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Medication abortion is a common, safe, and effective way to end a pregnancy up to 70 days (10 weeks) after the pregnant person’s last menstrual period (LMP). Since its approval by the FDA in 2000, medication abortion has grown increasingly popular; the most recent estimates show that approximately 60% of individuals who are ≤10 weeks pregnant choose to have a medication abortion (as opposed to an in-clinic procedure).[i]

Medication abortion consists of two forms of medication. First, the pregnant person takes 200 milligrams of mifepristone, a progesterone blocker which stops the pregnancy from growing. Then, 24 to 48 hours later, the pregnant person takes 800 micrograms of misoprostol inserted buccally (placed between the mouth’s cheek and gum) or vaginally, which causes the uterus to contract and empty.[ii]

Medication abortion is effective 95% of the time; when it is not effective, more medication or an in-clinic procedure is required to remove the pregnancy tissue.[iii] The rate of serious complication, including hospitalization or blood transfusion, due to medication abortion is 0.4%.[iv] In contrast, the rate of significant complication due to cesarean section is 3.6%.[v] The risk of dying from carrying to term and childbirth in the United States (0.009%) is 14 times greater than the risk of dying from complications due to mifepristone (0.0063%).[vi]

We at NARAL Pro-Choice Maryland stand with all people in their right to determine if, when, and how they choose to parent. Intrinsic to this right is the necessity to remove all unwarranted restrictions which make medication abortion—and abortion care in general—inaccessible, including the Food and Drug Administration’s (FDA) current Risk Evaluation and Mitigation Strategies (REMS) restrictions on mifepristone. REMS do not make mifepristone safer or more efficacious. Indeed, the burden created by the medication’s REMS program—and additional regulations from the states—are all the more problematic considering that the majority of folks who seek abortion care are low-income. Unfortunately, unnecessarily requiring folks to drive across states or get a hotel or pay for childcare stops people from getting the abortion care they want and need every day.

We stand with many other organizations, including the American Medical Association (AMA) and the American College of Obstetricians and Gynecologists (ACOG), in calling on the Biden/Harris administration and the FDA to lift the mifepristone REMS.[vii],[viii]

 

[i] Jones, Rachel, Elizabeth Witwer, and Jenna Jerman. 2019. “Abortion Incidence and Service Availability in the United States, 2017.” New York: Guttmacher Institute.

[ii] Cleland, Kelly, and Nicole Smith. n.d. “Aligning Mifepristone Regulation with Evidence: Driving Policy Change Using 15 Years of Excellent Safety Data.” Contraception 92: 127–81.

[iii] Donovan, Megan. 2018. “Self-Managed Medication Abortion: Expanding the Available Options for U.S. Abortion Care.” Guttmacher Policy Review 21: 41–47.

[iv] Raymond, Elizabeth, Caitlin Shannon, Mark Weaver, and Beverly Winikoff. 2013. “First-Trimester Medical Abortion with Mifepristone 200 Mg and Misoprostol: A Systematic Review.” Contraception 87: 26–37.

[v] Creanga, A. A., Bateman, B. T., Butwick, A. J., Raleigh, L., Maeda, A., Kuklina, E., & Callaghan, W. M. 2016. “Morbidity Associated With Cesarean Delivery in the United States.” Obstetric Anesthesia Digest, 36(3), 138.

[vi] Cleland, Kelly, Mitchell Creinin, Deborah Nucatola, Montsine Nshom, and James Trussell. 2013. “Significant Adverse Events and Outcomes After Medical Abortion.” Obstetrics & Gynecology 121 (1): 166–71.

[vii] American Medical Association (AMA), Ending the Risk Evaluation and Mitigation Strategy (REMS) policy on mifepristone (Mifeprex), Policy H-100.948, 2018,

[viii] American College of Obstetricians and Gynecologists (ACOG), ACOG statement on medication abortion, news release, Washington, DC: ACOG, Mar. 30, 2016,

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