Medication abortion, in which a woman takes two drugs to terminate an early pregnancy at home, became the most commonly used method in the U.S. during the Covid-19 pandemic, particularly after the Food and Drug Administration stopped requiring the prescription be dispensed at healthcare facilities and allowed it to be delivered directly to users. Many online pharmacies around the world ship them without a prescription at all.

As the Supreme Court prepares to give states the power to ban abortion, medication abortion could be a game changer — the last option for women in conservative states who are unable to travel elsewhere to end their pregnancies.

“We see medication abortion as being a potentially transformative and disruptive technology in the face of these unjust laws that are being passed,” said Elisa Wells, co-founder and co-director of Plan C, a website that provides information on finding and using the medication. “It is a bit of a safety net, potentially.”

Medication can be shipped discreetly, in some cases evading detection from those who hope to ban its use. It is so hard to track that statistics on so-called self-managed medication abortions — those conducted without a prescription or a doctor’s guidance — are not well researched.

“It will be very different from the pre-Roe era when abortion was illegal in that it’s harder to restrict pills,” said Dr. Daniel Grossman, an abortion provider and director of Advancing New Standards in Reproductive Health at UC San Francisco. “It’s easier to potentially access them through various channels. And the pills are very safe and effective, unlike … methods of unsafe abortion or methods that people might have used on their own in the 1960s.”

But just as abortion rights supporters look to shore up access to medication abortion, antiabortion groups are focusing on enacting additional state restrictions on pills, making medication the next battleground in the decades-long cultural standoff over abortion.

“It’s one of our biggest priorities and it’s certainly something that a lot of states are thinking about much more than they were three years ago,” said Katie Glenn, government affairs counsel at Americans United for Life, a law firm that opposes abortion and advises states on legislation. “We saw a huge uptick in the pill use during Covid.”

The process of a medication abortion consists of two drugs taken in succession. Mifepristone is taken first to block the effects of progesterone, a hormone needed to sustain a pregnancy. The second medication, misoprostol, is taken one or two days later to generate cramping and bleeding, like an early miscarriage.

A 2015 study showed that at nine weeks of pregnancy or less, medication abortion was successful 99.6% of the time.

Even so, medication abortion “is not a solution to the problem” of a Supreme Court ruling that undermines abortion rights, Grossman said.

Obstacles may include the drug’s costs, shipping delays, legal risks and the relatively short recommended 10-week window for use. A medication abortion also takes longer than an in-office procedure, and sometimes patients worry they’ve used them incorrectly….

The above comes from a May 5 story in the L.A. Times.