For many, a missed period can be distressing, given that it could indicate a pregnancy. Suppose there were a pill you could take if you missed your period, but you didn’t want to know whether you were pregnant. The pill would terminate a pregnancy and cause bleeding; in the case of no pregnancy, it’d cause period-like bleeding. The pills would be safe, but have side effects similar to regular menstruation. Would you have interest in taking them before a definitive pregnancy test?
Some people say yes, according to a study published in Contraception Journal in September.
The study, conducted by researchers from Gynuity Health Projects, posed that exact scenario in a survey given to people seeking pregnancy tests at nine health centers in two states between 2015 and 2017. Of the 678 people asked, 42 percent showed interest in the pills. Interest was greatest among people who indicated in the survey they’d be unhappy if they were pregnant, but 12 percent of people who said they’d be happy if they were pregnant also showed interest.
“Our findings suggest that some people with missed periods do not desire pregnancy confirmation before taking medications that might disrupt a pregnancy,” the researchers wrote. “If missed period pills were available in the United States, demand might be substantial and wide-ranging across demographic groups.”
Chika Ekemezie, a 23-year-old freelance writer in Washington, D.C., wasn’t involved in the study. But, like 42 percent of respondents, she says she would be interested in such pills. The pills would essentially be the same as those used in medical abortions now: a combination of the drugs mifepristone and misoprostol, which stop the pregnancy from growing and cause the uterus to evacuate. These types of abortions make up more than one-third of all abortions in the United States today and are considered very safe; they can typically be used up to 11 weeks after the first day of your last period.
Ekemezie refers to her attitudes toward abortion as “cavalier”; she doesn’t want children right now, but images of abortion she’s seen on television always seem to show fear and pain. That’s why using a “missed period pill” appeals to her.
“It just seems more convenient to kind of have some preemptive measure,” she says. She also believes being able to access the pills might improve reproductive freedom by allowing people to choose this option privately, as well as remove the layer of embarrassment or shame sometimes associated with seeking an abortion.
Indeed, for those interested in the pills in the study, there were two main reasons. The first was to avoid, prevent or terminate a pregnancy. The second was the potential emotional benefits, including managing abortion stigma. Those who said they weren’t interested, meanwhile, cited safety concerns as well as their desire to have a baby or not have an abortion.
According to lead researcher Wendy Sheldon, the findings, although not nationally representative, suggest some people just don’t want to know if they’re pregnant before taking a pill that would cause an abortion (or induce period-like bleeding, if they’re not pregnant). They’re not the same as Plan B, or emergency contraceptive, which reduces the risk of pregnancy but doesn’t cause an abortion if someone is already pregnant.
Kelsey, a 26-year-old nonprofit worker in Connecticut, says the missed period pills are “exactly what I would want.”
Kelsey, who asked that she only be identified by her first name because she is a survivor of domestic violence, knows what it’s like to fear a positive pregnancy result. Six years ago, she was attending college in the Midwest when she had a pregnancy scare. Although she had been on birth control pills, she hadn’t been taking them regularly, and her then-boyfriend removed the condom during sex — an act many would define as sexual assault.
“So, I remember thinking like, ‘Oh, I’m in a very red state, am I going to be able to get an abortion?’” she says. She didn’t have a car, and she didn’t tell her friends about the details of her relationship, which she says was abusive. She felt “really alone.”
Kelsey ultimately found out she wasn’t pregnant. But, had she been, she would have preferred to never have known. Instead, she says, she would have appreciated the option to “take a pill and put it out of my mind.”
“It’s kind of a feeling of ignorance is bliss,” Kelsey says. Keeping her then-boyfriend in the loop about an abortion would have caused her distress, she adds.
Kelsey also says the notion of “missed period pills,” as opposed to “abortion pills,” appeals to her, because it leaves some of the stigma around abortion out of the conversation. “I think maybe removing [abortion] from the phrase, or that term from the marketing of the pills, would be really helpful,” Kelsey says.
The impact of abortion stigma is well documented. Research published in the journal Women’s Health Issues, for example, found that abortion stigma may not affect just women who have had abortions, but also those providing abortions and those advocating abortion.
A 2013 study also found that people who experience abortion stigma may have worries about judgment, isolation, self-judgment and community condemnation. Using those four factors, researchers found that women with the strongest religious beliefs, particularly those who identified as Catholic and Protestant, had the highest levels of self-judgment and perception of community condemnation compared with “somewhat religious” women.
But Robin Marty, an abortion rights advocate and author of two books on abortion and Roe v. Wade, says the idea of a “missed period pill” isn’t that simple. In fact, she argues, it could add to abortion stigma. For people already uncomfortable with the idea of speaking about abortion as abortion, this could perpetuate “the stigma that it’s something that needs to be hidden, and cannot be interacted with in the general public,” she says.
The 43-year-old also says it’s possible that people who are drawn to the idea of using a missed period pill may end up regretting their abortion down the road. The gray area of missed period pills might also lead to psychological distress, she argues. Someone could believe they did actually have an abortion when they weren’t pregnant and feel regret for something that never happened, for example.
Still, she says, the pills put power in “the realm of the person who has decided that they want to have an abortion.” She adds that pills used to induce medical abortions are safe and can be used at home, as long as a person is aware that there is a potential risk they may have an ectopic pregnancy, which would require a surgical removal.
Some antiabortion activists, meanwhile, dismiss the idea of a missed period pill. Students for Life of America President Kristan Hawkins says calling something a “missed period pill” doesn’t change “the facts, the repercussions to women’s lives or the implications.”
“What is exceptionally reckless of the abortion lobby is their willingness to expose women to chemicals and blood loss when they might not be pregnant,” Hawkins wrote in an email.
Sheldon, the lead researcher, says that the study presents a hypothetical option that isn’t for everyone. However, she says, it provides a starting place for further research on language and applicability, a conversation she hopes can be had by the people who are interested in reproductive care. Sheldon says she, along with other colleagues in her field, are continuing work on researching the acceptability, safety and efficacy of practical use of these pills.
“Some people might want to call it the abortion pill: They’re seeking the abortion without knowing if they’re pregnant,” she says. “Others might want to say, I’m taking this pill. I know they’re also used for abortion but, for my purpose, they’re missed period pills.”