The Abortion Pill Can Be Used Later Than the FDA Says

The “abortion pill” is a bit of a misnomer. Known formally as medical or medication abortion, it is really two separate drugs—mifepristone, which stops the pregnancy from progressing, followed by misoprostol, which triggers uterus contractions—that together mimic what happens in a miscarriage. And so, in the early days of at-home medication abortion in the 1990s in the U.K. and Sweden, doctors looked to this parallel to establish a cutoff for its use: nine weeks, when a miscarriage is also typically managed safely at home. Over time, however, the line has slowly shifted later into pregnancy.

When the U.S. finally approved medication abortion in 2000——the FDA allowed only self-managed abortions up to and did not . Since then, though, international consensus has now recommends 12 weeks, or the end of the first trimester, as the cutoff for self-managing a medication abortion. “The FDA label is lagging behind what the science says,” Heidi Moseson, a researcher at Ibis Reproductive Health who has studied the issue internationally, told me. And in practice, women are using these pills even later in pregnancy. In countries where abortion is or until recently had been illegal, such as , , activists have for years helped women self-manage medication abortions in the second trimester up to 24 weeks. Different stages in pregnancy just require different doses of the drugs.