How do abortion pills work? Here’s what doctors say

5 mins read
abortion pills

When a woman takes an abortion pill, she is, more often than not, unaware of exactly what will happen — and what she will see, according to medical experts.

Three obstetrician-gynecologists spoke with Our Sunday Visitor about the reality of abortion pills ahead of a Texas judge’s decision in a lawsuit that challenges the U.S. Food and Drug Administration’s (FDA) approval of these abortion drugs.

The FDA first approved mifepristone, which is paired with another drug called misoprostol, for earlier abortions in 2000. Permitted for use up to 10 weeks of gestation, this type of abortion is also known as the abortion pill, chemical abortion, medication abortion or telemedicine abortion.

Today, it accounts for more than half of all U.S. abortions, according to the Guttmacher Institute, a reproductive research organization once associated with Planned Parenthood.

Women, doctors say, are not fully informed about it.

“When I did abortions — and when they do abortions today — they always tell you you’ll be fine afterward,” Dr. John Bruchalski, author of “Two Patients: My Conversion from Abortion to Life-Affirming Medicine,” said.

Dr. Ingrid Skop, senior fellow and director of medical affairs for Charlotte Lozier Institute (CLI), which filed an amicus brief in the Texas lawsuit, and Dr. Christina Francis, board member and CEO-elect of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), a plaintiff in the Texas case, said that women are told it is “safer than Tylenol.”

The reality, they say, is different.

How abortifacient pills work

Skop, who practices in Texas, described this type of abortion as consisting of two pills: mifepristone (also known as Mifeprex or RU-486) and misoprostol (also known as Cytotec).

The first pill, mifepristone, is the one that usually ends the life of the baby in the womb, stressed Francis, who practices in Indiana. It works by interfering with a key hormone in early pregnancy called progesterone, she said, and cuts off the flow of nutrients and oxygen that the baby needs.

The second step, misoprostol, essentially induces labor, according to Francis, so that the unborn baby comes out of the woman’s body. Usually taken 24-48 hours after mifepristone, this pill causes a woman’s uterus to contract, softens the cervix, and allows for the expulsion of the baby and other pregnancy-related tissues, she said.

Dr. John Bruchalski, who once performed abortions and is the founder of Divine Mercy Care, a non-profit to advance pro-life healthcare, and Tepeyac OB/GYN, a pro-life faith-based obstetrics and gynecology practice, emphasized how abortion pills harm both woman and baby.

“It’s about starvation and abandonment,” Bruchalski, who practices in Virginia, said. “You starve the pregnancy with the first pill … and you abandon the woman to go back home to have the abortion by herself or with minimal support.”

With abortion by pill, and with all abortions, Bruchalski stressed that the woman is “never the criminal.” Instead, he said, she is a victim, along with her unborn child.

What (and who) women see

After a woman takes the abortion pills, she may actually see her child, all three doctors said. Even at eight weeks gestation, an embryo is already the size and shape of a gummy bear, according to Skop, with a clearly-defined head, arms and legs.

“He looks like a person because, of course, he is a person,” she said.

While the pills are FDA-approved for up to 10 weeks, she added that sometimes women take them past that point, when the baby is even more formed.

“They look in the toilet and they don’t just see blood; they see a human being that is their own child,” she urged.

These babies are often flushed down the toilet, Skop said, adding that abortion clinics tell women to do just that.

Pointing to organizations that AAPLOG works with, Francis said that they are hearing stories on an almost weekly basis of “women seeing their babies, their fully-formed babies, at home and not knowing what to do” after taking the abortion drugs.

Women are calling these organizations for help, she said. One even told her that women are placing their babies inside Ziploc baggies and storing them in the freezer “because they don’t know what else to do.”

Expectation vs. reality

These drugs, Francis cautioned, are turning women’s homes, dorm rooms and dorm bathrooms, “into abortion facilities.”

“They’re not being prepared for, really, the emotional and mental trauma that they’re going to go through in addition to the really horrendous physical symptoms when they do pass their babies at home,” she said.

Like Francis, Bruchalski stressed that abortion will take place in a woman’s bed or hallway, on their bathroom floor or in their toilet.

“They’re going to come face to face with the reality of this brutality,” he said. “It’s going to be vividly bloody, filled with blood clots and horrific abdominal cramping.”

Side effects include nausea, diarrhea and severe abdominal cramping, he said, adding that women might also experience light bleeding for up to a month afterward.

Skop emphasized that complications happen. A woman came to her emergency room after an abortion two months ago in California. She had bled every day for two months — and her uterus, Skop said, was full of dead tissue.

Loosened restrictions

Over the years, the FDA has loosened restrictions on the abortion-pill regimen, beginning with expanding the gestational age range from seven to 10 weeks in 2016. More recently, in 2021, the federal agency lifted restrictions on mifepristone distribution. That decision authorized doctors to prescribe the drugs online and mail the pills without ever having to see pregnant women in person.

Ahead of the FDA’s 2021 decision, CLI released a study authored by Skop and other experts finding increased access to abortion pills a public health threat.

“The rate of abortion-related emergency room visits following a chemical abortion increased over 500% from 2002 through 2015, according to an analysis of Medicaid claims data,” the press release announced.

Among other things, the study also found that the rate of abortion-related emergency-room visits is increasing faster for chemical abortions than for surgical abortions and that over 60% of abortion-related ER visits following a chemical abortion in 2015 were miscoded as treatment for a miscarriage.

All three doctors criticized the FDA for removing safeguards, particularly the requirement for women to see someone in person. This is important, Francis said, in order to confirm the gestational age or rule out an ectopic pregnancy.

Skop explained that mifepristone does not work with ectopic pregnancies, where an embryo implants outside the uterus or womb, usually in one of the fallopian tubes. Instead, she said, the baby continues to grow, which can rupture the tube and cause the woman to die.

Among other things, physicians should also determine factors such as whether a woman is anemic — because she could bleed for weeks afterward — or if she has an RH negative blood type (in which case, she should receive a shot that prevents her from developing an immune response to future children), Skop said.

Skop also expressed concern that “we don’t even know who’s ordering these pills.”

“It could be an incestuous abuser or a sex trafficker or a coercive boyfriend pretending to be a woman, ordering the pills online, and then providing them to a woman who does not want an abortion,” she cautioned.

Abortion pill reversal

Bruchalski, along with AAPLOG and CLI, support what is called “abortion pill reversal.” While some groups, such as the American College of Obstetricians and Gynecologists condemn it, Bruchalski said he has witnessed women successfully use it to save their babies after taking the first pill, mifepristone.

Abortion pill reversal attempts to overcome the effects of mifepristone, which blocks progesterone, by giving women more progesterone, he described.

“My question is, why would you not try this if you hesitate or have second thoughts?” he asked. “We understand that women going through this procedure, this surgery, this ending of the life of their child, the ending of the pregnancy, it is traumatic,” he said. “These women are not happy about this. They are doing this as a last available option.”

Katie Yoder is a contributing editor for Our Sunday Visitor.

Katie Yoder

Katie Yoder is a contributing editor for Our Sunday Visitor.