Medication Abortion Up to 70 Days of Gestation

Abstract

Medication abortion, also referred to as medical abortion, is a safe and effective method of providing abortion. Medication abortion involves the use of medicines rather than uterine aspiration to induce an abortion. The U.S. Food and Drug Administration (FDA)-approved medication abortion regimen includes mifepristone and misoprostol. The purpose of this document is to provide updated evidence-based guidance on the provision of medication abortion up to 70 days (or 10 weeks) of gestation. Information about medication abortion after 70 days of gestation is provided in other ACOG publications (1).

Barriers to abortion provision in primary care in New England, 2019–2020: A qualitative study

“…We hypothesized that social stigma, colleague opposition, and government regulations, including the mifepristone REMS, would affect trained clinicians' ability to provide abortion. We also hypothesized that a perceived need for routine in-house ultrasound would be a barrier; though notably, the Society of Family Planning and American College of Obstetricians and Gynecologists clinical guidelines support an ultrasound-as-needed protocol for medication abortion [24] .…”

Impact of COVID-19 on abortion method under ten weeks gestational age in Southern California

“…During the first 10 weeks of gestation, there are 2 options for an induced abortion or management of an early pregnancy loss- either medication management or suction aspiration, sometimes called dilation and curettage. The medication abortion regimen most commonly used consists of mifepristone taken in the clinic (if available) and misoprostol taken at home 24-48 hours later 9 . A repeat ultrasound has often been required at many clinics, including at our study heath centers, although SFP guidelines also support follow-up after medication abortion by an in-person assessment, hCG testing, and/or by telephone 9 .…”

“…The medication abortion regimen most commonly used consists of mifepristone taken in the clinic (if available) and misoprostol taken at home 24-48 hours later 9 . A repeat ultrasound has often been required at many clinics, including at our study heath centers, although SFP guidelines also support follow-up after medication abortion by an in-person assessment, hCG testing, and/or by telephone 9 . Even with 2 appointments, medication abortion could require less overall time in clinic than a suction aspiration, which could influence a person's decision making.…”

“…Even with 2 appointments, medication abortion could require less overall time in clinic than a suction aspiration, which could influence a person's decision making. Alternatively, some patients may elect for a suction aspiration because it has a higher success rate, causes less bleeding than medication abortions, and typically does not require a follow-up visit 9 .…”

Making the case for advance provision of mifepristone and misoprostol for abortion in the United States

“…Currently there are several new models of medication abortion provision that remove in-person visits and pre-abortion ultrasound, as recommended by professional groups,9 10 and are being implemented globally. These models include implementation of a no-test protocol, mail order, and pharmacy provision; research indicates these models are safe, effective and acceptable to patients 8 11–17.…”