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
How developed is the embryo? At about 21 days, the embryonic heart begins to beat. Brain activity can be recorded at 40-42 days. By 7 weeks, within the time abortions can be done by this method, the developing fetus has arms and legs. See pictures of the way a baby develops here: http://www.visembryo.com/baby/index.html
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.
if you are considering having an abortion by pill, you should find out as much information as you can. Any abortion procedure is serious.
Abby Johnson, former Planned Parenthood director, discussed her experiences with the abortion pill which she took to terminate her pregnancy. She had had a previous surgical abortion. She describes her experience with medical abortion in the following way:
"They [Planned Parenthood] told me these were the pills that would start my bleeding and cramping…but nothing a few Ibuprofen couldn’t take care of. I was told after taking the pills at home that I would probably start bleeding in about an hour. So, I made myself comfortable on the bed and turned the TV on. Ten minutes later, I started to feel pain in my abdomen unlike anything I had ever experienced. Then the blood came. It was gushing out of me. I couldn’t wear a pad…nothing was able to absorb the amount of blood I was losing. The only thing I could do was sit on the toilet. I sat there for hours…bleeding, throwing up into the bathroom trashcan, crying and sweating. I used to watch shows about childbirth. I would see these women in labor and they would be covered in sweat. I would always think, “Gosh, do they keep it hot in the delivery room, or what?” But at that moment, sitting on the toilet, I knew it wasn’t from heat…it was from pain.
.... I filled the tub and climbed in. ... I opened my eyes after 15 minutes and was horrified. My bathwater was bright red. It looked like I was sitting in the middle of a crime scene....
I knew I had to get up and wash the blood off of me. I stood up slowly and straightened out my body. As soon as I was completely upright, I felt a pain worse than any other I had experienced. I began to sweat again and felt faint. I grabbed on to the side of the shower wall to steady myself. Then I felt a release…and a splash in the water that was draining beneath me. A blood clot the size of a lemon had fallen into my bath water. Was that my baby? ... I stood in the warm shower for a few minutes…feeling a little relief from the cramping. Then came the excruciating pain again...."
Abby Johnson goes on to say that her bleeding and cramping went on for eight weeks.
Her complete story can be found here: http://www.abbyjohnson.org/2011/10/tonsillectomy/
Is Abby Johnson's experience typical? It is hard to say. Few women are willing to talk about their abortions. However, other women have come out saying that they had terrible experiences with medical abortion. Here is another woman's experience:
"The initial injection made me very ill, I thought I was going to "get sick" all night, and that was just the beginning of the hellish torture I was about to endure over the next three weeks.... The doctor gives you 2 days of pills that will make you go into contraction. The doctor gave me 6 Percoset to help ease the pain. Sounds easy enough, right? WRONG! I was in agony for 6 hours for 2 consecutive nights. The pain made me scream in tortuous wails. I lay on my boyfriend's couch, the first night alone, and writhed, twisted and contorted my body praying that either I would die or the pain would stop. I called the emergency number they gave me and told them that the pain killers were not working. They said very callously that there was nothing more they could do for me, informing me that this is normal and to just wait it out. After two nights of what I thought would end this nightmare I began to bleed, a little. On the third day after the contractions I passed the first "tissue" mass. I thought, that's it, it's over, now I can begin to heal, right? WRONG! About one and a half weeks later while watching TV I began to feel very ill, and began to cramp up again. Thinking this must be normal (yeah right), at first I thought nothing of it. Within two hours I began to bleed very heavily. The bleeding became increasing worse; eventually I couldn't get off the toilet. I began to pass blood clots the size of golf balls, and yet another fleshy mass. The cramps became contraction and the bleeding became uncontrollable, I went through a pack of maximum strength maxi pads inside of 12 hours. While sleeping the first night I ruined three pairs of P.J. pants. I again called the emergency number the clinic provided me with and they said it was normal and to just wait it out."
The woman eventually had to seek medical attention to stop the bleeding. Her story can be found here: http://clinicquotes.com/site/story.php?id=772
I include these stories because a woman contemplating abortion should have access to all the information about the possible range of side effects and should know exactly what she may go through. Abortion by pill or injection is legal and will remain a choice for many women. 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