Beyond the ‘abortion pill’: Real stories about mifepristone : Shots


Because it was first authorized to be used in 2000, mifepristone has been utilized by thousands and thousands of girls to supply abortions and handle miscarriages.

Gracey Zhang for NPR

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Gracey Zhang for NPR

Because it was first authorized to be used in 2000, mifepristone has been utilized by thousands and thousands of girls to supply abortions and handle miscarriages.

Gracey Zhang for NPR

For some time, it was generally known as RU-486. It is known as Mifeprex or mifepristone – however many comprehend it as “the abortion tablet.” It’s one among two medicine – together with misoprostol – which might be utilized in greater than half of abortions within the U.S. now. And it’s the topic of a federal courtroom case that would make it unlawful.

As attorneys collect in New Orleans this week on the fifth Circuit Courtroom of Appeals to argue whether or not this remedy must be faraway from the market all around the nation, NPR requested folks to share their experiences with utilizing mifepristone. Greater than 150 folks responded.

The tales illustrate how mifepristone is certainly an “abortion tablet” — but it surely additionally performs different essential roles in folks’s lives.

Many individuals wrote about how they took the medication in remedy of a miscarriage. Others used it as a part of their fertility journeys. Bodily, taking mifepristone and misoprostol was a significantly painful expertise for some and induced few signs for others. Some mentioned that they had by no means been extra certain of any resolution, others wrote that they nonetheless weren’t certain in the event that they made the proper name.

Listed below are a number of the methods individuals who wrote to NPR used mifepristone.

A remedy for recurrent miscarriages

“I knew – going into attempting to have kids – that there could be one thing completely different about me,” says Larissa Adams. Relations alluded to the truth that getting pregnant was arduous for ladies within the household. As an example: “My grandmother obtained married at 19, however did not have her first child till she was 35.”

When her first being pregnant in 2017 led to a miscarriage at ten weeks, she was devastated. “We thought that was going to be the top of it,” she says. “We spent the subsequent 4 or 5 years getting pregnant recurrently after which – miscarriage after miscarriage after miscarriage.”

She finally discovered precisely how she (and, most likely, her grandmother) are completely different than different folks. “I’ve what’s known as a balanced translocation – primarily, one among my chromosomes is lacking a bit of chunk on the thirteenth chromosome and it is moved on to the 14th,” she explains. “It would not influence me other than copy, as a result of numerous my eggs do not have both a thirteenth or 14th match-up chromosome.”

For a number of years, she and her husband saved attempting to get pregnant. “Each different month I used to be getting pregnant and, hitting about 10 to 12 weeks, simply the identical telltale indicators [of miscarriage],” she says. Every time, she wanted an intervention to finish the miscarriage, and she or he would first strive mifepristone and misoprostol – typically she additionally wanted a dilation and curettage process. That is a surgical process, generally known as a D&C, that clears the uterus. It’s also utilized in abortions.

Finally, Adams and her husband spent $42,000 to attempt to get pregnant through in vitro fertilization – of 24 fertilized eggs, just one was viable. Medical doctors transferred the embryo into her uterus and hoped it might implant. “And by sheer luck – I’ve at all times puzzled, are we the luckiest folks on the earth [or] have the worst luck? – it caught,” she says. “We’ve a three-year-old and she or he’s completely wholesome.”

Adams says she’s grateful in all these years of miscarriages that she had remedy to take to hurry the method so they might strive once more.

“While you fall into the world of being pregnant loss, you grow to be so conversant in mifepristone and all of those drugs – it turns into this second language,” Adams says. “It has been so weird to listen to this attain a nationwide dialog degree and to listen to courts discussing this and politicians discussing this […] as if it’s a harmful instrument or a harmful drug that threatens folks’s lives.”

She desires folks to know mifepristone is typically used as “a part of the puzzle of individuals having households.”

Selena Simmons-Duffin

Accessibility in distant locations

For a lot of girls in rural areas, entry to abortion clinics may be troublesome, even in states the place it is authorized. Lengthy drives and the a number of docs’ appointments wanted for surgical abortions may be prohibitive.

In mid-2020, with the pandemic in full swing, a girl named Rebecca realized she was pregnant. (She requested that NPR use solely her first title as a result of a lot of her members of the family are unaware of her abortion.)

On the time, she and her husband had been married for about two years. Neither of them wished to have kids, she mentioned, and watching her sister expertise a number of troublesome pregnancies helped to solidify that call.

“I’ve seen absolutely the carnage it has induced her. She has had so many well being points from the pregnancies. It is taken away her physique from her,” she mentioned. “For me, that is one thing I’ve by no means wished to do.”

She was utilizing an intrauterine system, but it surely failed. “I took the being pregnant take a look at and just about had a meltdown. I used to be simply sitting there, shaking,” she mentioned.

Whereas the choice to get an abortion was simple for Rebecca, it was not as simple to really get one. Her husband was then within the armed forces, so abortion wasn’t coated by their insurance coverage. (Federal legislation prohibits TRICARE, the army medical health insurance program, from masking abortion care.) They usually have been stationed at a base in upstate New York, greater than an hour’s drive away from the closest sizable metropolis. Even there, the native clinic that offered abortions was working at decreased capability because of pandemic-era security measures, making appointments troublesome to get, she mentioned.

As soon as she had an ultrasound, she was in a position to get a prescription from a telehealth service and obtained the mifepristone by mail. She took the tablet, and the misoprostol that adopted, in her own residence along with her husband.

“With the ability to try this was a godsend,” she mentioned. A lot of her members of the family oppose abortion rights, she added. “With the ability to do it within the privateness of my house and never having to clarify something to anybody is the most important a part of it.”

In 2021, the FDA formally lifted a number of the laws round mifepristone to permit the drug to be prescribed and distributed by mail, slightly than in-person in a clinic or hospital. That call to develop entry to the drug is one topic of the oral arguments being heard this week.

Becky Sullivan

Privateness throughout troublesome conditions

When Alexandra was 21, her then-boyfriend was so emotionally abusive that for years her household referred to him as “Voldemort” – a reference to the Harry Potter villain. (NPR is utilizing her first title solely as a result of she has skilled considerations about sharing this story.)

“He was controlling. He remoted me. He took my shallowness all the way down to nothing,” mentioned Alexandra.

His abuse hadn’t turned bodily, however there have been warning indicators that it was headed that manner, she mentioned. After two years collectively, Alexandra was depressed, combating college and unable to see a manner out.

Then, in the future in 2007, she noticed an advert on TV for an at-home being pregnant take a look at. Though she was utilizing contraception, she nonetheless felt a robust flash of hysteria: May she be pregnant?

She went to the pharmacy to purchase a take a look at, which got here again constructive. “I instantly was like, ‘I can not have this child. I can not,'” Alexandra mentioned. Racing via her thoughts, she mentioned, have been ideas about college, her future profession, her life goals and greater than anything, her abusive boyfriend.

“If I’ve a toddler with this man, I am going to by no means get away from him,” she recalled pondering.

In 2007, the FDA’s approval of mifepristone coated its use as much as seven weeks of being pregnant. Alexandra had found hers early sufficient however had no time to waste. A surgical abortion was much less interesting than the remedy, she mentioned.

She wasn’t but prepared to inform her dad and mom, and the time away wanted for a D&C can be extra conspicuous, she thought. Utilizing mifepristone “was very a lot a no brainer for me,” she mentioned.

She took mifepristone at a physician’s workplace, then went house to take the misoprostol. The subsequent yr, she was in a position to depart the abusive boyfriend. Quickly after, she enrolled in legislation college and has since had a profitable profession as a lawyer.

“I’ve by no means as soon as thought, ‘What if?'” she mentioned. “Even now, as I am 37 years outdated and I am not married — I believed that I might have a household, but it surely’s actually not wanting prefer it’s within the playing cards — I nonetheless haven’t any regrets by any means.”


Management over when and the place to expertise a miscarriage

Michelle Brown and her fiance have been planning their marriage ceremony after they realized she was pregnant. Although their first response was panic – they wished youngsters, however thought it might occur after the marriage – it quickly turned to pleasure, although, she mentioned, and so they welcomed the being pregnant.

However round eight weeks, she realized that the embryo wasn’t rising; she was having a miscarriage.

Medical workers advised her she may take a mix of mifepristone and misoprostol to immediate her physique to expel the tissue. Or she may look forward to her physique to cross it naturally, they mentioned.

At first, she selected to attend. However on the time, she was a professor at a college about an hour’s drive from her house in New Orleans — a commute that concerned driving lengthy distances over our bodies of water, the place it may very well be harmful to drag over in case of emergency, Brown mentioned.

Over the subsequent week, she spent each commute feeling racked with dread. “I used to be actually afraid. Like what if it occurs now?” she mentioned. “I used to be doing what I may to arrange, however I used to be nonetheless feeling numerous concern.”

Quickly, she requested her physician to prescribe the tablets. Her fiance then labored in retail, and their solely time without work collectively was Sunday. She was in a position to time the remedy so they might each be house collectively as her physique handed the tissue.

Brown says the entire expertise made her conscious of what number of issues have been outdoors her management, regardless of all of the planning she had been attempting to do.

Regardless that she and her fiancé had determined to maintain the being pregnant, it had nonetheless upturned her life, she mentioned — solely to then upturn it once more when she discovered she was miscarrying.

For Brown, having the ability to select when and the place to shut such a turbulent and emotional chapter was a salve. “With the ability to be like, ‘This isn’t going to upturn my life anymore, as a result of I could make this resolution,'” was “the massive factor,” she mentioned.

Brown and her now-husband obtained married just a few months later. They’ve since had two kids, a 7-year-old and an 8-month-old child.


A nonbinary particular person’s expertise

As a teen within the mid-2000s, Mel Cody had by no means heard the time period “nonbinary.” Cody was assigned feminine at beginning, however struggled via their teenage years with emotions of physique dysphoria, they mentioned. “I did not know what it meant, as a result of I did not need to transition into a person. I did not need to be a dude, however I additionally did not really feel like a girl,” Cody mentioned.

Cody additionally had undiagnosed autism, and their teen years have been troublesome and at instances traumatizing, they recalled. “Puberty was terrible. I developed breasts very early, and that was fairly life-ruining, actually,” they mentioned. “Horrible issues occurred to me being autistic and browse as femme.”

Starting their freshman yr on the College of Colorado, Cody hoped the brand new setting may very well be a recent begin. However quickly after they began relationship somebody, they turned pregnant.

The being pregnant triggered a physique dysphoria so acute that Cody thought of killing themselves, they mentioned. “That was at the back of my head in the event that they turned me away. That was my subsequent alternative,” they mentioned, recalling the journey to Deliberate Parenthood.

“I’ve struggled on and off with suicidality since I hit puberty, principally, simply because I do not really feel proper,” Cody mentioned. “It’s a devastating thought to consider my physique altering any extra.”

A physician on the clinic talked Cody via the choices: retaining the kid, adoption, surgical abortion or a drugs abortion. “I used to be in college full time, I used to be working full time. I wanted one thing the place I may simply take a weekend,” they mentioned.

“With the ability to take management of an unplanned being pregnant and select to not have it was most likely the primary time I ever obtained to make decisions about what occurred to my very own physique for myself,” Cody mentioned. Afterward, the clinic additionally helped them with contraception, which allowed Cody to cease having intervals for the primary time.

That have helped to point out Cody that they might change different issues about their life and physique, they mentioned — their garments, their haircut, whether or not to shave their legs — as an alternative of following society’s expectations for female our bodies.

“I haven’t got to decorate myself up like a doll to exist on this world. I may be me and exist. And I feel having an abortion gave me that present of figuring out that I can management my very own physique to a point,” they mentioned. “And I am a lot happier now. I really feel a lot extra proper on the earth.”


In case you or somebody you already know could also be contemplating suicide or is in disaster, name or textual content 988 to succeed in the Suicide & Disaster Lifeline.

An opportunity to maintain caretaking

Daybreak’s first being pregnant was difficult from the start. She spent the previous couple of weeks of it within the hospital with extreme preeclampsia, a severe situation that may be lethal. Her daughter was born prematurely, at solely 29 weeks. “She weighed lower than 2 kilos,” Daybreak explains. (NPR is barely utilizing her first title as a result of she fears household {and professional} repercussions from sharing her story about mifepristone.)

Her daughter was in neonatal intensive care on the hospital for greater than three months after beginning. “I ended up having to give up my job as a instructor to care for her full time – she wanted around-the-clock nursing care. I spent most of my time in that yr attempting to maintain her alive, taking her to completely different physician and specialist appointments, taking her to feeding remedy and simply attempting to determine which manner is up.”

When her daughter was lower than a yr outdated, within the fall of 2017, Daybreak found she was pregnant once more. “In that second, I knew that it might be bodily, emotionally, mentally devastating for us – financially too, as a result of we’re simply barely squeaking by on one earnings in Brooklyn on the time,” she says.

She and her associate agonized over the choice – she made an appointment at Deliberate Parenthood, canceled it, then made one other appointment. “Then I lastly went – I needed to go on my own as a result of we did not have little one look after our first little one,” Daybreak says. “We have been the one ones to look after her due to all of her advanced wants.”

Daybreak selected to have a drugs abortion so she may keep away from having a process in a medical setting. “I used to be carrying numerous the load of getting spent weeks and months in a hospital, first as a affected person after which visiting my daughter within the NICU daily or so,” she explains. She wished to be at house. The expertise was “disagreeable,” she says – she did not sleep for an evening, and had heavy bleeding just a few weeks later that frightened her, however turned out to be effective, she says.

“Actually, I really feel prefer it saved my life,” she says of the abortion. “I can not think about how our lives would have ended up had I not had that possibility.” She and her associate did have a second little one years later, when her first little one was older and in class and so they have been prepared.