that we continue our fight for safe, legal, and accessible abortions here in the U.S., lest we be added to the list of nations where people are forced to seek abortion through other means.

If you’re interested in making a donation to Women on Web:


Talia Parker ’20 is a member of H*yas for Choice’s leadership team.

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