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How The Abortion Pill Really Works

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Abortion pill, medical abortion, RU-486… You’ve probably encountered these words before, especially if you’ve ever considered ending a pregnancy. Maybe you typed them in Google and found basic answers on how to use it, up to what week of pregnancy and what side effects to expect. But would you like to dig deeper and truly understand the ins and outs of the abortion pill? If so, you first need to know the story of your body. Hang in there because we promise you, it’s captivating.

You Are Your Hormones

Your body is complex, coordinated and resilient… and it is composed of about 30 trillion cells. Yes, trillions. Since all these cells must communicate for your body to function properly, you are equipped with two great communication systems: the nervous system, and the endocrine system. The nervous system is like a high-speed rail network whereas your endocrine system (in other words, your hormones) is like a canal network because it is a little slower. * The abortion pill acts upon your hormones, so with this in mind, here’s how hormones work:

  • Different glands in your body (your hypothalamus, your thyroid, your ovaries…) produce different hormones;
  • Hormones travel through your bloodstream to deliver instructions to specific cells located in other parts of the body;
  • Once they arrive at destination, hormones are received by hormones receptors, which act as the “eyes” and “ears” of a cell;
  • If both the right kind of hormone and hormone receptor are present, the two bind together, the instruction is delivered and a particular activity can start in the cell.

While slower, your hormones are just as important as your nervous system! These little chemical messengers control a wide range of bodily functions and also affect your mood and your thoughts. Your reproductive system, for instance, is regulated by hormones.

Menstrual Cycle

The Story of Your Menstrual Cycle

Why do you have your periods every month or so? Because biologically speaking, your body is programmed to reproduce. This means that, except for special situations such as breastfeeding, illness or food scarcity, your body prepares for a potential pregnancy every cycle.

Ovulation is the main event and corresponds to the release of one (or more) egg(s) by your ovaries. Sperm can then fertilize that egg if you have sex. Since each woman is different, it is good to remember that cycles can last anywhere from 21 to 40 days and that ovulation can happen on any day too, not just on day 14.

So how does the cycle work precisely? Well, several hormones are involved and you can memorize the entire process (only if you want to!) with this short acronym: FELOP: **

  • Follicle Stimulating Hormone
  • Estrogen
  • Luteinizing Hormone
  • Ovulation
  • Progesterone

To start with, you have 15 to 20 eggs that begin to mature in your ovaries under the influence of Follicle Stimulating Hormone. Each egg is contained in a follicle, which in turn produces estrogen. When estrogen reaches a peak level, it triggers an abrupt surge of luteinizing hormone, which causes ovulation.

After all this is done, the body can relax, take a seat back and wait to see whether the egg(s) released will get to meet sperm or not. In the meantime, the follicle that enclosed the egg transforms into what is called corpus luteum or “yellow body”. It will stay alive for about 12 to 16 days (unless pregnancy occurs) to release progesterone.



What Does Progesterone Do?

So what is this progesterone for? Along with estrogen, progesterone is one of the most popular female hormones. Although it is also present in men to help with sperm production, as a woman you have more of it especially after ovulation and during pregnancy. If fact, it is vital for pregnancy, so the abortion pill works by being an obstacle to it.

  • After ovulation:

 The progesterone produced by the corpus luteum preps the uterine lining (or endometrium) for the implantation of the embryo, which happens about a week after fertilization.

  • During pregnancy:

If fertilization happens, the corpus luteum doesn’t disintegrate and continues to produce progesterone until the placenta forms and takes over. The progesterone prevents the release of other eggs, which protects you against multiple pregnancies. And it also protects the brand new life growing inside you. It prompts the endometrium to provide nutrients and oxygen to the developing baby, and it allows the uterus to grow without having contractions, meaning, without expelling the embryo.

You guessed it. This natural mechanism is exactly what the abortion pill interferes with.

Abortion Pill

Here Comes The Abortion Pill

The term “abortion pill” can be a bit misleading because it actually consists of two pills: mifepristone and misoprostol:

  • Mifepristone (also called RU-486 or Mifeprex, the brand name) was developed in France in the 1980s. The FDA later approved it for use in the US in 2000. This first pill blocks the hormone progesterone. Think of mifepristone as a hacker. It comes in disguise and deceives the progesterone receptors in order to bind to them instead of the real progesterone. As a consequence, no chemical reaction can occur and the lining of the uterus, to which the developing baby was attached, breaks down. Most of the time, you will read that “mifepristone stops the pregnancy from growing”. But what it means exactly is that the little human growing inside you is deprived from oxygen and nutrients, and dies as a result. Growth stops because life stops.
  • The second pill, misoprostol, induces uterine contractions, resulting in the expulsion of the embryo.

The entire process lasts only a few days but some severe complications can arise, such as heavy bleeding.

But did you know that the effects of the abortion pill can be reversed? If you have taken the first pill mifepristone and would like to continue your pregnancy, there is hope! Reversing an abortion is a safe but time sensitive method. There is absolutely no fear or shame to change your mind during an abortion. If you happen to be in this situation, Lifeline is here to help you. You can read more about the abortion pill reversal protocol and what to expect at our clinic.


* The Truth About Hormones, Vivienne Parry, 2009.

** Taking Charge of Your Fertility, Toni Weschler, 2015.