Abortion with Pills: What is it?

Abortion can be, arguably, one of the most challenging topics to discuss with young people. And yet, abortion, like so many other aspects of human existence, is a normative part of the life cycle and sexual health. It is estimated that one in four people with a uterus will have an abortion at some point in their lives. These odds increase the likelihood that a young person will either know someone who has had an abortion, or will elect to have one themselves. For this and other reasons, learning and having healthy conversations about abortion with your child is of utmost importance.

There are many misconceptions surrounding abortion that must be cleared up before any meaningful conversation on the topic can take place. To begin, abortion occurs when a pregnancy—any pregnancy—stops developing. This can be either voluntary or spontaneous, such as in the case of a miscarriage. If a person chooses to have an abortion, they will either pick a surgical or medical abortion procedure. Emergency contraception, or “Plan B,” does not cause an abortion and is different from a medical abortion. Emergency contraception can, if taken within 72 hours of unprotected penile-vaginal sex, prevent a pregnancy from occurring. It cannot, however, stop a pregnancy once it has already started.

A surgical abortion is a short procedure—usually 10 to 15 minutes long—that takes place in a clinic or hospital, and is performed by a medical professional. During the procedure a person is given anesthesia, and a small tube is used to gently suck the developing pregnancy (called an embryo or fetus) from the uterus through the vagina.

Medication abortion involves the use of a specific type of medication to end a pregnancy. People are often prescribed two different medicines by their doctor. These pills are called mifepristone and misoprostol. Research shows that misoprostol alone also can be very effective.The two medicines work by stopping a pregnancy from growing, and then causing cramping and bleeding to empty the uterus through the vagina. For some people, a medication abortion may feel similar to a very heavy period. For others, especially if they usually have light periods or no cramps, medication abortion may feel more intense.

Many people seeking medication abortion visit a family planning or abortion clinic to get these pills. Often the person will take the first pill at the clinic and then take the next one at home. In some places, people can get the pills from their pharmacy or sent to their home, after an online visit with a doctor.

Another type of medication abortion is called self-managed abortion. A self-managed abortion is one in which a person obtains mifepristone and misoprostol, or just misoprostol alone, without the help of a clinic or doctor. People often find the specific dosage information from a trusted source like the World Health Organization (WHO).

There are lots of reasons why someone might choose self-managed abortion. Self-managed abortion might give a person more control over the timing and location of their abortion. Some might choose a self-managed abortion because they didn’t have good experiences going to a doctor or clinic in the past, others might want more privacy than they might get from visiting a clinic or doctor. Others might simply want to choose who they want to support them during their abortion. And in some places a self-managed abortion might be more affordable. For some people, there are laws that restrict abortion where they live and they cannot travel to a clinic or doctor outside their state or region to get the medication. We don’t always know a person’s circumstances or why they may choose to self-manage their abortion. But for many people, self managed abortion helps them to feel safe and in control of their situation.

States’ laws vary as to whether or not parental permission is required for a young person to receive an abortion, or even if abortion is available at all. In some states parental notification is necessary for a young person to receive an abortion. Ideally, young people will talk with a parent or caregiver when making a decision about an unplanned pregnancy. That said, teens are much more likely to use adult counsel when they trust that they will not be shamed or judged for having had an unintended pregnancy in the first place and when they feel fully supported in their decision-making process. Fear, mistrust and doubt are three major factors in preventing young people from reaching out when in a vulnerable situation.

Voluntary abortion is, above all else, a medical procedure. People have abortions for a wide range of reasons, and the choice can be easy or difficult, depending on a whole host of factors. In any case, the decision to parent or not parent lies firmly with the person who is pregnant. In the case of a young person, having a caring and trusted adult available is crucial to helping them make the best decision for themselves.

CONVERSATION STARTERS

When parents and caregivers engage in open and honest conversations with children about abortion, it lessens the shame and stigma that may come with experiencing an unintended pregnancy. Bringing up abortion as a topic even before it needs to be considered can be a useful way to normalize pregnancy loss, and to let your child know that you are available for any questions or concerns they may have. Engaging in early conversations about abortion—and pregnancy more generally—shows that you value your child’s developing autonomy, and respect their ability to make sound, responsible and informed decisions.

Ideally, your children will look to you as the trusted adult they can come to if they experience an unintended pregnancy. Be open to hearing what they have to say, and avoid projecting your judgments or plans onto them, regardless of your personal values related to abortion.