Introduction

Global demand for medication abortion has surged in recent years. In many countries, it’s the most popular way to access abortion. Medication abortion gives patients greater privacy and flexibility. It expands access for patients without a local clinic or with lower incomes.

In the U.S., the most common form of medication abortion uses two kinds of pills:

• Mifepristone, which blocks the action of the hormone (progesterone) that supports the pregnancy.
• Misoprostol, which causes the cervix to dilate and the uterus to contract.

The World Health Organization (WHO) recommends the use of mifepristone followed by misoprostol. But it also recognizes that Misoprostol can be safe and effective on its own.

People can take abortion pills as soon as they know they’re pregnant. The two-pill regimen is approved by the FDA for up to 10 weeks, and by WHO for up to 12 weeks. Research has shown it to be effective until at least 12 weeks from the first day of the last menstrual period.  

Safety & efficacy

Medication abortion is safe and effective.

Medication abortion is effective at ending pregnancy more than 95% of the time. In rare cases, pregnant people may need additional doses or procedures.

Side effects are typically minor, and can include bleeding or cramping. Studies show that more than 99% of patients experience no serious side effects. The WHO even includes mifepristone and misoprostol on its list of essential medicines.

Advantages

There are many advantages to medication abortion.

Medication abortion can reach people who have otherwise limited access to abortion care. In many countries, it can be prescribed by non-physicians and via telemedicine. That makes it accessible to people who live far from clinics and providers. And it costs less on average than procedural abortion, reducing financial barriers to care.

Some people also report that medication abortion helps them feel more in control. Since abortion pills can be safely taken in non-clinical settings, patients are able to decide when and where their abortion takes place. They can be at home or in another private space, and they can choose who is there to support them.

Global use

Medication abortion is commonly used around the world.

The abortion pill mifepristone has been approved for use in nearly 100 countries. Across the majority of high-income countries, medication abortion accounts for at least half of all abortions. In some Nordic countries, that fraction is as high as 9 in 10.

In the U.S., the use of medication abortion has increased dramatically since the overturn of Roe v. Wade took away the constitutional right to abortion in 2022. As of 2023, over 60% of abortions in the U.S are medication abortions.

Attacks on medication abortion

Anti-abortion extremists are targeting medication abortion.

Medication abortion’s popularity has put it in the crosshairs of anti-abortion activists. In the U.S., the anti-abortion movement is pushing laws and policies that make it harder to get and use.

These laws and policies are not about protecting people’s health. They are about making it harder for people to get the care they need—making them less safe, rather than more.

Some common but unfounded restrictions on medication abortion are:

• In-person requirements. These laws may require patients to be examined by a doctor, to pick up their pills in-person, or to take the first dose of pills in a doctor’s office.
• Restrictions on telehealth or mailing pills. These laws explicitly prohibit abortion pills from being prescribed via telemedicine or sent through the mail.
• Physician-only requirements. These laws prevent physician assistants and other qualified health care professionals from prescribing medication abortion
• Gestational duration limits. Some states and countries limit how late into a pregnancy medication abortion can be used, contrary to the scientific evidence on its safety and efficacy.
• Misinformation on “reversal.” Some states require that prescribers give patients medically inaccurate information about the possibility of “reversing” a medication abortion.

General abortion restrictions also impact the use of medication abortion. Some states require mandatory biased counseling, where patients are often given additional misinformation about abortion. Many states also enforce waiting periods, which means that a patient cannot get abortion treatment for a certain number of hours after counseling—necessitating two separate trips to a provider.

Learn more about attacks on medication abortion in the U.S here.

Expanding access

Better laws and policies can expand access to medication abortion.

At the Center, we’re working on breaking down barriers to medication abortion. We’ve developed a list of laws and policies that can help. To increase access, governments should:

• Ensure medication abortion is widely available.
• Explicitly permit medication abortion whenever the evidence supports its safe and effective use.
• Let providers prescribe abortion pills via telemedicine.
• Allow physician assistants, advanced practice registered nurses, and other qualified non-physicians prescribe medication abortion.
• Remove in-person requirements for medication abortion.
• Remove counseling requirements and mandatory waiting periods.
• Prevent physicians from spreading misinformation on “reversal.” 

Learn more