Select CVS and Walgreens pharmacies in Massachusetts are set to dispense mifepristone, a pill used in medication abortions, in the coming weeks. Photo by Rowan Jordan/iStock

Health & Medicine

米非司酮现在在马萨诸塞州的一些药店有售。 Here’s What You Need to Know about the Abortion Medication

Student Health Services administrators explain how the pill works

Mifepristone, one of two pills used in medication abortions, is now available with a prescription at select CVS and Walgreens pharmacies in Massachusetts.

The move comes following a rule change issued by the Food and Drug Administration (FDA) that allows certified pharmacies to dispense the medication in states where abortion is legal. 

Prior to the rule change, patients had to pick up the pill in person from the hospital or clinic of their prescriber. The FDA change does not impact misoprostol, the second pill used in medication abortions, which is less subject to restriction than mifepristone and more widely available.

Mifepristone can be used to terminate a pregnancy up to 10 weeks along. Both Walgreens and CVS are rolling out mifepristone gradually to store locations in Massachusetts, California, Illinois, New York, and Pennsylvania in the coming weeks. Eventually, the chains intend to offer it in all of their physical pharmacies in states where abortion is legal. (Find information about Walgreens’ rollout plan here.)

But how exactly does mifepristone work? And how does a medication abortion compare to a surgical abortion? BU Today spoke to Boston University Student Health Services (SHS) administrators and nurse practitioners Hannah Landsberg, SHS associate director, and Deborah Lipkin, assistant director of primary care, for answers to these and other common questions about mifepristone.

Even though the rule change impacts only states where abortion is already legal, “this is a step in the right direction for more access to abortion care, women’s healthcare, and women’s rights,” Landsberg says. “This will most help individuals in less resource-dense areas who can now go to a pharmacy [instead of having to travel] for appointments at a clinic.”

Mifepristone FAQ

What is mifepristone?

Mifepristone makes up the first part of a two-pill medication abortion regimen. Mifepristone works by blocking progesterone, a necessary pregnancy hormone that helps maintain a healthy uterine lining and keeps a fertilized egg in place, Lipkin says. In the absence of progesterone the uterus cannot support a pregnancy and empties itself. The second pill, misoprostol, softens the cervix and causes the uterus to contract and expel its contents. 

Abortion medication can only be used in the early stages of a pregnancy. “The recommendation for mifepristone is to take it as early as possible up to 10 weeks,” Lipkin says. Misoprostol can be used safely and effectively by itself to terminate a pregnancy. However, providers almost always recommend mifepristone in conjunction with misoprostol, she says, with misoprostol usually given 24 to 48 hours after mifepristone.

How effective is a medication abortion?

A medication abortion is a safe and effective noninvasive alternative to surgical abortion. Abortion pills can be taken at home, under the direction of a medical professional, and are approximately 95 to 99 percent effective. 

Note that if you have an intrauterine device (IUD), you should have it removed before taking mifepristone and misoprostol, Lipkin says.

What are the risks of using medication to terminate a pregnancy?

Medication abortions are fairly low-risk and serious complications are rare, Lipkin says. Complications can include an unsuccessful abortion, retained products of conception, heavy bleeding and clotting, and infection. Side effects can also include painful cramping, nausea, dizziness, and fevers. 

How do I decide between a medication or a surgical abortion?

Individual situations and preferences vary. Two key differences to note are that a medical abortion takes longer to complete than a surgical abortion, and a surgical abortion is less likely to result in retained products of conception. A medication abortion may be best for a patient in the early stages of pregnancy who doesn’t want to or cannot make it to in-person appointments. A surgical abortion may be best for a patient who prefers to undergo an abortion under full medical supervision. 

Ultimately, “it’s important for a patient and a clinician to discuss what [option is] best, both medically and preference-wise, for the patient,” Landsberg says. 

How do I get a prescription for mifepristone and misoprostol?

Book an appointment with your doctor or at a clinic like Planned Parenthood in West Campus. If you are covered by BU’s Student Health Insurance Plan (SHIP), know that Student Health Services does not prescribe mifepristone, but can provide a referral to an outside provider, Landsberg says. SHS can provide unplanned pregnancy consultation and abortion aftercare.

Is mifepristone the same thing as the morning-after pill?

No. The morning-after pill is emergency contraception, not abortion medication. When taken within the appropriate window of time, the morning-after pill—such as Plan B or Ella—keeps an egg from being fertilized by delaying or preventing ovulation. The morning-after pill cannot end a pregnancy where an egg has already been fertilized and implanted. (Learn more about emergency contraception here.)

What pregnancy prevention services are available through Student Health Services?

SHS offers a full range of birth control services for students. (Learn more about your birth control options here.) Students can access contraception counseling, and get a prescription for birth control pills, a patch, a ring, or Depo shots. Students with SHIP can have an IUD or arm implant inserted. Students without SHIP can receive referrals for IUDs or implants. Additionally, the Condom Fairy program mails free safe-sex supplies to students living on and off campus.

And remember: whatever your situation, “students can come to us,” Landsberg says. “We’re people’s first stop on campus for medical care, whether that’s questions, concerns, or wondering where to go. We are here to help you navigate your health.” 

Questions? Reach out to an SHS provider or book an appointment through Patient Connect.