The new normal: Medication Abortion's future is at the comfort of your home

The new normal: Medication Abortion's future is at the comfort of your home

We've all spent the last year contemplating the "return to normalcy" in the aftermath of the epidemic. But our world is always changing, even when nothing appears to be out of the ordinary. Sometimes that shift manifests itself in the form of a spectacular, unexpected rupture; other times, it manifests itself more discreetly. What elements of the envisioned, far-off future could soon become a part of our everyday lives? We're asking policy experts, historians, biologists, economists, and artists to predict how society will change next - developments that previously appeared unthinkable but now appear feasible.


This has been the worst legislative year for abortion rights in the United States on record. More limitations will be imposed in 2021 than in any previous year since Roe v. Wade. In the most severe scenario, abortions after six weeks of pregnancy were prohibited in Texas. The Supreme Court may be on the verge of overturning Roe v. Wade. Nonetheless, despite efforts by certain governments to make clinic abortions more difficult to acquire, a rising number of individuals are utilizing abortion pills at home.


Medication abortion, which includes taking two tablets 24 hours apart to terminate pregnancies up to 10 weeks, is one of the easiest and safest treatments in medicine. Bleeding and cramps are caused by the tablets. Following that, a simple pregnancy test can confirm that the tablets were effective. However, for many people in the United States, getting these medicines is a challenge due to a slew of state-level limitations that prevent clinic access. With no federal or state assistance available, the cost of $300 to $800 is frequently borne by the individual.


Ironically, it is precisely these constraints that have spurred innovation in where and how individuals obtain drugs. When laws prevent access to abortion clinics, people frequently take matters into their own hands and self-manage their abortions outside of established health care settings. Indeed, some people prefer self-management; it provides convenience, privacy, and an option for those who doubt the traditional healthcare system. According to 2020 research, around 7% of U.S. women have attempted a self-managed abortion – in any form, including pills — at some point in their lives.

The use of medicines for self-abortion has increased in recent years. Aid Access, the first online telemedicine service to enable self-managed prescription abortion, was created in 2018 by an Amsterdam-based clinician. People submit a $110 donation and complete out an online consultation form, after which drugs are shipped to them. The program has received 57,506 inquiries in its first two years of existence, demonstrating the magnitude of demand.


At-home medication abortion may also become commonplace in the official healthcare system. Mifepristone has been subject to FDA limits on its use since its release in 2000. Many jurisdictions allow clinicians to phone consult with their patients and then mail drugs to them.


According to the authors, at-home methods of pharmaceutical abortion provide greater flexibility while retaining the same level of safety. They discovered that 98.8 percent of women terminated their pregnancies without additional medical intervention. Politics, not the medical establishment, is the most significant impediment to the acceptance of at-home medication abortion. Despite the lack of consultation with a doctor, these abortions are exceedingly safe and successful. The most serious hazards are legal, not medical.


The FDA has announced a comprehensive review of its mifepristone regulations, paving the way for a future in which one option for pharmaceutical abortion might be as simple as stepping into a drugstore and picking up tablets. Will we tolerate a two-tiered system based on Zipcode, in which some people have access to at-home services through the healthcare system while others face criminalization, or can we imagine a future in which everyone has access to a complete range of options? Abortion via medicine at home is here to stay. The issue is, what form will it take?