Abortion pill: definition, disadvantage, in pharmacy?

What is the definition of the abortion pill?

It is called “the pill” but the abortion pill has no nothing to do with the birth control pill. “It’s very important to clarify this because confusion is very often made, immediately informs Dr. Marie-Laure Brival, gynecologist-obstetrician. Pill is a generic term used to talk about contraception. We continued to inappropriately refer to it as an abortion “pill” because it is a tablet, but it is not a form of contraception. Contraception is intended to prevent in prevention the arrival of the pregnancy whereas the abortion pill causes an abortion i.e. the termination of an ongoing pregnancy (gestation progressing).” The abortion pill is a drug that is used to perform all pregnancy terminations, even medical terminations that may occur beyond the first trimester of pregnancy.

Can you have the abortion pill in France?

The abortion pill is authorized in France for abortions occurring in the first trimester of pregnancy. This is mifepristone sold under the trade name Myfegyne®. It is issued by prescription. It can also be administered:

• in the softening and dilation of the cervix before surgical termination of first trimester pregnancy.
• in preparation for the action of prostaglandins during terminations of pregnancy for medical reasons beyond the 1st trimester.
• to induce labor in terminated pregnancies (death of the fetus in the uterus, and when the administration of prostaglandin or oxytocin is not possible).

What is the name of the abortion pill?

The scientific name of the abortion pill is “RU 486”. UK is the acronym of the Roussel-Uclaf laboratory which marketed it, and the three numbers 4-8-6 correspond to the order numbers for the synthesis of the molecule. Her active substance is mifepristone, marketed under the name Mifegyne®.

What are the disadvantages of the abortion pill?

The main disadvantage is the risk of failure “not heard enough” according to our interviewee: “The abortion pill is not 100% effective since there is 2 to 5% failure or the woman does not tell herself that it can fail. You have to hear this failure because in case of failure, it lengthens the delay of the finality of the abortion since the pregnancy continues to evolve. It is also important to be aware of the risk of failure in order to follow the procedure of taking this pill: “There is an obligatory follow-up consultation two weeks after taking it, some women do not do it. As they bled, they tell themselves that it worked but they can find themselves in very delicate situations” warns Dr. Brival. If the medical abortion did not work, it is necessary to go through the aspiration. Gold thesurgical suction is time limited to 14 weeks of amenorrhea (12 weeks of pregnancy or 3 months).

Where to buy the abortion pill? In pharmacy?

Mifepristone is delivered to the woman by the professional face-to-face or by the community pharmacy, as part of a teleconsultation procedure.

Is it emergency contraception?

The abortion pill is not emergency contraception. It is thus necessary to distinguish:

• The classic contraceptive pill that is taken to prevent pregnancy, available on prescription.
• The emergency pill (the morning after pill) is also a preventive technique for pregnancy but reserved for emergencies: “It’s a contraception taken after unprotected intercourse to prevent ovulation so conception, it is taken punctually, in case of forgetting the contraceptive pill, unexpected intercourse… but in no case in the long term” reminds the gynecologist. The emergency pill can be obtained without a prescription in pharmacies, even for minors.
• The abortion pill which is a medicine curative taken to abort And only available on prescription.

What is its composition?

The abortion pill contains mifepristonean artificial hormone that blocks the action of progesterone.

It promotes the detachment of the fertilized egg.

How does the abortion pill work?

The active substance of the abortion pill, mifepristone, acts as an antihormone. “The pregnancy hormone that will promote the implantation of the fertilized egg and its development in the uterus is progesterone secreted by the ovaries.explains Dr. Brival. There mifepristone is an artificial hormone that looks like progesterone but does not have the same keys, it will come to compete with progesterone in the event of pregnancy and cancel its effect by not promoting the implantation of the egg but its detachment.”

There taking the abortion pill in France is regulated by law and follows a regulated procedure. She can be done home in accordance with the protocol, at a time suited to the woman’s schedule and not necessarily in front of the health professional.

• Woman makes a first date with a doctor who performs medical abortions (in town or at the hospital). Any woman requesting an abortion must obtain a consultation appointment within 5 days of her call, recalls the HAS in April 2021. During this appointment the doctor will give him all the information on the procedure of the abortion (expulsion, bleeding…) and prescribe a blood test (to find his blood group…) as well as a pelvic ultrasound.
• The woman then returns for a second date. with her test results and the doctor gives her the two pills to take (the antiprogesterone mifepristone and a prostaglandin, misoprostol which will increase uterine contractions to evacuate the egg). An advice sheet on the normal consequences of abortion is given to the woman as well as a phone number to call in case of emergency.
• A follow-up visit to verify the success of the abortion should be scheduled between the 14th and 21st day post-abortion.

Up to how many weeks of pregnancy can it be taken?

The abortion pill can be taken as method of medical termination of active intrauterine pregnancy :

• at the latest until 63^th day after your last period (9 weeks of amenorrhea i.e. 7 weeks pregnant)
• in association with prostaglandin 36 to 48 hours later.

Bleeding, pain: what to expect after taking?

Metrorrhagia (bleeding), witnesses of the effect of medical treatment, occur within 3 to 4 hours following prostaglandin intake (after mifepristone), but are not proof of complete expulsion. “The frequency of complications from abortion at home (severe bleeding) is comparable to that of abortions performed in a hospital environment” underlines the High Authority of Health. “In the event of haemorrhage, which is exceptional, women have an emergency number given by the doctor during appointments” informs Dr. Brival. THE Abdomino-pelvic pain induced by uterine contractions are almost systematic. It is recognized that pain increases with parity, gestational age and the doses of prostaglandins used. Since the pain may vary in intensity from one woman to another, the prescription of level 1 analgesics such as NSAIDs (for example, ibuprofen analgesic dose) and 2 (for example, paracetamol combined with opium, codeine) is systematic.

“The abortion pill is not 100% effective”

What are the benefits of the abortion pill?

• its efficiency : “She is highly effective, argues the gynecologist, between 95 and 98% success and especially if it is taken early, from the observation at 4 or 5 weeks of pregnancy, the action is faster and simpler than at 9 weeks.
• its ease of use : in one tablet.

Who invented it?

The abortion pill was invented by the Professor Etienne-Emile Baulieu in 1982. He is a world famous physician, biochemist, endocrinologist. He is at the origin of the discovery of the anti-aging hormone DHEA in the 1990s and of the FKBP52 protein capable of blocking the Tau protein, active in Alzheimer’s disease and in other neurodegenerative pathologies.

Thanks to Dr Marie-Laure Brival, gynecologist-obstetrician and author of “SOS Contraception” at Editions First (June 2021).

Source: Voluntary termination of pregnancy by medical method – April 12, 2021. Haute Autorité de Santé.