by Sarah Terzo

Created on: November 19, 2008   Last Updated: January 16, 2009

When most people think of abortion, they think of a surgical procedure, usually performed in clinics. However, there is another type of abortion, a medical abortion.

These abortions generally have two stages. First, a drug is used to stop the development of the embryo. Mifespristone is given in pill form. It is also called RU-486. Another alternative is methotrexate, which is given by injection. Either one of these drugs, when administered, will kill the developing embryo. Once the embryo has died, however, a second drug must be given. A prostaglandin vaginal suppository triggers the woman's body to expel the pregnancy in what is essentially an induced miscarriage. This type of abortion is generally only effective in the first seven to nine weeks of pregnancy.

According to the Alan Guttmacher institute, medical abortions accounted for 13% of all reported abortions in 2004, with all others done by surgery. Nationwide, there were roughly 170,000 that year. 1

Women choose medical abortion over surgical abortion for various reasons. The trauma of surgery is avoided. The woman does not have to deal with navigating through anti-abortion protestors; she can spend little or no time in a clinic. Some women feel that medical abortions allow more control and privacy.

Another advantage is that medical abortion is very effective early on in pregnancy. Many clinics will not do surgical abortions before six weeks because the products of conception are so small that they can be missed by the suction machine's cannula. A woman can have a medical abortion as soon as she knows she is pregnant, thus eliminating the need to wait.

There are also disadvantages to the medical approach. Intense and very painful cramps are common. The abortion process takes much longer. And the woman will have to deal with the aftermath of her decision. Depending on how far along her pregnancy is, she may see her aborted embryo, which may, in some circumstances, be developed enough to have arms and legs, hands and feet, etc.One example of such an occurrence was documented in a 1995 Newsweek article which discussed the RU-486 abortions of several women. 2

There is some debate as to the safety of medical abortions. There is a possibility of infection, and several women have died. One highly-publicized death was that of Holly Patterson, 18, who died after taking RU-486 in 2003. Her father, who was not aware of Holly's abortion until she lay dying in a hospital outside of San Francisco, has spearheaded a campaign to ban this drug.

Medical abortion remains a legal abortion method, and will most likely continue to be. With more and more doctors willing to prescribe the abortion pill, it may become more common in the future.

1. Jones RK et al., Abortion in the United States: incidence and access to services, 2005, Perspectives on Sexual and Reproductive Health, 2008, 40(1):6-16.

2. Debra Rosenberg and Michele Ingrassia "Blood and Tears" Newsweek Sept 18, 1995. Vol 126, Issue 12

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