On May 2, 2023, Governor Kathy Hochul signed legislation (A1395-C/S1213-B) to ensure students have access to medication abortion prescription drugs at SUNY and CUNY campuses, including Binghamton. It went into effect on Aug. 1 and requires:
- All SUNY and CUNY campuses to prescribe, or refer students to provide, medication abortion
- SUNY administration to report to the Governor's office, senate and assembly whether campuses are compliant with the law and the number of individuals at each campus authorized to presribe these drugs. This requirement goes into effect 24 months after the effective date of this legislation and annually thereafter
Decker Student Health Services Center (DSHSC) approach
The DSHSC will continue to evaluate and support students who are pregnant. Our providers will educate pregnant students on all options available to them, including those who wish to have an abortion. There is a private medical practice nearby – Southern Tier Women's Health Services – which offers abortion care. This clinic has been quickly responsive to our students and has treated our students well. Caregivers at the DSHSC will continue to refer students to this office, which is 5.5 miles from the main campus. If you need assistance with transportation, please call DSHSC (607-777-2221) and ask to speak with the Director of Health and Counseling.
Medication protocol
Students have two options for abortion care. “Medical” abortions use medications to induce the passage of the pregnancy tissue without the need for surgery. A “surgical” abortion is performed by a trained medical professional and uses instruments to evacuate the pregnancy from the uterus. Many students prefer a medical abortion since they can manage the abortion in the privacy of their own dwelling and it avoids the need for a procedure. However, some students prefer to have the abortion “over-and-done-with,” and choose the surgical option.
The usual protocol for a medication abortion is to use two medications. The first is mifepristone, which has anti-progesterone effects that stop the pregnancy. It is taken as a single, 200mg dose. The second medication is misoprostol, a prostaglandin which leads to contraction of the uterine muscle and the expulsion of the pregnancy tissue. Misoprostol is usually taken as an 800mg dose (two 200mg pills dissolved in both cheeks at the same time), and is taken 24 hours after the mifepristone. The dose of misoprostol may need to be repeated three to six hours after the first.
Timing and abortion method
The use of mifepristone and misoprostol for medical abortions is approved by the Food and Drug Administration (FDA) until the 70th day of the pregnancy. However, there is data to show it is safe and effective up through the 77th day, and many abortion providers will use it through this date. Complication rates become unacceptably high when medications are used after this date, but surgical abortions remain an option. Many students don’t recognize they are pregnant until they are 42–49 days into their pregnancy, so the process must work expeditiously to ensure students are able to identify they are pregnant, get an accurate date for the age of the pregnancy (usually requires an ultrasound), and a quick referral to an abortion provider before the 70th day.
Patient experience
Only 1%–5% of students will have bleeding or cramping after taking mifipristone and before they take misoprostol. On the other hand, most students will experience bleeding and cramping after taking misoprostol, with the pregnancy tissue usually passing within four to six hours. Bleeding should be similar to a heavy menstrual period and taper off over the first few hours to days after the passage of the tissue. However, up to 9% of students may still have some bleeding after 30 days. Cramping and abdominal pain should mostly resolve once the pregnancy tissue passes, and it is usually able to be controlled with medications like ibuprofen or naproxen. On average, the pain is reported to be 5.5/10 on a scale where 10 is the worst pain imaginable, and students are usually pain-free at 72 hours. The return of a normal menstrual cycle usually occurs in 30–60 days, but the first cycle may be heavier and/or longer than usual (8–17 days).
Complications
The overall the rate of “serious” complications, such as failed or incomplete abortion, emergency room visit, hospitalization, transfusion, need for intravenous antibiotics, need for a surgical procedure, or death, is 0.31%. “Minor” complications, such as uncontrolled pain, infections treated with oral antibiotics, or excessive bleeding, occur in 4.8% of patients.
Soaking through two menstrual pads per hour for two or more consecutive hours should cause a woman to seek medical care. Uterine infection, which may cause symptoms such as abdominal or pelvic pain, foul-smelling discharge, or fever, occurs approximately 1% of the time and is usually able to be treated with oral antibiotics.
Any tissue retained in the uterus can lead to serious infections if it is not removed, and misoprostol can cause serious birth defects. Therefore, a retained pregnancy usually requires the tissue to be removed surgically using a procedure similar to a surgical abortion (called a “dilatation and evacuation”).
Summary
There are many options available to Binghamton University students who find themselves pregnant. Do not delay seeking a consultation if you find yourself pregnant. The providers at the DSHSC are prepared to educate and support the decisions that these students make, including if they choose to have an abortion.
Contact
Use the online patient portal to send your provider a secure message about any medical related questions or issues, or to schedule an appointment.
