• Posted November 7, 2024

Using Abortion Pills Very Early in Pregnancy Is Safe, Study Finds

Abortion pills are safe and effective even very early in a pregnancy, a new study finds.

Clinics and hospitals tend to defer medication abortions until a woman’s pregnancy is confirmed using ultrasound, researchers said.

But abortion pills can be safely taken prior to the sixth week of pregnancy, researchers reported Nov. 6 in the New England Journal of Medicine.

“Women often find out very early if they’re pregnant, and a majority also know if they want a termination and if so, want it to take place as quickly as possible,” said lead researcher author Dr. Karin Brandell, a gynecologist at Karolinska University Hospital in Sweden.

Doctors prefer delaying a medication abortion until an ultrasound is performed, to rule out the risk of an ectopic pregnancy, researchers said. Ultrasound reveals a pregnancy in weeks five to six.

In an ectopic pregnancy, the embryo attaches outside the uterus, usually in the fallopian tubes, researchers said. An ectopic pregnancy is not terminated by a medication abortion, and can be life-threatening for the woman.

For the study, researchers analyzed data on more than 1,500 women at 26 clinics in nine countries who requested an abortion before ultrasound was able to confirm their pregnancy.

These women were randomly assigned to either receive their early medication abortion as requested or have their abortion delayed until pregnancy could be confirmed by ultrasound.

In both groups, more than 95% of women had a complete and successful abortion.

In the delayed treatment group, 4.5% of medication abortions failed and required additional surgery. In the early group, 3% of pregnancies continued and 1.8% of women required surgery for an incomplete abortion.

Overall, 1% of all participants had an ectopic pregnancy, researchers found.

“Very early medical abortion was just as effective and safe to perform, even in case of an undiagnosed ectopic pregnancy,” said Dr. Kristina Gemzell-Danielsson, a professor of obstetrics and gynecology at Karolinska Institute.

Women in the early group reported less pain and bleeding. In both groups, women wanted to have their abortion performed as quickly as possible.

“Abortion is a political as well as a medical issue,” Brandell said.

“In Sweden, a woman can repeat the procedure a week after a failed early abortion. But a woman in Texas, where abortion is banned after the sixth week, can’t,” Brandell said. “It was therefore important to show that early abortion is equivalent to current standard procedure at a later stage of pregnancy.”

Researchers now want to test if a new combination of drugs for early abortion might also prove effective in treating ectopic pregnancies.

They are also developing new contraceptives based on mifepristone, one of the two drugs used in a medication abortion.

“It can be taken in a lower dose than for abortion to prevent unwanted pregnancies in the form of one tablet a week, or when needed,” Gemzell-Danielsson said.

More information

Yale Medicine has more about medication abortion.

SOURCE: Karolinska Institute, news release, Nov. 6, 2024