Over-the-Counter Abortion Pills: Current Status and Future Prospects

There isn’t an abortion pill that you can get over-the-counter. You need a prescription from a nurse or doctor to get abortion pills.

Depending on the state you live in, you can get the abortion pill from Planned Parenthood health centers or other abortion providers. In some states, you can do your visit online (AKA telehealth) and get your abortion pills mailed to you or pick them up at a local pharmacy. For a trustworthy abortion provider, contact your nearest Planned Parenthood health center or AbortionFinder.org to help you find one closest to you.

Some people confuse abortion pills with morning-after pills, but they’re very different. Abortion pills end a pregnancy. The morning-after pill PREVENTS pregnancy before it happens. But you can buy most brands of morning-after pills over the counter at pharmacies and drugstores without a prescription.

Current Regulations and Access to Medication Abortion

Current regulations restrict access to medication abortion and contribute to the perception that people cannot safely take medication abortion pills (mifepristone and misoprostol) on their own without clinician supervision. Yet, mifepristone and misoprostol meet many of the FDA’s criteria for being available over the counter. They are safe, have no risk of overdose, are not addictive, and people are already using them safely on their own in many parts of the world.

Medication abortion is safe and effective. Medication abortion now accounts for more than 60% of abortions in the US and has the potential to further expand access to care. In the current context, patients are usually evaluated by a clinician either in-person or via telehealth or online models of care and then prescribed medication abortion to take at home.

The Potential for Over-the-Counter Medication Abortion

The possibility of an over-the-counter medication abortion model would involve the medications being available without a prescription in a drug store or grocery, similar to emergency contraception or condoms and pregnancy tests. The pills would come with detailed instructions as well as information about access to a number of different resources, such as a 24-hour telephone number to call with questions about the medication.

While not approved by the FDA, an over-the-counter (OTC) model where people can pick up the medications at a local pharmacy without a prescription could improve access to abortion for many. The OTC model has the potential to reduce travel burden, does not require internet access or a mailing address, and can help to ensure access to abortion care earlier in pregnancy.

Research into Over-the-Counter Medication Abortion

ANSIRH researchers are conducting a series of preliminary studies to address these gaps and to demonstrate whether medication abortion is appropriate for over-the-counter use.

In this study, we are investigating whether individuals can:

• Understand a Drug Facts Label
• Assess gestational age and rule out other contraindications for medication abortion, including by adolescents
• Self-administer the medications according to instructions
• Identify complications and know when to seek medical care, including for ongoing pregnancy

We sought to understand if abortion patients and the general public are interested in OTC medication abortion as a potential option, and found high levels of interest in being able to access OTC medication abortion, and identified many benefits to the model.

In Accuracy of self-assessment of gestational duration among people seeking abortion, researchers asked people seeking abortion a series of questions about how far along they thought they were in pregnancy. Researchers then compared their responses to their gestational duration on ultrasound. They found that broadening the screening questions used to assess gestational duration beyond the last menstrual period start date (LMP) resulted in improved accuracy and sensitivity of self-assessment at the 70-day (or 10 week) threshold to qualify for medication abortion.

Based on this study’s findings, the researchers developed an interactive tool for providers or patients to calculate the accuracy of their gestational duration self-assessment using different combinations of questions. In the short term, these efforts will help support a wide variety of efforts aimed at improving access to clinic-based and self-managed medication abortion. In the long term, FDA approval of an OTC mifepristone-misoprostol product could dramatically increase access to medication abortion.

Important Considerations

If you’re looking for places to get abortion pills, beware of “crisis pregnancy centers.” These are places that seem like normal medical centers, but they don't provide trustworthy or medically accurate abortion care or resources. Instead, they're run by people who want to scare or shame people out of getting an abortion. They will give you false or misleading information about pregnancy, abortion, and birth control, and they usually don't have to follow privacy laws to keep your information private.

Comparison: Abortion Pills vs. Morning-After Pills