Are You Considering an At-Home Abortion?

Are You Considering an At-Home Abortion?

(Also known as In-Home Abortion, Self-Managed Abortion, Online Abortion, or DIY Abortion)

Are you looking for a simple way to terminate your pregnancy without the expense of surgical abortion? If so, you may be thinking about the abortion pill. It can now be ordered online in the U.S. and worldwide without medical supervision and delivered to your home. Taking the pill at home may seem like an easy solution to an unwanted pregnancy. What’s the catch? Turns out ordering online can be sketchy. Protect yourself. Learn how to spot red flags from at-home abortion. 

Do You Know Everything About At-Home Abortion?

Test your smarts with our short quiz. If you’re reading this, you may be pregnant, anxious, and in a hurry. Take a deep breath and educate yourself before making a big decision. As with any medication or medical procedure, at-home abortions come with risks and side effects. Before you order abortion medications without medical care by an M.D. or healthcare provider, please take this short quiz:

 

  1. I know the names of the first and second medications in a medication abortion (or abortion pill). I know what each pill does and its effectiveness/risks. YES / NO
  2. I have verified my pregnancy with professional pregnancy testing and an ultrasound scan with my doctor or in a clinical setting. That way I know how far along I am (in weeks’ gestation) and my pregnancy is growing in my uterus. YES / NO
  3. I’ve previously purchased medications from the online source where I’m planning to buy the abortion pill. I am satisfied with the quality and effectiveness. YES / NO
  4. I've decided to have this abortion at home and I’m not feeling pressured to do it. I have the support of my partner and/or family and friends and will not experience my at-home abortion alone. YES / NO
  5. I have a doctor or other medical help on standby. I have access to a local emergency room in case of excessive cramping, hemorrhaging, or another emergency. YES / NO

If you didn’t answer YES to ALL five questions, read on to learn more before you order abortion medications online.

Let’s Define Abortion

There are two main categories of abortion methods:

is a surgical intervention that terminates a pregnancy by detaching and removing the developing embryo from the uterus (1). It is performed by an M.D. or abortion provider in a doctor’s office, clinic, or operating room. Two of the most common types of surgical abortion are suction, or vacuum aspiration, and dilation and evacuation (D&E). 

The abortion pill, or chemical abortion, involves taking two oral medications in early pregnancy (2). 

First, you take oral mifepristone (Mifeprex). This causes the lining of the uterus to thin and prevents the embryo from staying implanted and growing. An M.D. or health care provider usually administers the first pill.

Next, immediately or up to two days later you take the second oral medication called misoprostol. The second pill causes the uterus to contract and expel the embryo through the vagina.  Your doctor will follow up with you during and after the abortion process, which can take from five hours to a week or more.

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and won’t profit from your decision either way. Please click below to chat or to make an appointment to learn more.

 

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An At-home abortion with abortion pills from the internet is riskier than pills mailed from your physician or an abortion clinic. It's riskier because you don't have medical supervision and follow-up.  It’s also riskier because you don’t know about the quality, effectiveness, or identity of the pills. (Two pills are standard, but some online services only provide one pill.)

 

Is At-Home Abortion for Me?

At-Home Abortion is less expensive than surgical abortion and may seem more convenient. In theory, you can experience the process at home and order the pills confidentially online. 

Since you get the pills by mail and take them while you relax in bed or on the couch, you may think of this as a DIY project. DIY is a popular trend right now. It’s a fun way to highlight your hair or create new clothes at home, but it is not the best idea for managing a medical procedure. Chemical abortion can last for weeks and is usually associated with intense pain, nausea, vomiting, and heavy bleeding. Since it takes so long, it’s impossible to predict where you will be when intense bleeding and pain occur. 

You need accurate information and answers to these questions before choosing an at-home abortion:

 

How far along am I?

If you took a home pregnancy test, it’s important to verify your pregnancy and due date with accurate, professional pregnancy testing.

Often women don’t have an accurate idea of their due date.

 "If a woman thinks she's 10 weeks pregnant but is 13 weeks, she's just increased her risk from one in 20 to one in three that a Medication Abortion will cause adverse events such as heavy bleeding, hemorrhaging or a painful, incomplete abortion and possible surgical intervention.” Donna Harrison, M.D. and author states (c).

NAME OF CENTER provides free pregnancy testing and ultrasound to determine the age and viability of your pregnancy.

 

Not in the CITY/STATE area? Find your local medical pregnancy help center through optionline or CareNet.

Do I know for sure if the pregnancy is growing in my uterus? 

A small percentage of pregnancies develop abnormally in the fallopian tubes (4) rather than the uterus. This is known as an ectopic pregnancy and one in 40 pregnancies is ectopic. When you have an ultrasound scan to determine how many weeks of pregnancy you are we'll also check that your pregnancy is growing in your uterus. Without an ultrasound scan, it’s impossible to know if the pregnancy is growing normally in the uterus.

If you take abortion pills with an ectopic pregnancy, you may think that the intense pain and bleeding are from a normal medication abortion. More likely, it’s from a rupture of the fallopian tube. Some women taking the abortion pill have died from unrecognized, rupturing ectopic pregnancies (5). They present dangerous risks to a woman’s health if undetected.

Medical abortions performed without a prior ultrasound scan were more likely to be incomplete and require follow-up surgery, according to an article published in the journal Contraception (6).

 

Get free pregnancy testing and ultrasound scans from Pregnancy Help Lebanon.

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Is there a doctor, nurse practitioner, or medical provider I can talk to first?

  • Before taking the abortion pill, see a licensed medical provider. Why? They can diagnose or warn you of any complications based on your medical history or current medical status. 
  • Plus, in the event of an adverse reaction to a medication abortion at home, it’s crucial to have a physician or nurse practitioner available to call.
  • If you don’t have the financial resources for physician care, consider choosing a pregnancy medical center (like ours) that offers free services and does not profit from your decision to end your pregnancy at home.

Where are the pills coming from? What am I getting in the mail?

  • CLI (7) found there are at least 72 unique websites that currently sell the abortion pill online. There is no screening before prescribing or assessment of how far along you are in pregnancy when purchasing from these websites. 
  • Many of these websites are outside of the United States. “They (websites) are not regulated and there is no guarantee what drug or dosage will be received, or if the package will be damaged. Some sites only send the second pill, misoprostol, which often causes birth defects when the baby survives the abortion attempt.” according to Donna Harrison, M.D., and author.
  • Some women have reported that their online sources provided only misoprostol along with an antibiotic and an anti-anxiety pill. There was no labeling or instructions about each pill or how to take it. 

Have I discussed this with anyone or am I trying to keep this a secret? 

  • Sometimes an unwanted pregnancy causes shame and secrecy. Are you trying to keep this a secret from your partner, family, or friends? 
  • It may feel like your world is falling apart because of this crisis, but this is the time to reach out for help so you can decide without shame or panic. Take a deep breath and talk to a trusted friend or family member. 
  • You’re not alone. There is help available. “If you’re ordering pills online and feel like you have to hide it from everyone, ask yourself ‘why am I doing it?’” Sarah Bowen of athomeabortionfacts.com (8).

Am I being pressured to have an At-Home Abortion? 

  • If you’re feeling pressured by a friend, partner, family member, or employer to have an abortion, please reach out and talk to someone.
  • Nobody can force you to have an abortion. It’s called coercion and it’s illegal in all 50 states in the U.S. Many places can help you have a safe and healthy pregnancy, care for you, and watch out for you. Contact optionline.org (9) to find out more.

What if I Change My Mind? 

If you take the first pill (mifepristone) and then change your mind about going through with the abortion, help is available. Please call (877) 558-0333 within 24 hours of taking either of the pills.

“Abortion pill reversal protocol was created to assist women who have taken mifepristone and would like to continue their pregnancies. However, we receive calls from women who have taken both mifepristone and misoprostol. We have protocols to help them as well.”

 

says Christa Brown, BSN, RN, LAS of abortionpillreversal.com (10). 

These medications prescribed for medical or non-surgical abortions come with reproductive risks. In fact, they are classified as hazardous medications by the National Institute of Occupational Safety and Health (NIOSH) (11).  The meds should be disposed of properly. 

Don’t have a medication abortion in these situations:

  • You are more than nine weeks pregnant. You shouldn't attempt a medical abortion if you are too far along in your pregnancy (calculated in weeks after the start of your last period). Some types of medical abortions aren't done after seven weeks of pregnancy. 
  • Have an intrauterine device (IUD).
  • Have a suspected ectopic pregnancy (pregnancy outside of the uterus).
  • Have certain medical conditions. (Including bleeding disorders; certain heart or blood vessel diseases; severe liver, kidney, or lung disease; or an uncontrolled seizure disorder.)
  • Take a blood thinner or certain steroid medications.
  • Can’t make follow-up visits to your doctor or don’t have access to emergency care.
  • Have an allergy to the medications.

Sources: Mayo Clinic (12) and FDA (5)

 

What Are the Risks/Side Effects of At-Home Abortion?

“Abortion is a medical intervention and taking pills at home doesn’t change the magnitude of the intervention a woman is undertaking—and now she’s doing it all alone.” Dr. George Delgado, M.D., F.A.A.F.P. (13)

 

Risks or complications from medication abortion:

  • Incomplete abortion, which may need to be followed by surgical abortion
  • An ongoing unwanted pregnancy if the procedure doesn’t work
  • Heavy and prolonged bleeding
  • Infection
  • Fever
  • Digestive system discomfort

Source: the Mayo Clinic (12)

NOTE: With an abortion at home, it’s up to you to handle safe abortion care. You have to make decisions such as:  Is it time to take the second pill? Am I bleeding and cramping too much? Should I go to the emergency room?

Most people who get the first pill, mifepristone will report adverse reactions (21). And "About 90% of patients report adverse reactions" after taking the second pill, misoprostol (21).

"Side effects include more heavy bleeding than a heavy menstrual period, abdominal pain, uterine cramping, nausea, vomiting, and diarrhea.” (21).

 

A study, published in the Journal of Obstetrics and Gynecology, (14) followed abortion outcomes in Finland. (They chose Finland because all pregnancy outcomes are accurately documented there). The study compares the risk of complications following both surgical and medication abortions (referred to as chemical):

The overall risk of an adverse event following an abortion

  • Chemical = 20% of patients (1 of 5)
  • Surgical = 5.6% of patients (1 of 20)

 

Hemorrhage Risk

  • Chemical = 15.6% (1 in 6)
  • Surgical = 2.1% (1 in 50)

 

Incomplete Abortion Risk

  • Chemical = 6.7% (1 in 15)
  • Surgical = 1.6% (1 in 60)

 

Emergency Surgery Risk

  • Chemical = 5.9% (1 in 15)
  • Surgical = 1.8% (1 in 60)

Medication abortion has also caused: 

  • Thousands of adverse events, including 768 hospitalizations and 24 deaths since 2000 according to data published in 2018 by the FDA (15).
  • A recent study (3) cites severe side-effects including heavy bleeding, intense pain, and some deaths. 
  • Twice as many ER visits as surgical abortions (16). (In 2015, surgical abortions were 6.2% of total ER visits. Chemical abortions peaked at 14.6% in 2015. (16).) 

 

Since many adverse events happen at home, they are underreported. There are discrepancies in the reporting of adverse events (17) from the abortion pill by abortion providers. Headlines shout the abortion pill is “Safer than Tylenol” (18). However, in the best of cases, there is pain, cramping, and bleeding for a day to weeks after taking the abortion pill. The worst cases involve hemorrhaging, incomplete abortion, and emergency surgery.

What are U.S. Food and Drug Administration (FDA) Guidelines for Online Sale of Abortion Pills?

In December 2019, partially in response to COVID-19 restrictions, the FDA permanently lifted a major restriction on access to abortion pills (19). This allows patients to receive the medication by mail instead of in person from certified health providers.

 

While this makes it easier for you to have access to the abortion pill, it also opens the door for online services not certified by the FDA to provide abortion access over the internet. Some of these online services are not pharmacies and are operating in other countries. Please beware of purchasing the abortion pill online. Use an online pharmacy you’re familiar with, and check that they meet the FDA qualifications (5) as a health care provider. 

 

  • Mifeprex must be ordered, prescribed, and dispensed by or under the supervision of a healthcare provider who prescribes and who meets certain qualifications.
  • Healthcare providers who wish to prescribe Mifeprex must complete a Prescriber Agreement Form before ordering and dispensing Mifeprex.
  • Mifeprex may only be dispensed in clinics, medical offices, and hospitals by or under the supervision of a certified healthcare provider.
  • The healthcare provider must obtain a signed Patient Agreement Form before dispensing Mifeprex.

Do Not Buy Mifeprex or its Approved Generic Over the Internet

 

Why not? Because you will bypass important safeguards designed to protect your health.

 

Mifeprex and its approved generic have special safety restrictions on how it is distributed to the public. Also, drugs purchased from foreign Internet sources are not the FDA-approved versions of drugs. They are not subject to FDA-regulated manufacturing controls or FDA inspection (2).

 

To learn more about buying drugs safely, please see Buying Prescription Medicines Online: A Consumer Safety Guide [PDF] (20).

You’re In Charge of Your Reproductive Health

Whatever your decision on at-home abortion, take advantage of the support available to you. You may have more questions like the ones listed below. If so, please reach out to us or any of the resources listed below. It’s your choice to protect your body and your reproductive health.

 

  • What if only one pill arrives in the mail? Is it misoprostol? Are the pills labeled?
  • What if my pregnancy is further along than I thought—beyond 10 weeks—and I only take the misoprostol pill? Will I have a live birth? What should I do?
  • What if I’m having heavy vaginal bleeding, hemorrhaging, or other complications? Who can I call and where can I go?
  • What if I change my mind after taking the first pill?
  • What if I’ve decided to continue my pregnancy but need help getting free pregnancy testing and an ultrasound scan?

Available Resources

Help and a listening ear are a phone call or click away. Contact any of the resources listed below.

Contact us now!

References

  1. https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/expert-answers/abortion/faq-20058551
  2. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/mifeprex-mifepristone-information
  3. Harrison, Dr. Donna. (2022, January 25). Personal interview. https://s27319.pcdn.co/wp-content/uploads/2021/04/Deaths-and-Severe-Adverse-Events-after-the-use-of-Mifepristone-as-an-Abortifacient-from-September-2000-to-February-2019-copy5.pdf
  4. https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088
  5. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifeprex
  6. https://pubmed.ncbi.nlm.nih.gov/34329607/
  7. https://lozierinstitute.org/fact-sheet-online-sales-of-mifeprex-and-misoprostol-for-self-abortion/
  8. Bowen, Sarah. (2022, January 24). Personal interview. https://www.athomeabortionfacts.com/
  9. https://www.optionline.org/ 
  10. Brown, Christa. (2022, February 1). Personal interview. https://abortionpillreversal.com/
  11. https://www.cdc.gov/niosh/docs/2016-161/pdfs/2016-161.pdf?id=10.26616/NIOSHPUB2016161 
  12. https://www.mayoclinic.org/tests-procedures/medical-abortion/about/pac-20394687
  13. Delgado, Dr. George. (2022, February 2). Personal interview.
  14. https://pubmed.ncbi.nlm.nih.gov/19888037/
  15. https://www.fda.gov/media/112118/download
  16. https://journals.sagepub.com/doi/full/10.1177/23333928211053965
  17. https://journals.sagepub.com/doi/full/10.1177/23333928211068919
  18. https://www.lifesitenews.com/news/cecile-richards-claims-abortion-pills-are-safer-than-taking-tylenol/
  19. https://www.nytimes.com/2021/12/16/health/abortion-pills-fda.html
  20. https://www.fda.gov/drugs/buying-using-medicine-safely/quick-tips-buying-medicines-over-internet 
  21. https://go.drugbank.com/drugs/DB00834