Most U.S. abortions performed using pills

Taking pills to end a pregnancy accounts for a majority of abortions in the United States, both legal and not. Now that the Supreme Court has overturned Roe vs. Wade, medication abortion will play a larger role, especially among women who lose access to abortion clinics.

Medication abortion is a regimen of pills, approved by the Food and Drug Administration, that women can take at home. The approved protocol includes two medications. The first one, mifepristone, blocks a hormone called progesterone that is necessary for a pregnancy to continue. The second, misoprostol, brings on uterine contractions.

In U.S. studies, the combination of these pills caused a complete abortion in more than 99% of patients and was as safe as the traditional abortion procedure administered by a doctor in a clinic.

“Some people still assume we’re talking about something dangerous or done out of desperation, but increasingly this information is becoming more mainstream,” said Abigail R.A. Aiken, an associate professor at the University of Texas who leads research on medication abortion.

About half of the women who get legal abortions in the U.S. (and three-quarters in Europe) use this method. During the pandemic, medication abortion became more common because patients wanted to avoid going to clinics in person, and a change in federal law made it easier for them to get prescriptions via telemedicine.

Pills from overseas are not legal, but it is illegal to sell prescription medicine to Americans without a prescription from a doctor licensed in the U.S.

Enforcement of overseas providers, however, has been uncommon, as it is with other medications ordered from abroad. And sales would be hard to stop because the medications generally are mailed in unmarked packages.