In the United States, the abortion pill has become the new battleground between supporters and opponents of abortion since a Supreme Court ruled that every state has the power to legislate on it.
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This method, which has been approved in the country for more than 20 years, is very widespread, but is now threatened with a court decision.
– In what ratio is it used?
More than half of abortions (53%) in the United States in 2020 were medical, according to the Guttmacher Institute.
This is less than in some European countries like France, where this method has been legal since 1988 and where medical abortions accounted for about 70% of voluntary terminations of pregnancy (IVG) in 2020.
– How does the abortion pill work?
The abortion pill is different from the morning-after pill. While the morning-after pill is taken after risky sexual intercourse to avoid pregnancy, the abortion pill is taken after pregnancy is confirmed for termination of pregnancy.
The method approved in the United States, like many countries, actually uses two drugs. The first is mifepristone (or RU 486), which stops pregnancy from developing by acting on a hormone called progesterone. The second, misoprostol, is taken a day or two later and induces labor and bleeding.
At the time of the abortion, women are at home or at a location of their choice and not in a health facility.
– What framework in the United States?
In the USA, the method with mifepristone and misoprostol has been approved by the American Medicines Agency (FDA) since 2000.
It is approved up to 10 weeks after the last menstrual period. In addition, women who wish to have an abortion must resort to an aspiration abortion.
– What effectiveness and what risks?
Abortions with mifepristone and misoprostol within the allowed time frame are very safe and effective, all experts hammer.
Studies have shown that pregnancies are actually terminated in over 95% of cases.
Complications (hemorrhage, fever, infections, allergic reactions) that require consultation are rare.
Important point: The pills do not work in an ectopic pregnancy (outside the uterus, 2% of pregnancies). An ectopic pregnancy can be detected with an ultrasound and needs to be treated as it can be fatal.
– Where is it currently available in the United States?
Since last summer, a dozen US states have made abortion illegal after a Supreme Court decision empowering them to legislate on the issue themselves. Medical abortions are therefore also prohibited in these states.
Despite this ban, organizations have stepped up to provide abortion pills to women in those states, from abroad, or from other US states. The extent of these detours is difficult to estimate.
Where abortion has remained legal, the FDA recently eased restrictions on mifepristone so that it can be mailed upon prescription or sold direct to pharmacies like any other drug (rather than being only dispensed at specialized facilities).
But even in those states, a lawsuit is threatening to challenge the FDA’s 2000 approval. This lawsuit was strategically filed in Amarillo, Texas, where the only federal judge is known for his aversion to abortion. He has to hear the positions of the parties on Wednesday and could make his decision quickly.