Medication abortion, more commonly known as the abortion pill, is growing to be the most popular abortion procedure in the United States. According to the Guttmacher Institute, more than half of recorded US abortions have been completed via the abortion pill.

Medication abortion is a two-part series, with the two drugs taken within a 48-hour window. The first pill, mifepristone, blocks progesterone from the pregnancy. Progesterone is a naturally occurring hormone in the female body that is necessary for her pregnancy to grow. The second pill, misoprostol, causes uterine contractions and pushes the pregnancy out of the body through the vagina. Symptoms can vary from mild to severe, and they can often resemble those of an early miscarriage. 

On the rise in recent years is a new phenomenon: ordering abortion pills online, without first being evaluated in-person by an abortion provider. While a surgical abortion is performed by a provider at a clinic, the abortion pill method can be self-administered at home. Some websites give instructions and/or provide telehealth evaluations along with the desired medication. Others allow for pills to be used with or without a positive pregnancy test, like how one would take a Plan B pill or other emergency contraception after unprotected sex. However, the function of the medications are not the same–Plan B prevents pregnancy primarily by delaying or preventing ovulation, while the abortion pill terminates an existing pregnancy. Even so, the landscape has shifted away from requiring in-person evaluation to access abortion pills. 

Many women are drawn to the convenience and privacy of ordering abortion pills online, for obvious reasons. Abortion is a very personal decision for many, so the sense of having full control of one’s abortion story can feel appealing.  

While ordering pills online may appear easier, it’s important to remember that these are drugs used in a medical procedure with specific safety restrictions applied by the FDA. Users should remain informed on their purpose and risks, and only use them in a way that’s safe for their body. It’s important that you are safe, and you are always safer when you are informed. 

So, let’s explore some key factors to consider before ordering abortion pills from an online provider. 

How Do I Know if It’s Safe for Me to Take the Abortion Pill?

Like any other medication, there are certain circumstances that may prohibit you from safely ingesting the abortion pill. These include: 

• If you are on certain medications, you shouldn’t take the abortion pill. Additionally, if you have allergies to the medications used and/or have certain medical conditions such as bleeding and or seizure disorders, you should avoid taking the abortion pill (1). 

• The abortion pill is only FDA-approved up to 70 days after the first day of your last menstrual period. This means after 10 weeks gestational age, the abortion pill is no longer considered safe for your body. Before ordering the abortion pill, it’s essential to know how far along you are. This information can be determined via ultrasound.

• In a condition called ectopic pregnancy, the pregnancy implants outside the uterus (usually in a fallopian tube). Abortion pills are contraindicated in women with an ectopic pregnancy. This means abortion pills should not be taken if someone has an ectopic pregnancy since it could result in the rupture of that ectopic pregnancy. This could be life threatening to the woman. Ectopic pregnancies are dangerous and must be treated through medication or surgery. According to Dr. Isabel Beshar, “While self-managed abortion has been shown to be safe and effective, it does not include some of the same safety checks for rare, but potentially serious, complications such as ectopic pregnancy” (2). 

• If you become pregnant with an IUD in place, healthcare professionals do not recommend using the abortion pill.

• If you do not have access to emergency care, you should not take the abortion pill. According to data from the National Institute of Health, roughly 2% of all US abortions lead to complications (3). However, when an abortion is unsupervised by a medical provider, this risk drastically increases. The risk of death with unsafe abortions goes up to 350 out of 100,000 worldwide (4). Unsafe abortions are among leading causes of maternal deaths and morbidities, according to the World Health Organization.

If you become pregnant with an IUD in place, it is not recommended to take the abortion pill.

Know the Risks of Getting Abortion Pills Online

Your body is precious! Obviously, we all hope for no side effects to any medication that we take. Still, you should be familiar with the risk of whatever medication you are ingesting so that you can be prepared to seek proper care if needed. Ordering the abortion pill online poses the additional risk of unintentionally ordering from an illegitimate provider and increasing your risk of complications. 

Some risks of taking the abortion pill include: 

• Incomplete abortion: Incomplete medical abortions can lead to infection and/or require surgical intervention. If taken at home without proper follow-up appointments, an incomplete abortion can go undetected for an extended period of time. 

• Pelvic Inflammatory Disease: PID is an infection in the female reproductive organs and a complication of certain STDs, including chlamydia and gonorrhea. Having an abortion with an untreated STI/STD can increase your risk of Pelvic Inflammatory Disease. 

• Hemorrhaging: While bleeding and cramping are standard side effects of the medical abortion procedure, in some cases it can lead to excessive bleeding and/or hemorrhaging. Statistics show that around 1% of abortion pill patients experience hemorrhaging, but death rates related to hemorrhaging are significant (5).

• Mental Health Complications: When it comes to abortion, research suggests that women who have had abortions may be at an increased risk for various mental health challenges. Data has also shown that risk factors, such as pre-existing mental illness, can put women at greater risk of increased mental health problems post-abortion (6). Grief, depression, and even prolonged grief disorder are common among the post-abortive. (Please note: If you have previously experienced abortion and are suffering from grief or emotional pain related to your abortion, join one of our post-abortion care programs to begin your healing process.)

Get an In-Person Evaluation Before You Decide

There’s a lot of information listed in this article, and maybe it feels overwhelming. You might just want to order the pills and get it over with. That’s understandable! We get it. Even so, ultimately, we feel better and do better when we make fully-informed decisions.

Maybe you’ve already ordered your abortion-by-mail. That’s okay; you still have time to schedule an ultrasound and STI test before you begin your procedure. An ultrasound will help you confirm the gestational age, ensuring that you are within the 10 weeks approved by the FDA. STI testing and treatment will protect you from complications such as Pelvic Inflammatory Disease. Even if you don’t have symptoms, it is still possible to have an STI, so it’s best to test either way.   

At Clearway Clinic, we offer ultrasounds to verify gestational age and testing and treatment for chlamydia and gonorrhea, all free of cost. No insurance is needed to access our services, and your appointment is fully confidential. 

If you are facing an unplanned pregnancy and considering taking the abortion pill, schedule your ultrasound and STI test today. We also offer comprehensive education on all possible pregnancy outcomes–miscarriage, abortion, adoption, and parenting–in order to empower you to make a well-informed choice. We are here to walk with you, wherever your pregnancy journey takes you! 

Reviewed by Lynn B., BSN RN

1. See https://assureomaha.com/3-things-to-know-if-you-are-considering-mail-order-abortion/ for more info.  
2. Quoted in article https://www.usnews.com/news/health-news/articles/2023-01-19/she-used-pills-to-medically-abort-but-had-a-dangerous-ectopic-pregnancy.
3. See https://www.ncbi.nlm.nih.gov/books/NBK430793/#:~:text=Roughly%20one%20million%20abortions%20are,%2C%20and%20post%2Danesthesia%20complications. for more info.
4. See https://www.goodrx.com/conditions/abortion/abortion-at-home for more info.
5. See study https://www.contraceptionjournal.org/article/S0010-7824(12)00954-7/fulltext for more info.
6. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6207970/ for more info.

Please Note: The information in this article is not meant to replace the advice of a medical professional. Schedule a visit with your clinician to learn more.