Are You Considering an At-Home Abortion?
(Also known as In-Home Abortion, Self-Managed Abortion, Online Abortion, DIY Abortion)
Are you looking for a simple way to terminate your pregnancy without the expense of surgical abortion? If so, you may be thinking about the abortion pill. It can now be ordered online in the U.S. and worldwide without medical supervision and delivered to your home. Taking the pill at home may seem like an easy solution to an unwanted pregnancy, but do you wonder about the quality and effectiveness of medication you can order online? Do you have questions about how far along you are and your abortion options? Your decision about your pregnancy affects your well-being, reproductive health, and requires a lot of thought. If you want to talk with someone who cares and won’t profit from your decision either way, please click below to chat or to make an appointment to learn more.
At-Home Abortion is the process of ordering over the internet the abortion medications used in medication abortion, also referred to here as the abortion pill or chemical abortion, to terminate an early pregnancy. How does it work?
- Order the abortion pill(s) from one of at least 72 websites that will send the pills to your home.
- Receive the pill(s) through the mail. (Two pills generally comprise the medication abortion, but some online services only provide one pill)
- Follow specific instructions to take the pill(s) on your own at home, or wherever you choose.
- Experience your own abortion at home.
If you’re reading this, you may think you’re pregnant, have a lot on your mind, and abortion at home sounds like a simple solution. As with any medication or medical procedure, at-home abortion comes with risks and side effects. Before you order abortion medications over the internet where medical care by an M.D. or healthcare provider is not offered, please take this short quiz:
- I know the names of the first and second medications in a medication abortion (or abortion pill). I know what each pill does and its effectiveness/risks. __YES __NO
- I have verified my pregnancy with professional pregnancy testing and an ultrasound scan with my doctor or in a clinical setting to determine how far along (weeks’ gestation) I am in pregnancy, and that my pregnancy is growing in the uterus. __YES __NO
- I’ve previously purchased medications from the online source I’m planning to buy the abortion pill from and am satisfied with the quality and effectiveness. __YES __NO
- I've decided to have this abortion at home and I’m not feeling pressured to do it. I have the support of my partner and/or family and friends and will not experience my at-home abortion alone. __YES __NO
- I have a doctor or other medical help on standby, and an available local emergency room in case of excessive cramping, hemorrhaging, or another emergency. __YES __NO
If you didn’t answer YES to ALL five questions, please learn more by reading the information presented here before you order abortion medications online.
Let’s Define Abortion
There are two main categories of abortion methods: (accordion info below)
- Surgical abortion(a) is a surgical intervention that terminates a pregnancy by detaching and removing the developing embryo from the uterus. It is performed by an M.D. or abortion provider in a doctor’s office, clinic, or operating room. Two of the most common types of surgical abortion are suction, or vacuum aspiration, and dilation and evacuation (D&E).
- Medication abortion(b), the abortion pill, or chemical abortion, involves taking two oral medications in early pregnancy. First, oral mifepristone (Mifeprex) is taken, causing the lining of the uterus to thin and preventing the embryo from staying implanted and growing. This is followed immediately or up to two days later by the second oral medication called misoprostol, which causes the uterus to contract and expel the embryo through the vagina. An M.D. or health care provider usually administers the first pill and follows up with the patient during and after the abortion process, which can take from five hours to a week or more.
At-Home Abortion uses the medications in the medication abortion,(c) or the abortion pill. Because the medications are ordered from an online pharmacy or another online source, received by mail, and not dispensed by a physician or in a clinic, there are questions and risks involving quality, effectiveness, and follow-up care in the event of an emergency. At-home abortion with abortion pill(s) received from an internet provider is riskier than pills received in the mail from your physician or an abortion clinic that dispenses the pills with medical supervision and follow-up.
Is At-Home Abortion for Me?
At-Home Abortion is less expensive than surgical abortion and may seem more convenient because in theory, you can experience the process at home or wherever you choose and order the pills confidentially online.
Since the pills can be confidentially mailed to your home and taken while you relax in bed or on the couch, you may think of this as a DIY project. DIY may be a popular trend right now and a fun way to highlight your hair or create new clothes at home, but it may not be the best idea when trying to manage a medical procedure like this that can last for weeks and is usually associated with intense pain, nausea, vomiting, and heavy bleeding.
Medication abortion can take from a few hours up to two weeks to finish the abortion process, so it’s impossible to predict where you will be when intense bleeding and pain occur.
Please seek accurate information and the answers to these questions before choosing an at-home abortion:
(all the bullets under each heading could be accordioned)
- How far along am I?
- Do you know for sure if you’re pregnant? If you took a home pregnancy test, it’s important to verify your pregnancy and estimated due date with accurate, professional pregnancy testing.
- Often women don’t have an accurate idea of their due date. Donna Harrison, M.D. and author states, "If a woman thinks she's 10 weeks pregnant but is 13 weeks, she's just increased her risk from one in 20 to one in three that a Medication Abortion will cause adverse events(d) such as heavy bleeding, hemorrhaging or a painful, incomplete abortion and possible surgical intervention.” (this point could be emphasized in a box or pop-up window)
- If cost is an issue, your local medical pregnancy help center (or our center) provides free pregnancy testing and ultrasound services to determine the age and viability of your pregnancy. (Request an Appointment)
- Do I know for sure if the pregnancy is growing in my uterus?
- It’s important to have an ultrasound scan to determine how many weeks of pregnancy.
- A small percentage of pregnancies develop abnormally in the fallopian tubes (dd) rather than the uterus. This is known as an ectopic pregnancy and one in 40 pregnancies are ectopic.
- Without an ultrasound scan, it’s impossible to know if the pregnancy is growing normally in the uterus. If you take abortion pills with an ectopic pregnancy, you may think that the intense pain and bleeding are from a normal medication abortion. More likely, it’s from a rupture of the fallopian tube. Some women taking the abortion pill have died from unrecognized, rupturing ectopic pregnancies, which present dangerous risks to a woman’s health if undetected.
- According to an article published in the journal Contraception (e), medical abortions performed without a prior ultrasound scan were more likely to be incomplete and require follow-up surgery.
- Your local medical pregnancy center (our center) provides free pregnancy testing and ultrasound scans. (Request an appointment)
- Is there a doctor, nurse practitioner, or medical provider I can talk to first?
- Before taking the abortion pill, see a licensed medical provider who can diagnose or warn you of any complications based on your medical history or current medical status.
- In the event of an adverse reaction to a medication abortion carried out at home, it’s crucial to have a physician or nurse practitioner available to call.
- If you don’t have the financial resources for physician care, consider choosing a pregnancy medical center (like ours) that offers free services and does not profit from your decision to end your pregnancy at home.
- Where are the pills coming from? What am I getting in the mail?
- A study from the Charlotte Lozier Institute(f) states there are at least 72 unique websites that currently sell the abortion pill online. There is no screening before prescribing or assessment of how far along you are in pregnancy when purchasing from these websites.”
- Many of these websites are outside of the United States. According to Donna Harrison, M.D., and author, “They (websites) are not regulated and there is no guarantee what drug or dosage will be received, or if the package will be damaged. Some sites only send the second pill, misoprostol, which often causes birth defects when the baby survives the abortion attempt.”
- Some women have reported that their online sources provided only misoprostol along with an antibiotic and an anti-anxiety pill with no labeling or instructions about each pill or how to take it.
- Have I discussed this with anyone or am I trying to keep this a secret?
- Sometimes an unwanted pregnancy causes shame and secrecy. Are you trying to keep this a secret from your partner, family, or friends?
- It may feel like your world is falling apart because of this crisis, but this is the time to reach out for help so you can decide without shame or panic. Take a deep breath and talk to a trusted friend or family member.
- You’re not alone. There is help available. Check out athomeabortionfacts.com (g). Sarah Bowen, from the website, shares this, “If you’re ordering pills online and feel like you have to hide it from everyone, ask yourself ‘why am I doing it?’”
- Am I being pressured to have an At-Home Abortion?
- If you’re feeling pressured by a friend, partner, family member, or employer to keep your pregnancy a secret and have an abortion at home by ordering pills online, please reach out and talk to someone.
- Nobody can force you to have an abortion. It’s called coercion and it’s illegal in all 50 states in the U.S. Many places can help you have a safe and healthy pregnancy, care for you, and watch out for you. Contact optionline.org (h) to find out more.
- What if I Change My Mind?
- If you take the first pill (mifepristone) and then change your mind about going through with the abortion, help is available. Christa Brown, BSN, RN, LAS of abortionpillreversal.com(i) states, “Abortion pill reversal protocol was created to assist women who have taken mifepristone and would like to continue their pregnancies. However, we receive calls from women who have taken both mifepristone and misoprostol. We have protocols to help them as well.” Please call (877) 558-0333 within 24 hours of taking either of the pills.
- These medications prescribed for medical or non-surgical abortions are classified by the National Institute of Occupational Safety and Health (NIOSH) as hazardous medications due to their reproductive risk and should be disposed of properly.
- Your local medical pregnancy help center (our center) can help you talk through your emotions and concerns about this process.
What Are the Risks/Side Effects of Medication Abortion?
“Abortion is a medical intervention and taking pills at home doesn’t change the magnitude of the intervention a woman is undertaking—and now she’s doing it all alone.” Dr. George Delgado, M.D., F.A.A.F.P.
The Mayo Clinic(k) lists the following possible risks or complications from medication abortion:
- Incomplete abortion, which may need to be followed by surgical abortion
- An ongoing unwanted pregnancy if the procedure doesn’t work
- Heavy and prolonged bleeding
- Digestive system discomfort
A study, published in the Journal of Obstetrics and Gynecology, (L) followed abortion outcomes in Finland, where all pregnancy outcomes are accurately documented. The study compares the risk of complication following both surgical and medication abortions (referred to as chemical):
The overall risk of an adverse event following an abortion
- Chemical = 20% of patients (1 of 5)
- Surgical = 5.6% of patients (1 of 20)
Risk of Hemorrhage
- Chemical = 15.6% (1 in 6)
- Surgical = 2.1% (1 in 50)
Risk of incomplete abortion
- Chemical = 6.7% (1 in 15)
- Surgical = 1.6% (1 in 60)
Risk of emergency surgery
- Chemical = 5.9% (1 in 15)
- Surgical = 1.8% (1 in 60)
Medication abortion has also caused:
- Thousands of adverse events, including 768 hospitalizations and 24 deaths since 2000 according to data published in 2018 by the FDA (m).
- A recently published study(n) cites severe side-effects, including heavy bleeding, intense pain, and some deaths.
- The need for emergency room visits(o) for complications for an average of 5-8% of women taking these chemicals.
There are discrepancies in the reporting of adverse events(p) from the abortion pill by abortion providers which call abortion at home “Safer than Tylenol,” “Completely safe, effective, pain-free and infection-free,” “Harmless and successful.” However, in the best of cases there is pain, cramping and bleeding for a day to weeks after taking the abortion pill. The worst of cases involve hemorrhaging, incomplete abortion, and emergency surgery.
The American Pregnancy Association(q) cautions against medication abortion in these situations:
- You are too far along in your pregnancy. You shouldn't attempt a medical abortion if you've been pregnant for more than nine weeks (after the start of your last period). Some types of medical abortions aren't done after seven weeks of pregnancy.
- Have an intrauterine device (IUD).
- Have a suspected pregnancy outside of the uterus (ectopic pregnancy).
- Have certain medical conditions. These include bleeding disorders; certain heart or blood vessel diseases; severe liver, kidney, or lung disease; or an uncontrolled seizure disorder.
- Take a blood thinner or certain steroid medications.
- Can’t make follow-up visits to your doctor or don’t have access to emergency care.
- Have an allergy to the medications.
What are U.S. Food and Drug Administration (FDA) Guidelines for Online Sale of Abortion Pills?
In December 2019, partially in response to COVID-19 restrictions, the FDA permanently lifted a major restriction on access to abortion pills,(r) which now allows patients to receive the medication by mail instead of requiring them to obtain the pills in person from specially certified health providers.
While this makes it easier for you to have access to the abortion pill, it also opens the door for online services not certified by the FDA to provide abortion access over the internet. Some of these online services are not pharmacies and are operating in other countries. Please beware of purchasing the abortion pill online. Use an online pharmacy you’re familiar with, and check that they meet the FDA qualifications(s) as a health care provider.
This is the published FDA Risk Evaluation and Mitigation Strategy (REMS) (t) regarding purchasing the abortion pill online: (accordion the info below)
- Mifeprex must be ordered, prescribed, and dispensed by or under the supervision of a healthcare provider who prescribes and who meets certain qualifications;
- Healthcare providers who wish to prescribe Mifeprex must complete a Prescriber Agreement Form before ordering and dispensing Mifeprex;
- Mifeprex may only be dispensed in clinics, medical offices, and hospitals by or under the supervision of a certified healthcare provider;
- The healthcare provider must obtain a signed Patient Agreement Form before dispensing Mifeprex.
Do Not Buy Mifeprex or its Approved Generic Over the Internet
You should not buy Mifeprex or its approved generic over the Internet because you will bypass important safeguards designed to protect your health.
Mifeprex and its approved generic have special safety restrictions on how it is distributed to the public. Also, drugs purchased from foreign Internet sources are not the FDA-approved versions of the drugs, and they are not subject to FDA-regulated manufacturing controls or FDA inspection of manufacturing facilities.
To learn more about buying drugs safely, please see Buying Prescription Medicines Online: A Consumer Safety Guide [PDF]
You’re In Charge of Your Reproductive Health
Whatever your decision regarding at-home abortion, take advantage of the support available to you. You may have more questions like the ones listed below. If so, please reach out to your local medical pregnancy center (our center) or any of the resources listed below. It’s your choice to protect your body and your reproductive health.
- What if only one pill arrives in the mail? Is it misoprostol? Are the pills labeled?
- What if my pregnancy is further along than I thought—beyond 10 weeks—and I only take the misoprostol pill? Will I have a live birth? What should I do?
- What if I’m having heavy vaginal bleeding, hemorrhaging, or having other complications? Who can I call and where can I go?
- What if I change my mind after taking the first pill?
- What if I’ve decided to continue with the pregnancy but need help getting free pregnancy testing and an ultrasound scan?
Help and a listening ear are a phone call or click away. Contact any of the resources listed below.
- At Home Abortion Facts
- Option Line
- Abortion Pill Reversal Network
- Your local pregnancy center (our center)
Links to References