After a long period of research and refinement, medical abortion is finally at a place where it has become the most common and safest way of ending a pregnancy. It has come to a point where you can easily get yourself the abortion pill by post and manage the whole procedure in the privacy of your home. But just because something is safe for most people does not mean it is safe for everyone or in every situation.
While the vast majority of women are likely suitable candidates, a small number must not proceed without an in-person medical assessment. So, if you are someone who is currently considering a medical abortion, take a moment to understand whether these pills are right for you or not. It is absolutely important that you don’t fall into a group that requires extra caution with this procedure or avoid it altogether. Keeping that in mind, let us go through every possible situation where medical abortion may not be safe and appropriate.
Precautions to take before using abortion pills
Before you get yourself the abortion medication, it is important that you have a clinician or a fertility specialist take a structured test of your pregnancy. This can confirm three very important things: how far along you are, whether your pregnancy is located inside the uterus, and whether you have any underlying health problems that can complicate things.
The thing with medical abortion is that it is only considered in cases of early pregnancy, typically up to 10 weeks. Beyond that point, its effectiveness can go down with each passing week, and the bleeding will become heavier – it’s part of the reason why doctors often recommend surgical abortion for gestational age above 10 weeks.
You also need to be absolutely certain that the pregnancy is intrauterine in nature. If it’s not, you may be experiencing an ectopic pregnancy, in which the embryo implants outside the uterus, generally in the fallopian tube. Abortion pills cannot treat an ectopic pregnancy, and this is an emergency situation that will require different medications for treatment or a surgical procedure for removal of the pregnancy tissue.
If you are experiencing symptoms such as severe one-sided abdominal pain, shoulder tip pain, dizziness, or fainting, accompanied by pregnancy, it is recommended that you avoid abortion pills for the time being. Last but not least, you need to ensure that you have access to competent and adequate follow-up care – either in person or remotely in cases of abortion at home. Even though complications after taking the pills are rare, there is still a chance that you may experience heavier bleeding than expected or an infection. Such situations demand prompt medical attention, so anyone who wants to pursue the medical abortion route should have access to emergency services if needed.
Even if none of the earlier categories matches you, pause to see if you’re unsure of your last period and may be over 10 weeks—get an ultrasound first. If you notice sharp abdominal pain, shoulder tip pain, or discomfort using the toilet, seek urgent care, as these may suggest ectopic pregnancy.
If you feel that you don’t have any safe or private space to manage the side effects that follow a medical abortion, consider waiting, as such an environment is a recipe for stress and danger. Don’t forget that a medical abortion is a physically demanding procedure that can go on for several hours after the second pill. Not only do you need a safe space, but it is also recommended that you have a trusted person with you at all times during the process.
What are the red flags you should know for medical abortion?
There are a few clear medical situations in which abortion pills should not be used at all, also known as contraindications. One of the most important of the bunch is a confirmed or suspected ectopic pregnancy, as mentioned prior. To reiterate, this is a life-threatening situation, and abortion pills are practically useless in it. Another absolute contraindication is chronic adrenal failure. One of the two pills used in medical abortion, called mifepristone, works by blocking the progesterone hormone in our body. This completely stops the progress of pregnancy. But in people with adrenal insufficiency, this medicine can be somewhat unsafe as it can interfere with the steroid balance in the body.
Mifepristone acts similarly in cases where long-term corticosteroid use is a concern. Because this medicine has anti-glucocorticoid properties, it can cause issues for people who rely on corticosteroids for asthma, bronchitis, autoimmune diseases, arthritis, and other such conditions. Though rare, this is a case where doctors may recommend getting a medical abortion with supervision in a clinical setting instead.
People who struggle with bleeding disorders or rely on anticoagulant therapy will also need to take a moment and check their compatibility for medical abortion. This procedure, after all, involves bleeding. Someone with a clotting disorder could experience prolonged bleeding that can quickly become dangerous.
If you’re currently relying on an intrauterine device (IUD), it must be removed before taking abortion pills, as leaving it in increases the risk of infection and complications. Also, inherited porphyria is a rare but recognised reason not to use abortion pills, since they can potentially trigger an acute attack affecting your skin or nerves.
Forced or coerced abortion
One area that is often overlooked in such discussions is the topic of forced abortions and coercion. It is simple: no one should take abortion pills under pressure, force, or fear. Consent is not an optional part of this procedure; it is your fundamental right.
If a partner, family member, or anyone else is pushing someone into ending a pregnancy forcefully, understand that this is no longer a medical decision. In the eyes of the law, it is abuse. Even telemedicine providers in the UK are trained to ensure that you are taking these pills of your own accord, and not due to someone else.
Abortion, only when it’s in your best interest
At the end of the day, if a medical abortion does not feel safe for you, don’t do it – period. Whether it’s due to a health concern, societal pressure, or familial pressure, remember that this is a decision only you should make. If you do want an abortion but mustn’t get it from the pills, you can always seek a surgical abortion. It is a safe procedure that won’t make you feel a thing, and you can return to your normal life even sooner. The point is, move forward with this decision when you have all the pieces in their right place. If that’s not the case, pause and get proper support first before taking the next step.
