Quotes from Experts

Medication abortion

To help reporters covering the changing abortion landscape, SciLine asked experts about the fundamentals of medication abortion, an alternative to surgical abortion that is administered via a course of pills.

Journalists: Get Email Updates

What are Quotes from Experts?

May 4, 2022


How effective are medication abortions?


Claire Brindis, Dr.P.H.

“Research has shown us that medical abortions are as effective as surgical abortions, but we need to consider that we want to use medical abortion earlier in the pregnancy. So it’s effective, especially effective, up to ten weeks of pregnancy.” (Posted May 4, 2022 | Download Video)

Claire Brindis, Dr.P.H.
Founding director of the Bixby Center for Global Reproductive Health, University of California, San Francisco

Daniel Grossman, M.D.

“The most commonly used regimen for medication abortion in the United States involves two medications, mifepristone followed by misoprostol, which is approved by the U.S. Food and Drug Administration for use up through ten weeks of pregnancy. There is evidence about its safe use up until about eleven or even twelve weeks, but overall these medications are about 97 percent effective—meaning that about 3 percent of people who use them will need to have a vacuum aspiration or a procedural abortion to complete the abortion.” (Posted May 4, 2022 | Download Video)

Daniel Grossman, M.D.
Director, Advancing New Standards in Reproductive Health; professor, department of obstetrics, gynecology and reproductive sciences, University of California, San Francisco

Lauren Elizabeth Owens, M.D., M.P.H.

“Medication abortions are highly effective. The best data we have—and how I counsel my patients—is  that medication abortions are 95 plus percent effective.” (Posted May 4, 2022 | Download Video)

Lauren Elizabeth Owens, M.D., M.P.H.
Fellow, American College of Obstetricians and Gynecologists; assistant professor of obstetrics and gynecology, University of Michigan Medical School

What are the possible complications from medication abortions? Are they common?


Claire Brindis, Dr.P.H.

“We have found that medical abortions have had a very low incidence of any type of complications. Less than one percent—0.4 percent of women—experience any kinds of additional complications, such as heavier bleeding, low-grade fevers, and some additional pelvic pain that over time is eliminated.” (Posted May 4, 2022 | Download Video)

Claire Brindis, Dr.P.H.
Founding director of the Bixby Center for Global Reproductive Health, University of California, San Francisco

Daniel Grossman, M.D.

“Abortion using medications is very safe. This has been very well studied, and really millions of patients have now used it in the U.S. Serious complications are very rare, occur in less than half a percent. These include things like heavy bleeding, possibly requiring a blood transfusion—the risk of blood transfusion is less than one out of a thousand people who use the regimen. Infection similarly is very rare.” (Posted May 4, 2022 | Download Video)

Daniel Grossman, M.D.
Director, Advancing New Standards in Reproductive Health; professor, department of obstetrics, gynecology and reproductive sciences, University of California, San Francisco

Lauren Elizabeth Owens, M.D., M.P.H.

“Like any procedure in medicine, there are complications with medication abortion. I would say they’re extremely rare. So, it’s very unusual to have excessive bleeding that would require a transfusion, to have a medication abortion not be complete and to require another procedure, or to have infection that would require antibiotics. Those are probably the most common things that could happen with a medication abortion, but to call them common is really an overstatement. They’re extremely unusual.” (Posted May 4, 2022 | Download Video)

Lauren Elizabeth Owens, M.D., M.P.H.
Fellow, American College of Obstetricians and Gynecologists; assistant professor of obstetrics and gynecology, University of Michigan Medical School

How does the safety of telehealth medication abortions compare to medication abortions performed in a clinical setting?


Claire Brindis, Dr.P.H.

“Medical abortions have been shown to be extremely safe and effective, as comparable to surgical abortion, particularly early in the woman’s pregnancy. What is important to note is that an ironic outcome of COVID has been the pivoting to the use of telemedicine, which has been shown to be extremely effective in being able to provide these types of services to women in a very cost-effective and also patient-centered approach. So counseling can take place, other types of advice, following the procedure, and a lot of attention that women in the past might not have received when they were just going to their doctors’ offices for their medications or for the surgical abortion.” (Posted May 4, 2022 | Download Video)

Claire Brindis, Dr.P.H.
Founding director of the Bixby Center for Global Reproductive Health, University of California, San Francisco

Daniel Grossman, M.D.

“You know we’ve learned so much about telehealth during the COVID pandemic. Telehealth has expanded in really every area of medicine, including for providing medication abortion. And there are now several published studies, both from the United Kingdom and now from the United States, showing that safety and effectiveness outcomes are really pretty much identical with medication abortion provided by telehealth compared to in-person provision. So all of the evidence really points to this being safe and effective. So much so, in fact, that the FDA has endorsed the practice and says that this is an evidence-based practice.” (Posted May 4, 2022 | Download Video)

Daniel Grossman, M.D.
Director, Advancing New Standards in Reproductive Health; professor, department of obstetrics, gynecology and reproductive sciences, University of California, San Francisco

Lauren Elizabeth Owens, M.D., M.P.H.

“We know that telemedicine medication abortion is really equivalent to a clinical setting, as far as outcomes. We have really great data out of Iowa around that; we have great data from Dr. [Daniel] Grossman, [and] from Gynuity [Health Projects]. And I perform my care in Michigan, which is a state that does have telemedicine medication abortion, which is a great service to offer people, as folks who live rurally may have more barriers to care than other people.” (Posted May 4, 2022 | Download Video)

Lauren Elizabeth Owens, M.D., M.P.H.
Fellow, American College of Obstetricians and Gynecologists; assistant professor of obstetrics and gynecology, University of Michigan Medical School

How safe are medication abortions performed at home without medical supervision?


Claire Brindis, Dr.P.H.

“Based upon previous research, I don’t anticipate that there are many more complications for women using these medications at home to perform an early abortion. One thing that is very important to recognize is that many of these women are savvy consumers of knowledge and information. They will seek out advice either from friends who’ve already had one or from other internet resources that help them prepare for what to expect, first, before, during, and after.” (Posted May 4, 2022 | Download Video)

Claire Brindis, Dr.P.H.
Founding director of the Bixby Center for Global Reproductive Health, University of California, San Francisco

Daniel Grossman, M.D.

“People have been self-managing their abortions for hundreds, if not thousands, of years. The difference now, over the past few decades, is that people have the option of using these same medications—either mifepristone together with misoprostol or misoprostol used alone—which they may obtain online or from pharmacies in some countries or from a variety of sources, and all of the evidence that we have so far, particularly from other countries, indicates that self-managed abortion using these medications is very safe. And that people will seek care from a clinician if they have a question or concern about a complication. So as a physician I don’t have concerns really about the medical risks so much from self-managed abortion using these medications. I do have concerns about the legal risks that patients may take. We know that a number of people, more than twenty, have been arrested or prosecuted or even imprisoned for allegedly attempting to self-manage their abortion or for helping someone else self-manage their abortion.” (Posted May 4, 2022 | Download Video)

Daniel Grossman, M.D.
Director, Advancing New Standards in Reproductive Health; professor, department of obstetrics, gynecology and reproductive sciences, University of California, San Francisco

Lauren Elizabeth Owens, M.D., M.P.H.

“I really think medication abortion exists on a spectrum. So when we think about an—in quote—in-clinic medication abortion, folks are frequently getting a first pill in clinic and then taking the second pills at home. So even though that’s clinically done at the start, really the procedure is completed at home. When folks are self-sourcing medication abortion, there are many ways to do that, but there are some really great data with almost 3,000 folks showing that there are really similar outcomes with success as far as completion of medication abortion. And so like one percent or less than one percent rate of any serious adverse event occurring. And that’s really comparable with—quote—clinic-administered medication. An asterisk there is even with a clinic-administered initial medication, folks are taking the misoprostol, the other pills for medication abortion, at home.” (Posted May 4, 2022 | Download Video)

Lauren Elizabeth Owens, M.D., M.P.H.
Fellow, American College of Obstetricians and Gynecologists; assistant professor of obstetrics and gynecology, University of Michigan Medical School

What are the physical effects of medication abortions? Are any long-lasting?


Claire Brindis, Dr.P.H.

“The physical effects of using these medications are short-term. They really are only around the time of the abortion. And they’re not long-lasting in the women’s body. The physical ailments may be additional bleeding, cramping, but no further and long-term consequences of using these medications.” (Posted May 4, 2022 | Download Video)

Claire Brindis, Dr.P.H.
Founding director of the Bixby Center for Global Reproductive Health, University of California, San Francisco

Daniel Grossman, M.D.

“With medication abortion, the medications have the effect of causing cramping and bleeding that leads to expulsion of the pregnancy. I will say that the side effects of the regimen can be intense for some people, particularly the pain. In studies that have looked at this, the maximum pain level that people report on a scale from zero to ten can be seven to eight. And of course some people even have higher levels of pain. And I think that there’s more that we can do, there is more recent evidence about ways that we can address the pain. But it is something that’s really important to inform patients about. The medication can have other side effects like nausea, vomiting, diarrhea, sometimes people have fevers or chills right after taking particularly the second medication, misoprostol. In general these side effects are very short-lived, and there are no long-term risks. There are no risks to fertility in the future or risks of complications of a future pregnancy. These medications are very safe, and we have a great deal of experience with them now.” (Posted May 4, 2022 | Download Video)

Daniel Grossman, M.D.
Director, Advancing New Standards in Reproductive Health; professor, department of obstetrics, gynecology and reproductive sciences, University of California, San Francisco

Lauren Elizabeth Owens, M.D., M.P.H.

“So, medication abortion involves two medications. The first pill that folks can either take in clinic or have mailed to them is mifepristone. And I usually tell my patients they shouldn’t feel too different after taking that. They may have a little bit of nausea, but so many folks are already having nausea with their pregnancies. Then misoprostol, the second pills that folks can take at home, either in their cheek or vaginally or under their tongue, those medications’ job is to cause cramping and to help the uterus empty. That’s what they do during inductions of labor, that’s what they do for post-partum hemorrhage, and that’s what they do with medication abortion care, as well. So with that, patients can expect having cramping and bleeding, likely within four hours of taking those pills. Sometimes folks can get a little bit of a fever with them. But there really shouldn’t be long-lasting impacts for folks. I see a lot of patients who are worried about what having an abortion could mean for their future fertility, and medication abortion should not have any impact on future pregnancies.” (Posted May 4, 2022 | Download Video)

Lauren Elizabeth Owens, M.D., M.P.H.
Fellow, American College of Obstetricians and Gynecologists; assistant professor of obstetrics and gynecology, University of Michigan Medical School

Claire Brindis, Dr.P.H.


Daniel Grossman, M.D.


Lauren Elizabeth Owens, M.D., M.P.H.

Claire Brindis, Dr.P.H.
Founding director of the Bixby Center for Global Reproductive Health, University of California, San Francisco

None.

Daniel Grossman, M.D.
Director, Advancing New Standards in Reproductive Health; professor, department of obstetrics, gynecology and reproductive sciences, University of California, San Francisco

None.

Lauren Elizabeth Owens, M.D., M.P.H.
Fellow, American College of Obstetricians and Gynecologists; assistant professor of obstetrics and gynecology, University of Michigan Medical School

None.