The Government’s proposed law will make abortion available ‘on request’ up to 12 weeks (see explanation here).
According to the FDA, abortion pills are safe to use and are highly effective in early pregnancy. Where a pregnant person seeks abortion care within that time frame it is likely that she will have the option of using abortion pills to have a medical abortion.
This will require the Health Products Regulatory Authority to ensure all appropriate licences are in place to allow for medication abortion pills to be prescribed under the new law.
What are abortion pills?
Abortion pills are the mechanism for medical abortion. They comprise two medicines: mifepristone and misoprostol.
The first pill (mifepristone) is taken 36-48 hours before the second (misoprostol). This is the WHO recommended drug combination for medical abortion.
Their combined effect is to cause cramping and bleeding and, thus, to empty the uterus.
Are abortion pills effective?
Yes. According to Planned Parenthood:
For people who are 8 weeks pregnant or less, it works about 98 out of 100 times. From 8-9 weeks pregnant, it works about 96 out of 100 times. From 9-10 weeks, it works 93 out of 100 times.
Misoprostol and mifepristone, are on the WHO’s list of essential medicines.
Medical abortion is most effective earlier in pregnancy. As a pregnancy progresses the risk of incomplete abortion increases. Berer summarise effectiveness as follows:
…medical abortion works almost all the time at the time when a woman first misses her period. In fact, up to nine weeks of pregnancy, pregnancy continues only in about one per 100 women and in about 3–5 women, abortion is incomplete. From 9–13 weeks of pregnancy, some 96 out of 100 medical abortions using the [Royal College of Gynaecology] regimen were complete in one large study, without the need for surgical intervention. From 13–20 weeks of pregnancy, the rates of ongoing pregnancy and incomplete abortion get higher; about five women per 100 may have ongoing pregnancies. (footnotes removed; read this in the context of the overall study here at p. 23)
Are abortion pills commonly used?
Yes. Although medical abortion is not right for everyone, it is increasingly being used.
62% of all abortions that took place in England and Wales in 2016 were medical abortions (i.e. used abortion pills) (2016 statistics, p. 5). 72% of abortions under 10 weeks were medical abortions (2016 statistics, p. 19).
The number of women on the island of Ireland accessing abortion pills through the website Women on Web continues to increase year on year. According to Professor Abigail Aiken’s research “since 2010 (the first year for which data are available) the number of Irish women requesting early medication abortion through Women on Web has more than tripled, from 548 in 2010 to 1,748 in 2016” (opening statement to the Joint Oireachtas Committee on the 8th Amendment | supporting document).
Thoai D Ngo, Min Hae Park, Haleema Shakur, and Caroline Free, “Comparative effectiveness, safety and acceptability of medical abortion at home and in a clinic: a systematic review“(2011) 89 Bulletin of the World Health Organisation 360
Marge Berer, “Medical Abortion: A Fact Sheet” (2005) 13(25) Reproductive Health Matters 20
Abigail Aiken, Opening Statement to the Joint Oireachtas Committee on Repeal of the 8th Amendment, 11 October 2017 (& supporting exhibits).