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Friday, June 24, 2022

What is a drug, or medical, abortion? 3 doctors answered 5 questions

In advising Politico to reverse Roe v. Wade, Justice Samuel A. The use of abortion is in the limelight after Alito Jr. released a leaked draft of the Supreme Court opinion. On May 4, 2022, SciLine, a non-profit, independent service that connects scientists with journalists, interviewed three medical experts to answer questions about drug abortion: Dr. Claire Brindis Bixby Center for is the founding director of Global Reproductive Health and is a professor. School of Medicine at the University of California, San Francisco. Dr. Daniel Grossman is the Director of Advancing New Standards in Reproductive Health and Professor of Obstetrics, Gynecology and Reproductive Sciences at the University of California, San Francisco. Dr. Lauren Owens is a Fellow of the American College of Obstetricians and Gynecologists and Assistant Professor of Obstetrics and Gynecology at the University of Michigan Medical School.

The Conversation has collaborated with SciLine to bring you highlights from the discussion, which have been edited for brevity and clarity.

How effective are drug abortions?

Claire Brindis: Research has shown us that medical abortions are just as effective as surgical abortions, but we tend to use medical abortions earlier in the pregnancy. It is particularly effective up to 10 weeks of pregnancy.

Daniel Grossman:: The most commonly used regimens for drug abortion in the United States include two drugs: Mifepristone followed by Misoprostol, which has been approved by the U.S. Food and Drug Administration for use up to 10 weeks of pregnancy. There is evidence about its safe use for about 11 or 12 weeks, but overall these drugs are about 97% effective – meaning that about 3% of people who use them complete vacuum aspiration or procedural abortion. would be required. Abortion.

Lauren Owens: Drug abortions are highly effective. The best data we have – and how I recommend it to our patients – is that drug abortion is more than 95% effective.

What are the possible complications from drug abortion? Are they common?

Brindis: We have found that medical abortion has very few complications of any kind. Less than 1 percent — 0.4% of women — experience additional complications of any kind, such as heavy bleeding, low-grade fever and some additional pelvic pain that dissipates over time.

Grossman: Abortion using drugs is very safe. It has been very well studied, and in fact millions of patients now use it in the US. Serious complications are very rare; They occur in less than half a percent.

How does the safety of telehealth drug abortion compare to drug abortion performed in a clinical setting?

Owens: We know that telemedicine drug abortion is virtually the equivalent of a clinical setting, as far as outcomes are concerned. We have really great data for Iowa from Dr. Daniel Grossman, [and] From Dr. Elizabeth Raymond in Gynuity [Health Projects], I care for myself in Michigan, a state where telemedicine drug abortions take place, which [I believe] There is a great service to offer people, as people living in rural areas may have more barriers to care than others.

Grossman: Telehealth has expanded into virtually every area of ​​medicine, including providing drug abortion. And now there are several published studies, from the United Kingdom and now the United States, showing that the safety and effectiveness outcomes with drug abortion provided by telehealth are actually quite similar, compared to individual provision.

How safe are drug abortions performed at home without medical supervision?

Grossman: People have been self-managing their abortions for hundreds, if not thousands, of years. The difference now is that people have the option of using the same drugs they can get online or from pharmacies in some countries or from different sources. And all the evidence we have so far suggests that self-managed abortion using these drugs is very safe. And that people will seek medical care if they have any questions or concerns about a complication.

Brindis: Based on previous research, I do not anticipate that there are many more complications for women using these drugs at home to have an early abortion. One thing that is important to recognize is that many of these women are knowledgeable consumers of knowledge and information. They’ll either seek advice from friends who already have one or other Internet resources to help them prepare for what to expect before, before, during, and after.

Owens: I really think that drug abortion exists on a spectrum. So when we think of “in-clinic” drug abortion, people often take the first pill at the clinic and then the second pill at home. So even though it is done medically in the beginning, the process is actually completed at home. There is some very good data with about 3,000 people showing that there are actually similar outcomes with self-managed versus in-clinic medication abortions.

What are the physiological effects of drug abortion? Are any long lasting?

Brindis: The physiological effects of using these drugs are short-lived. They are really only around the time of the miscarriage. And they are not long lasting in women’s bodies.

Grossman: The drugs have the effect of causing cramping and bleeding which leads to the expulsion of the pregnancy. I would say that for some people the side effects of the diet can be intense, especially the pain. Other side effects of the drug may occur such as nausea, vomiting, diarrhea, sometimes with fever or chills, especially after taking another medicine, misoprostol. In general, these side effects are very short-term, and there are no long-term risks. There are no risks to future fertility or risks of future pregnancy complications.

Owens: I’ve seen a lot of patients who are concerned about how having an abortion might affect their future fertility, and that drug abortion should have no effect on future pregnancies.

SciLine is a free service based at the non-profit American Association for the Advancement of Science that helps journalists incorporate scientific evidence and experts into their news stories.

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