Chemical Abortions: With and Without Medical Supervision.

Chemical abortions, otherwise known as "medication-induced" abortions, were approved by the FDA in September 2000, and now account for over 50% of abortions in the United States. Women are being encouraged to order and carry out their own abortion, without in-person supervision by health care professionals, contributing to increased risks of complications. This paper describes the use of synthetic chemicals to induce abortion and the complications faced by women who obtain care in a medical setting, including hemorrhage and incomplete abortions that may require surgical intervention. Additionally, it describes the increased risks for those women who use telemedicine or the Internet to obtain their chemical abortion, especially when those abortions are completed without physician supervision (self-managed). The risks may include an undiagnosed ectopic pregnancy, increased complications due to underestimated or understated gestational age, Rh isoimmunization, and undiagnosed infection. Intimate partner violence, reproductive coercion, and human trafficking are also less likely to be suspected in the absence of an in-person medical evaluation. The American College of Pediatricians strongly encourages health care professionals, policy makers, and women of all ages and their families to understand the serious risks associated with chemical abortions, especially when self-managed. Additionally, pregnant women with regrets after starting chemical abortions need to be informed about the potential for abortion pill reversal.