So with all the abortion talk going on and a lot of people promoting mail-order pharmaceutical abortion, I wanted to go over some of what that entails. I'm going to try not to use too much jargon to make this accessible for folks, but please don't hesitate to PM me with questions. I'm writing this from my experiences as a nursing student and as someone who has taken abortion doula training, but as with anything there may be errors in my post. Please feel free to point them out, and always make sure to do your own research and contact knowledgeable, trustworthy people.
A lot of people see it as an "abortion pill" but actually it is a pair of medications that you're given.
The first is mifepristone or methotrexate and the second is misoprostol. Sometimes all three are used.
Mifepristone is a hormone blocker which blocks progesterone. When a pregnancy is implanted, the fertilized egg tells your body to lower your estrogen and raise your progesterone to maintain the pregnancy. When you take mifepristone, it blocks progesterone so that your pregnancy doesnt continue to develop. It's given in concert with misoprostol to both stop a pregnancy and expel it altogether.
Methotrexate is a bit different. It is also used in concert with misoprostol, but it is actually a cancer drug that is an immuno-suppressant. Its purpose in pharmaceutical abortion is to inhibit rapidly developing cells (as would be present with cancer or with a newly formed embryo) . It can also cause DNA mutations and be teratogenic (cause mutations in an embryo/fetus) which may prevent the pregnancy from being viable. It's less commonly used than mifepristone and may also be given with both misoprostol and mifepristone.
Misoprostol is a synthetic prostaglandin. Prostaglandins are substances produced at the site of inflammation in the body and also help to protect your stomach lining. This is why misoprostol is often given for ulcers caused by NSAIDs (non-steroidal anti-inflammatory drugs) because NSAIDs block prostaglandin production which leads to less protective mucous and thus, ulcers.
But! Prostaglandins can also begin uterine contractions, which are necessary to expel uterine contents, whether that be during your menstrual cycle, a birth or an abortion. So misoprostol is used to begin uterine contractions to help expel a pregnancy. It can also help "ripen" the cervix to make it easier for tissues to be expelled, and these medications can also be topical prostaglandin. (topical meaning, applied directly to the cervix either as a cream or a pill that is placed up against it)
Pharmaceutical abortion is safe in most cases, but generally the cut off is 10-12 weeks of pregnancy. The embryo must still be small enough to pass through your cervix which, while prostaglandins may help relax it slightly, is still a supremely small space. The biggest risks are hemorrhage (excessive bleeding) or failure to expel tissues.
In the latter case, if any embryonic tissue or clots are retained in the uterus, it could cause an infection that may lead to sepsis. Make sure to monitor for symptoms of infection including fever, malaise, excessive pain, confusion, shaking/chills, heavy bleeding past the first 12hrs after you took the pills or as defined below, and low blood pressure/feeling light-headed or fainting upon standing.
Bleeding is expected with an abortion - it's basically a heavy period and will likely last a few days. However, bleeding should be heaviest in the first 12 hours and be minimal following that. You should seek immediate assistance if you are passing clots larger than an inch (2.5cm) in diameter, if you are soaking a menstrual pad with blood in less than 2 hours, or are bleeding heavily past the first 12hrs.
There are many people out there selling snake oil and saying that they have ways to stop a pharmaceutical abortion once you have already ingested the pills. These claims are false, you cannot stop a pharmaceutical abortion that has already begun. Many of these concoctions or remedies or what have you can be dangerous or cause complications. If you feel on the fence about having an abortion, I strongly suggest you seek options counseling from Planned Parenthood or another choice-based organization to help you clarify your needs so you can be sure this is the best option for you. You cannot stop it once it starts.
Pharmaceutical abortions can be painful. Like I said, they're like a heavy period - there will be cramping, bleeding, maybe bloating and general discomfort in addition to potential emotional reactions to having an abortion. In general, you can take mild pain medications like ibuprofen (advil/Motrin) or acetaminophen/paracetamol (tylenol), but with anything always check with a trusted medical professional about any medications you take, even over-the-counter ones.
I strongly suggest having someone with you or checking in with you when you are going through this process just to make sure you're safe and supported. Planned Parenthood may offer support. You could also look for abortion doulas in your area - many doulas I know offer free abortion support and there may be some around you doing this work covertly. I suggest looking up Birthing Advocacy Doula Training to find resources, workers or organizations in your area.
Abortion can mean different things to different people, and everyone's experiences or reasons will vary. I had my abortion because I was 19, broke, and in a terrible relationship - but I still mourned the loss of what I felt could have been my child. I felt guilty for having gotten pregnant and not being more careful with birth control. That being said, I'm incredibly grateful that I had abortion services in my area and people around me who were supportive.
On the flip side, my mother has had 3 abortions and thinks nothing of it. She never felt guilt, never looked back, only felt relief.
Everyone is different and I strongly suggest seeking emotional support before and after because you never know what kinds of things might come up. It may be difficult, or it may be easy - only you can determine your needs, values and responses.
I hope this was helpful. Again, please don't hesitate to reach out to me for questions or support, or if you see some info that isn't correct in this post. Stay safe, keep yourself informed, and know that your choice is the only one that matters.
