Pregnancy termination is now very difficult to get in many regions. The abortion pill–medication abortion–is one dose of the antiprogesterone mifepristone followed by one or more doses of the prostaglandin misoprostol. The therapy is well studied and unequivocally safe and effective up to 10 weeks gestation.
For women who have access to both medication and surgical abortion, there are plusses and minuses to each but the main difference is that a surgical abortion is a brief procedure requiring anesthesia and uterine instrumentation, whereas a medication abortion occurs over several days in the patient’s home.
But medication abortion allows women without access to surgical abortion to safely terminate pregnancy. In the US, federally authorized abortion pills are highly restricted for reasons that are political, not medical. So a network of activists have developed robust programs for getting this treatment into the hands of women who need it.
The role of emergency providers in managing women who request elective termination of pregnancy depends on the resources available in your community, but all of us need to know about medication abortion, if for no other reason than it is a rising therapy and you’re going to get asked. Especially if you practice in an area where surgical abortion is poorly available or unavailable, familiarize yourself with the relevant options so you can properly counsel appropriate patients. This is another way that emergency clinicians stretch the scope of their practice to meet the changing needs of the patients they serve.
New York Times, Farhad Manjoo