7 simple questions on the abortion pill

Brut America

How is the abortion pill different from Plan B? Are there age limits to take it?  As the F.D.A. makes it available by mail, here are 7 simple questions about the abortion pill answered by a gynecologist. ANSIRH

Transcript

00:00Really, as soon as someone has a positive pregnancy test, the most important criterion

00:21is how far along they are in their pregnancy.

00:24So the FDA has approved these medications for use through 10 weeks of pregnancy, counting

00:29from the first day of the last menstrual period.

00:31There's actually evidence that they can be used up through 11 weeks.

00:35But if patients are much past that, then this isn't the best method.

00:39Emergency contraception works by preventing an unwanted pregnancy after someone's had

00:49sex.

00:50If a pregnancy has already been established, emergency contraception has no effect.

00:56It won't cause an abortion.

00:58But these two pills for medication abortion work to end an already established pregnancy.

01:12So the abortion pill is actually two pills.

01:16The first one is called mifepristone, and the second one is called misoprostol.

01:22So mifepristone works by blocking the progesterone receptor, and progesterone is really important

01:28in helping to sustain the early pregnancy.

01:31And by blocking that effect, it causes the lining of the uterus to become thin, and the

01:36pregnancy starts to kind of separate from the uterine wall.

01:39The second medication, misoprostol, is a prostaglandin, and prostaglandins have the effect of causing

01:47the cervix to open up and causing the uterus to contract.

01:52And so the effect of this medication is to essentially expel the early pregnancy.

01:58Very similar to miscarriage.

02:05Patients can use medication abortion really at any age.

02:08I've had patients who are, you know, young, younger than 15 years of age who have used

02:15medication abortion.

02:16There's no evidence that having a medication abortion has any effect on future fertility

02:24or outcomes with a future pregnancy.

02:27Some states may have certain requirements in terms of parental notification or requiring

02:33parental consent, but usually that process is no different for medication abortion compared

02:40to having a vacuum aspiration abortion.

02:47Serious complications are really, really rare.

02:51Things like having to be hospitalized, needing to have a blood transfusion, needing to have

03:00surgery like abdominal surgery.

03:04In studies that have looked at this, it's less than half a percent of patients who have

03:09a serious complication like that.

03:12The risk of blood transfusion is generally less than one in a thousand.

03:17So again, it's normal to have bleeding, but it would be abnormal to have excessive bleeding.

03:23If people have a fever, that could be a sign of developing infection.

03:26People should be on the lookout for that.

03:27And if they have that, get seen.

03:34Someone has a bleeding disorder or takes blood thinning medications, again, causing heavy

03:39bleeding.

03:41Or if someone has an IUD, intrauterine device for birth control inside the uterus, that

03:48needs to be removed first.

03:50People who have been on steroids for a long period of time might also not be the best

03:59candidates.

04:04Medication abortion is generally available in most clinics that provide abortion care.

04:14Some private OBGYN offices or primary care clinicians like family medicine doctors also

04:21provide medication abortion.

04:24There are many registries online where you can go and actually see where services are

04:31available.

04:32The past year or so, there's been a development of several online telehealth services that

04:39are providing medication abortion.

04:41They can only operate in some states.

04:45Sometimes it involves talking to a clinician directly.

04:47Sometimes it involves putting your health information into the online portal that then

04:51gets reviewed by a clinician.

04:54And then the medications are sent through a mail-order pharmacy.

04:57It may be very different in other states.

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