Mail-order abortion pills safe and effective: Study

Medicinal abortion pills (mifepristone and misoprostol) are effective and have a low risk of serious adverse events when mailed to patients, a new study shows.

The study was published in a peer-reviewed publication on Monday JAMA Internal Medicinelooks at the experiences of more than 500 people who wanted to end their pregnancies between January 2020 and May 2022.

Researchers conducted a cohort study of patients at 11 abortion clinics and primary care clinics across seven states.

Eligible participants were seeking medical abortion within 63 days of pregnancy, spoke English or Spanish, and were at least 15 years old.

“After assessing eligibility for medical abortion through in-person screening, mifepristone and misoprostol were prescribed using mail-order pharmacies,” the study authors wrote.

Daniel Grossman, a professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the University of California, San Francisco and co-author of the study, said participants were required to undergo screening to comply with U.S. Food and Drug Administration regulations. .

In 2020, the FDA required that mifepristone be dispensed directly in clinics, doctor’s offices, and hospitals, and researchers had to obtain special permission from the FDA through an investigational new drug application to conduct research.

“At the time, the FDA refused to approve the IND protocol unless the patient underwent an ultrasound or physical exam,” Grossman told The Hill via email. “Therefore, the focus of our study was to specifically examine whether there is a difference in outcomes depending on whether the drug is dispensed in person or by mail.”

The study found that most participants received their pills in the mail three days after enrolling in the study, and only five received a second package after a shipping delay occurred.

Complete medical abortion occurred in 499 of 510 participants, including 27 who received additional doses of misoprostol.

“This compares favorably with the 97.4% complete abortion rate stated on the mifepristone label,” the study said.

A total of 11 participants had unsuccessful medical abortions, and 10 of them underwent vacuum aspiration for incomplete abortion or continuation of pregnancy, the study authors wrote.

And one participant chose to continue the pregnancy after taking the drug and “reported that she subsequently delivered a healthy newborn without complications.”

Among all participants, 24 adverse events occurred that were “probably, probably, or definitely” related to medication abortion.

These events included unscheduled hospital visits for symptoms such as bleeding, pain, nausea, vomiting, infection, and diarrhea, the study said.

Seventeen of these events involved emergency room visits, 10 of which resulted in treatments such as pain medications, antibiotics, intravenous fluids, or vacuum suction for incomplete abortions.

Three people suffered serious adverse events, all requiring hospitalization, the study added. One received a blood transfusion after bleeding during an incomplete abortion, one was given antibiotics for an infection during an incomplete abortion, and one “received no treatment.”

Almost all participants in this study said they were satisfied or somewhat satisfied with mail-order pills and would use this method again if needed.

The researchers wrote that the findings support the U.S. Food and Drug Administration’s 2023 decision to eliminate in-person dispensing requirements for mifepristone. According to , misoprostol is already available by prescription at most pharmacies. American College of Obstetricians and Gynecologists.

“This care model is particularly helpful for primary care providers who are interested in providing medication abortion but face difficulty stocking mifepristone in their offices,” Grossman said in an email. Stated.

“The ability to prescribe medications at local retail stores or mail-order pharmacies makes service delivery much easier.”