3 Major Abortion Pill Myths to Be Aware of Right Now

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The chaos around abortion care access continues to swirl, and the latest development in a post-Roe world is no exception: Access to mifepristone—the first of two drugs in the standard medication abortion regimen—is being challenged in the Supreme Court. The case, FDA v. Alliance for Hippocratic Medicine, officially kicked off on March 26.

The lawsuit was filed by a group of anti-abortion doctors who relied on retracted research to form the basis of the case, and it questions whether the FDA overlooked safety issues when it made mifepristone more easily accessible in 2016 and 2021. If the Supreme Court rules the group has legal standing to sue the FDA and then ultimately rules to roll back certain forms of access, including the drug’s availability via mail-order pharmacies, getting mifepristone could become much, much harder—even in states where abortion care rights are currently well protected. Given that medication abortion accounted for 63% of all abortions in the US last year, this case could have a huge impact on people’s access to care.

First, let’s break down how we ended up here.

The FDA approved mifepristone for medication abortion in September 2000, but people who were prescribed the drug could only get it by going to an authorized clinic, medical office, or hospital, thanks to an “in-person dispensing requirement.” (Remember this part—it will come up a lot.) The FDA first eased some of its restrictions on the drug in 2016, which included expanding the gestational age limit to end a pregnancy from seven weeks to 10.

In April 2021, the FDA officially stopped enforcing the in-person dispensing requirement while COVID-19 remained a public health emergency—meaning, people who were prescribed mifepristone could use mail-order pharmacies to get it, a major win because a lot of reproductive health clinics had temporarily shuttered, leaving people who needed abortion care with few options. Removing the in-person dispensing requirement became official later that year, with the caveat that pharmacies needed to be certified to offer the medication.

Then Roe v. Wade, the landmark case that guaranteed the right to an abortion, was overturned in June 2022. Several states have since imposed tight restrictions on abortion care access, some have banned it completely, and others have become safe havens (including via telemedicine) for people who need this form of health care.

That’s why this new case is such a big deal: Conservative judges and lawmakers have claimed that the reversal of Roe would “send abortion back to the states”—but this shady lawsuit has the potential to severely limit mifepristone access on a national level. As the Center for American Progress notes, “It’s critical that drug approvals be based on science and safety, not politics.”

Below, we consulted three reproductive health experts—and the data—to dispel common myths about mifepristone’s safety. You’re unfortunately bound to hear them if this case picks up steam, so here’s the truth.

Myth #1: The FDA rushed the decision to make mifepristone more accessible.

Mifepristone has been FDA-approved for more than 20 years, and that approval is based on decades of robust, peer-reviewed medical data. Clinical trials began in 1983, and the FDA continues to conduct periodic reviews of data on mifepristone use for medication abortion—no new safety concerns have come to light.

“The abortion pill remains unnecessarily over-regulated,” Ashley Jeanlus, MD, ob-gyn and assistant professor at the University of California, San Francisco’s Bixby Center for Global Reproductive Health, tells SELF. She says the initial label changes made by the FDA in 2016, including the increase of the gestational age limit to 10 weeks, were “consistent with medical evidence.”

And the agency’s decision to ease in-person dispensing restrictions during the height of the pandemic—remember: a public health emergency—was fueled by the advocacy of top medical organizations: The American College of Obstetricians and Gynecologists (ACOG), with support from the Society for Maternal–Fetal Medicine, legally challenged the FDA to stop enforcing its in-person dispensing requirement so that people who needed abortion care did not have to risk “avoidable COVID exposure to themselves and their clinicians.”

The updates to mifepristone access weren’t just a quick check of a box—they reflected careful (and necessary) consideration of ongoing safety data, the overarching consensus of the medical community, and the health care needs of hundreds of thousands of people during an unprecedented global health crisis.

Myth #2: Mifepristone poses serious safety risks.

Reproductive health specialists have long argued that mifepristone’s in-person dispensing requirement does not make abortion care safer; isn’t based on scientific evidence or medical need; prevents both doctors and patients from accessing the medication during early pregnancy loss; and disproportionately impacts marginalized communities, including people of color and folks living in health care deserts.

Verda J. Hicks, MD, the president of ACOG, shared a statement following the oral arguments that kicked off in the Supreme Court yesterday—and she didn’t mince words: “Decades of data have consistently demonstrated that mifepristone is safe and effective for both medication abortion and management of early pregnancy loss. In fact, over time, additional clinical study of mifepristone has led to an improved regimen with an even better safety and efficacy profile,” she said. “The supposed harms of mifepristone have not been substantiated or have been intentionally misrepresented by opponents of abortion in an effort to limit access to a safe and effective drug.”

The statement also pointed out that the case is based on bogus research, and that “the overwhelming majority” of mifepristone’s potential side effects—like bleeding, cramps, and pelvic pain—are “easily treatable or require no additional intervention at all.”

To be totally transparent, the FDA has received 32 reports of deaths associated with mifepristone since the drug was first approved more than two decades ago. But the medication itself was not attributed as the cause of these deaths; the use of other drugs and medical treatments, co-existing conditions, and gaps in understanding patients’ health statuses were all variables that could have played a role.

“We know that this medication is extremely safe,” Ushma Upadhyay, PhD, MPH, a researcher and core faculty member at Advancing New Standards in Reproductive Health, tells SELF. “In the largest, most rigorous studies, the serious adverse event rate is one third of 1%.”

Myth #3: Mifepristone complications send a lot of people to the hospital.

Dr. Upadhyay conducted a study in 2015 that examined 54,911 medication and surgical abortions. Among all abortions, one out of 16 were followed by a visit to an emergency department within six weeks, but only one of 115 hospital visits were for an abortion-related complication. In fact, the major complication rate was only 0.31% for medication abortion.

So why might people go to the hospital after they take abortion pills? “Many people go through the medication abortion by themselves, and they don’t know whether the amount of bleeding they’re experiencing is normal,” Dr. Upadhyay says. “But bleeding is part of the process—these medications cause cramping and bleeding so the contents of the uterus are expelled.” (Mifepristone blocks a hormone called progesterone, which the body needs to continue a pregnancy. The second drug in the regimen, misoprostol, causes the cervix to soften and dilate to help the body expel the pregnancy.)

Some people may also go to the hospital for reassurance that the abortion was effective, she says. That’s because a pregnancy test “won’t give accurate results for four to five weeks after the abortion,” thanks to lingering hormones in the body, Dr. Upadhyay says.

And if you live in an area where there aren’t a ton of clinics, the closest major hospital might be your only option to see a doctor. Hospital visits associated with mifepristone don’t boil down to an inherent lack of safety—which all comes back to stigma: “The reality is people need more information and support when it comes to self-managing their care,” Nancy Cárdenas Peña, campaign director of the Abortion On Our Own Terms campaign, tells SELF. “With accurate information, people can safely self-manage their abortions completely at home.”


Originally Appeared on SELF