The phrase calling abortion a decision “between a woman and her doctor” was always odd. It conjured a discussion between the pregnant female and her physician about her pregnancy, the factors leading her to consider abortion, an analysis of those factors plus alternatives (adoption? parenting?) before settling on abortion. This idea never made sense as doctors are not moral authorities nor, unless psychiatrists, do they necessarily become intimately knowledgeable about a patient’s private life.

The phrase can be jettisoned in the “medication” abortion era when abortion pills are mailed and taken at home.

If pills are mailed, a medical examination’s protection vanishes.

To get a first look at abortion pills, we should review what is called “normal” and “not normal” by the famously “pro-choice” Planned Parenthood according to its video “What to Expect After Taking Abortion Pills.” It states “bleeding is heaviest a couple of hours after taking the misoprostol pills,” but should lighten “after a day or so,” although it may persist for weeks more or even a month. It adds that, if all goes well, a normal period occurs four to eight weeks following the abortion. The first period might be unusually heavy. PP warns women to “contact a doctor or nurse” if blood flow is so heavy it soaks two maxi pads an hour for two hours in a row. They should also seek help if expelling “blood clots bigger than a lemon for more than two hours” or odious discharge.

Painful cramping is normal, starting about four hours after taking misoprostol, expected to last several hours. PP advises women to ease pain through medicine recommended by medical personnel (although a woman might have consulted no medical personnel if pills were acquired via mail), a heating pad, a warm shower or bath. Patients should regard as “not normal” if there is “severe pain and cramping” that fails to respond to its treatments.

On the day misoprostol is taken, PP elaborates, the taker should expect fever, chills, nausea, vomiting, diarrhea, and fatigue. These symptoms should cease after about a day. If they persist, the woman should seek medical attention. Also pointing to a need for medical attention is a fever of 100.4+ degrees Fahrenheit or fainting.

If a woman still feels pregnant a week or more after taking the abortifacients, PP states, she should see a doctor.

PP fails to say it but if the user “still feels pregnant,” she could still be pregnant. If she does no more at this point, the pregnancy will continue naturally and she will give birth — usually to a healthy baby. Aid Access, an organization that helps females obtain abortions, reports there is a “very low” increased risk of deformities due to the misoprostol. (It is hardly surprising that something designed to kill can also harm.)

Continued pregnancy symptoms may occur when the female has aborted but retained tissues. Resulting complications include infections which might cause life-threatening sepsis, anemia due to severe blood loss, and chronic pelvic pain. It is vital to get to a doctor to have tissues removed.

It is understandable if my reader is a bit baffled. After all, if everything goes “normally,” a patient suffers very painful cramping for about a day along with symptoms like fever, chills, nausea, vomiting, diarrhea, and fatigue. There is a distinct possibility that things might not go normally, meaning lemon-sized blood clots, foul smelling discharges, high fevers, and dead faints. Yet these things do not lead PP to warn that it is imperative they first see a doctor before taking abortion pills. Instead, PP supports them being available by mail.

Contrastingly, the Food and Drug Administration (FDA) warns against buying abortion pills through mail. On its website, it headlines a section, “FDA Does Not Recommend Buying Mifepristone Online.” It elaborates “buying it online” means “bypassing important safeguards specifically designed to protect health.” It comments there is no way to be certain any medication received through mail is safe. The FDA points out that medicines purchased online are often transported “from a foreign country” and the “FDA does not have regulatory oversight of prescription medicines from outside the U.S. drug supply chain; therefore, the FDA cannot ensure the safety, effectiveness, or quality of those medications.”

The Compass Women’s Center is described on its website as a “non-profit in West Virginia” that provides information regarding “reproductive health choices.”  Compass acknowledges the practice of ordering abortion pills online is legal but warns about the risks of purchasing “drugs or medications from online providers due to a lack of safety measures.” They point out that abortifacients obtained via mail have the “risk of being laced with additional drugs,” which could even be “lethal.”

Certainly it might be tempting for females who consider abortion “the easy way out” to consider abortion pills by mail the easiest. An in-person medical consultation and ultrasound are basic precautions since abortion pills are not considered an option if the woman is more than ten weeks along in her pregnancy. The pills are less effective if taken past that cut-off period and can be dangerous to the individual taking them. Considering how easily and how often girls and women miscalculate the timings of their pregnancies, this is a major risk indeed.

Abortion pills imperil those with ectopic pregnancies. Originating from an ancient Greek word meaning “out of place,” an ectopic pregnancy is one in which a fertilized egg failed to attach normally to the womb’s lining. In the vast majority of such pregnancies, the egg attached to the inside of a fallopian tube, making carrying to term impossible. Abortion pills do not work on ectopic pregnancies. Someone could take the abortion pills, mistakenly believe her pregnancy has been aborted, and go about her business until a fallopian tube bursts, causing a life-threatening emergency.

The pills are also dangerous if the pregnant female has a contraceptive called an intrauterine device (IUD) inside. (Since all contraceptives have a failure rate, this is all-too-possible.) Taking abortion pills with such a device inside makes complications likely with infections and retained tissue most common.

Several other conditions make abortion pills dangerous. According to the Mayo Clinic, taking abortion pills can worsen conditions of the heart, blood vessels, and lungs. They can aggravate health problems for those with kidney or liver disease because the substances in abortion pills leave the body at a slower than usual rate. Abortion pills can cause special problems to those taking blood thinners and long-term corticosteroids. The abortion pill triggers bleeding and blood thinners mean greater bleeding for a longer time. Mifepristone inhibits some hormone receptors that corticosteroids act upon so it can make such medicines temporarily less effective. If corticosteroids are being taken for conditions like an adrenal disorder, lupus, asthma, or rheumatoid arthritis, the results could be serious. If taken for minor ailments like a sinus infection, the results would be less serious but a doctor should still be informed.

Some women have found themselves traumatized by this easiest of “easy way outs.” Toni McFadden, who got pregnant while still in high school, was one. She took abortion pills and was surprised to find “it’s not just popping pills and you’re done.” She recalled, “I felt this tremendous pain and went to the bathroom. I had blood clots the size of my fist leaving my body. I didn’t realize it then, but I was hemorrhaging.” She went to the nurse’s office in distress  when this was happening and the nurse phoned her mother. Toni had not told her parents she was pregnant. Thinking her daughter simply sick, Toni’s mom drove to the high school where she picked Toni up to take her home. Toni went to her room, lay in the fetal position on her bed in between trips to the bathroom for hours where huge clots of blood went into the toilet. Toni also suffered the “realization that this isn’t normal and this is going to affect me for the rest of my life.” However, she had to suppress her feelings because, she said, “Our society tells us this is normal.” She later concluded, “for a woman, it changes you because we’re supposed to give life, not take it.”

Abortion pills might seem the pinnacle of convenience for someone with an unplanned pregnancy. However, reality undercuts fantasy in many areas.

References

“Can I Take the Abortion Pill If I Have an IUD?” Chicago Center for Women. May 8, 2026. https://www.chicagocenterforwomen.com/articles/can-i-take-abortion-pill-with-iud.html

“Ectopic pregnancy.” Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088

“Information about Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation.” U.S. Food & Drug Administration. https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/information-about-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation#:~:text=FDA%20Does%20Not%20Recommend%20Buying%20Mifepristone%20Online

“Is It Safe to Order Abortion Pills Online Without Going to a Clinic?” Compass Women’s Center. Dec. 17, 2025.                                 https://www.compass4women.org/post/is-it-safe-to-order-abortion-pills-online-without-going-to-a-clinic 

“Mifepristone (oral route).” Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/mifepristone-oral-route/description/drg-20067123

“Signs of pregnancy after abortion pills.” Aid Access.” https://aidaccess.org/en/page/463/how-do-you-know-if-you-have-a-continuing-pregnancy#_ftn1

“Taking the Abortion Pill Was Traumatic for Me.” Toni McFadden. Students for Life. https://www.youtube.com/shorts/B6Ffa7qgMEs

“What if I take the abortion pill with an ectopic pregnancy?” Ava Care of Harrisonburg. https://www.avacareforyou.org/what-if-i-take-the-abortion-pill-with-an-ectopic-pregnancy

“What to Expect After Taking Abortion Pills.” Planned Parenthood. https://www.youtube.com/watch?v=E-DTfTV17cw