Abortion pill mifepristone: An explainer and research roundup about its history, safety and future
Medication abortion is also known as abortion with pills or medical abortion. This piece aims to help inform the narrative on medication abortion with scientific evidence, explaining what medication abortion is, how individuals access it, and what research shows about its safety and effectiveness. It is endorsed by several organizations, including the American College of Obstetricians & Gynecologists and the American Medical Association.
Safety and Clinical Guidelines
The Food and Drug Administration has approved medication abortion for up to 10 weeks of pregnancy and the World Health Organization authorizes its use for up to 12 weeks. Medication abortion can also be used beyond 12 weeks of pregnancy, according to several organizations including the World Health Organization and the International Federation of Gynecology and Obstetrics. Medication abortions are less expensive and are often available through telehealth appointments, although some clinics only see patients in person.
It’s important for journalists covering abortion to have a good understanding of medication abortion so that they can better inform their audiences. A recent analysis finds that while U.S. newspapers are treating the topic of abortion in general as serious policy issues, they are under-covering medication abortion considering its prevalence as the leading abortion method in the U.S.
| Organization | Guideline / Authorization |
|---|---|
| Food and Drug Administration (FDA) | Approved for up to 10 weeks of pregnancy |
| World Health Organization (WHO) | Authorizes use for up to 12 weeks |
| ACOG & AMA | Endorsed as safe termination of early pregnancy |
Legal Challenges and Supreme Court Rulings
On June 13, the Supreme Court justices in a unanimous decision preserved access to mifepristone, a medication that’s used for the safe termination of early pregnancy. The legal future of mifepristone had hung in the balance for several months. Previously, in August 2023, the 5th U.S. Circuit Court of Appeals ruled that mifepristone should not be prescribed past the seventh week of pregnancy, prescribed via telemedicine, or shipped to patients through the mail.
The justices heard oral arguments on March 26, 2024 before issuing the June 13 ruling, writing that “federal courts are the wrong forum for addressing the plaintiffs’ concerns about FDA’s actions.” Meanwhile, abortion is on the ballot in several states this year, with initiatives that aim to ban, restrict, or expand abortion rights. State laws that ban abortion apply to both abortion medications and surgical procedures.
Impact on Access and Healthcare Providers
A case before the U.S. Supreme Court could drastically limit access to medication abortions, now the most common form of abortion in the United States. This could increase the already fast-growing flow of patients to Wichita trying to escape abortion bans that have swept through the region since the high court overturned Roe v. Wade in June 2022. They rely on a regimen of two drugs, rather than surgery, to end early-stage pregnancies.
Dr. Kelly Pfeifer said she is preparing for a surge of even more patients if the justices change rules around the abortion pill mifepristone. Her 15-month-old Wichita clinic, Aria Medical Clinic, saw 3,100 patients in 2023 — nearly all from states where abortion is no longer legally available. Aria, which only offers medication abortions, expands abortion access by focusing on medication abortions.