Thread by @McMisoprostol

🧵I am seeing A LOT of confusion about the different types of abortions. Here's a very brief guide to some of the most common abortion methods:

Medication abortion is overall the most common method. It uses 2 medications: mifepristone (mife) & misoprostol (miso) to end an early pregnancy (usually up to 10 weeks). If you go into a clinic, you usually take mife there, and then take miso at home. It's very safe & effective.

There's also telemedicine abortion, a type of medication abortion. Instead of going to the clinic, you talk with a clinician via video or phone, and the same mife and miso pills you would get in the clinic are mailed to you. This is legal in 31 states. Very safe & effective.

There's self-managed abortion, which is when a person self-sources (without a clinician) abortion pills from foreign pharmacies. SMA is NOT the same as telemedicine. It's very safe & effective—but can be legally risky. Most don't get caught, but ~22 people have been criminalized.

Beyond pills, there's also suction abortion performed in the clinic. It's sometimes called "surgical abortion" but there's no cutting or stitching. Gentle suction is used to remove pregnancy tissue from the uterus, up to ~16 weeks. Very safe & effective. Sedation is often used.

95% of abortions happen before 16 wks. But people need abortions after this for a variety of reasons: some have their care delayed by anti-abortion restrictions, some w/o regular periods discover pregnancy later, some get a poor diagnosis for themselves or their fetus. All valid.

Dilation and evacuation abortion is the most common method used for 2nd trimester abortions. The cervix is dilated, then suction & sometimes surgical instruments are used to gently remove pregnancy tissue. Sometimes fetal demise is first induced via injection. Safe & effective.

Induction abortion is rare in the U.S., but sometimes patients prefer it or it's the safest option for them or they have a non-viable pregnancy & want time to grieve. There are 2 procedures that have been called 'induction abortion' & I didn't include both before, so fixing that:

With induction abortions, it's generally a 3-day procedure. Fetal demise is induced through an injection & the cervix is slowly dilated, often using both medication & physical dilators. On the 3rd day, labor is induced with medication & the pregnancy is removed vaginally.

Induction is also used when delivery is the only treatment for an urgent threat to a person's health, but their pregnancy isn't viable. Labor is induced & the patient often chooses comfort care & cuddling until natural death, rather than medically-unsound resuscitation attempts.

Abortions happen in several different ways for a lot of different reasons. It depends on many factors: patient preference, gestational age, availability of trained providers, and anti-abortion restrictions. Everyone deserves access to the abortion care that's best for them.

Notably NOT included b/c it is NOT abortion: emergency contraception (Plan B, Ella, morning-after pill, etc.) Emergency contraception helps to *prevent* pregnancy before ovulation occurs. It will NOT cause an abortion. It's also less effective after 155 (Plan B) & 195 (Ella) lbs.

Addendum: As Dr. Upadhyay added in the replies, there are many providers who offer telehealth abortion through chat-only! It doesn’t necessarily have to be a video or call. It depends on the service provider & most have the answer for how their appointments work in their FAQs.

*Note: Some of these have tweets have been deleted and reposted for clarity, correcting a definition-altering typo, and fixing an accidental omission. I don't want to be sharing inaccurate or incomplete info! I won't tag folks again but a huge thanks to those who caught those! ❤️