Science Vs - The Abortion Pill: How Dangerous Is It Really?

Episode Date: May 23, 2024

The Abortion Pill is now the most common way to have an abortion in the US. Yet what exactly happens when you take these pills is shrouded in mystery. Even many doctors don't know how well they work! Today, we're letting the sun shine on the abortion pill. We'll walk you through what happens when you take these pills: what they do to your body, and how safe are they for your physical and mental health? To explore all this - and more - we speak to Dr Sara Whitburn, Professor Oskari Heikinheimo, and Professor Ushma Upadhyay. UPDATE 7/15/24: The episode has been updated to clarify that surgical abortions do not always happen at a hospital by a doctor, while the patient is under general anesthesia. They can also happen at clinics and patients can get a local anesthetic. Find our transcript here: https://bit.ly/ScienceVsTheAbortionPiill The Abortion Project's Instagram @theabortionproject Science Vs's Instagram @science_vs If you want to talk to someone - there's some great resources in here: spotify.com/resources In this episode, we cover: (00:00) The battle over the abortion pill  (04:28) How does the abortion pill work?  (09:05) How it feels to take the abortion pill (14:34) How often do people hemorrhage? (21:22) What's "normal" bleeding?  (24:11) Does taking the abortion pill affect your mental health?  (32:02) Why some people prefer the abortion pill This episode was produced by Meryl Horn and Wendy Zukerman, with help from Rose Rimler, and Michelle Dang. We’re edited by Blythe Terrell. Fact checking by Diane Kelly. Mix and sound design by Bobby Lord. Music written by Bobby Lord, Emma Munger, So Wylie, Bumi Hidaka and Peter Leonard. Thanks to all the researchers we spoke to including Dr. Tiffany Green, Dr. Ned Calonge, Professor Jenny Higgins, Dr. Daniel Aaron, Dr. Beverly Winikoff, and Dr. Abigail Aiken. Also thanks to Lauren Silverman, the Zukerman Family and Joseph Lavelle Wilson. Science Vs is a Spotify Studios Original. Listen for free on Spotify or wherever you get your podcasts. Follow us and tap the bell for episode notifications.  Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman, and you're listening to Science Versus. Today on the show, the abortion pill. It's the most common way to get an abortion in the U.S. these days. And there is a huge spotlight on these pills right now. Now to the abortion pill battle. The Justice Department is... We've got some breaking news now here in the U.S. We saw the Louisiana House passing a bill that could make that state the first in the country to criminalize abortion pills.

And that spotlight is about to get even brighter. Because soon the Supreme Court will decide if the FDA has made these pills too easy to access. Supreme Court deciding the future of the abortion pill. This is now a case about how easy is it going to be to get that pill. You see, now in some US states, you can have abortion pills sent in the mail without ever seeing a doctor in person. And some say that this is bananas and totally dangerous.

How is it safe when one in 25 women will have to visit the ER? Others say that all that talk, it's just politics. But amidst all of this attention on the abortion pill, what's kind of wild here is just how little some people know about the basics of these pills. A recent review paper found that even many primary care doctors don't know how well they work or their side effects. And this can leave the folks who are taking the pills stuck in the middle, unsure of what's about to happen to their own bodies. People like Heather Winton. She's a

documentary photographer who lives with her husband, four kids, and according to her website, too many pets. Heather, what is too many pets? Too many pets is two dogs, two cats, three rabbits, two hamsters. The hamsters. Oh, no, we're still going. And two foster bunnies. So it is entirely too many pets.

Back in 2019, Heather and her husband were in a tricky situation. I found myself unexpectedly pregnant with our fifth child. Here I was, like, in my 30s, married, with children, and I didn't want this. Heather was done having kids, and both her and her husband wanted to put their energy into taking care of the children that they already had. So Heather decided to have an abortion. Yeah, it was a hard moment. She went to a clinic and was given a bunch of pills to take it home. And Heather didn't really know what was about to happen.

Like in TV shows, you see people go to the clinic and have, you know, go behind the double doors and you don't know what happens back there. And I felt like it was the same with medical abortion. I had no idea what it was going to feel like or look like. I just wasn't prepared for the intensity of it all, honestly. I think I was just so overwhelmed. I very much came home and we made my husband's vasectomy appointment the next day. Yeah. Like, I was like, I will never do that again.

Yeah, yeah. And to Heather, all of this mystery around the abortion pill, it was frustrating. Why is it shrouded in this secrecy and taboo and shame and fear? Why can't we bring it out front and center and shine some light on it? So let's shine some light on the abortion pill. Hundreds of thousands of people get abortions in the U.S. every year. So let's take the secrecy and the politics out of this. Today, we're going to walk you through exactly what

happens when you take these abortion pills. And heads up, we are going to get detailed. And we'll also talk about how safe they are for your physical and mental health. Is it really just politics when people say it can be risky to take them? Think about this episode as a what to expect when you don't want to be expecting. It's all coming up just after the break. What does the AI revolution mean? For jobs, for getting things done? Who are the people creating this technology and what do they think?

I'm Rana El-Khelyoubi, an AI scientist, entrepreneur, investor, and now host of the new podcast, Pioneers of AI. Think of it as your guide for all things AI, with the most human issues at the center. Join me every Wednesday for Pioneers of AI. And don't forget to subscribe wherever you tune in. It's season three of The Joy of Why, and I still have a lot of questions. Like, what is this thing we call time? Why does altruism exist? And where is Jan 11? I'm here, astrophysicist and co-host, ready for anything. That's right. I'm bringing in the A-team. So brace yourselves. Get ready to learn. I'm Jan 11. I'm Steve Strogatz. And this is Quantum Magazine's podcast,

The Joy of Why. New episodes drop every other Thursday, starting February 1st. Welcome back. Today on the show, the abortion pill. Tell me about the cactus. Oh, wow. So it's a crocheted cactus that looks more like a penis. This is Dr. Sarah Whitman, Deputy Medical Director at Sexual Health Victoria in Australia. What came first, the pun about the coctus or the...

No, no, the art came first, the crochet came first, and then it was named the coctus. Okay, great, great. So, as part of your work, do you prescribe the abortion pill? I do, yes. Just how many people do you think in your career you've given it to? I'd say it'd be around about 100, yeah. Sarah doesn't just prescribe these pills. She also does a lot of education around how they work. And so I asked her to walk me through the cold, hard facts about the abortion pill.

Even though, you know, it's pretty soft and warm where we're going. And that's because our first question is simply, how exactly do these pills work? And to answer that, we need to head to the uterus. Okay, so each month, the lining inside the uterus changes a lot. At the start of your cycle, like just after you get your period, it's pretty thin. But then your body will pump out hormones which head to the uterus. And that helps the lining, what we call ripen. What do you mean by ripen? I know, there's no real good term for that. I am imagining like my uterus as a peach at this point. I know.

I know. I mean, you can also say stabilise or thicken. I'm going to go with thicken. So the lining of your uterus is getting thicker and thicker. And it's basically building this really cosy place so that just in case a sperm comes along, your uterus is going to be prepared to make a baby. So what it's saying is, hey lining, stay there, get ready, something might happen.

If you think of it as icing on the cake, but it's a nutrient-rich, blood-filled, oxygen-rich icing. The best kind of icing. The best kind, the best kind. If nothing happens, no sperm, no fertilisation, then levels of a hormone called progesterone will naturally drop. And that lining, that icing on the cake, it's going to shed. It'll fall down your vagina along with blood, blood vessels and mucus. And that is your period.

But let's say the coctis gets a little trigger happy and you get pregnant. Progesterone will keep getting pumped out and the icing in your uterus is going to get thicker and thicker. Now, if you'd rather that didn't happen, well, enter the abortion pill. This is also called a medication abortion. In the US, it's approved to be used for a pregnancy that's up to 10 weeks along.

And normally, you'd be given two different kinds of pills. The first you'll take is called mifepristone, which is what the Supreme Court is looking at. Now, this drug basically tells that nutrient-rich lining... Stop. Don't grow anymore. Don't support this pregnancy. OK, stop. It does this by blocking progesterone. And that means the uterus is basically like,

huh, no progesterone, I guess no pregnancy. Time to say goodbye to that nutrient-rich lining. It's time to let it shed away. And that's a lot more like what happens if you don't get pregnant. That's so interesting that it is sort of, on some level, mimicking the process of just having a regular period. Progesterone drops and your body's like, you don't need this. Yeah, it is.

And that's why you bleed. Some people might start bleeding as soon as they take pill number one, mifepristone, but for most of us, the bleeding starts after pill number two, which you'll take a day or two later. That second pill is called misoprostol, and it's filled with a chemical that heads for the muscles that live around your uterus, and it makes them squeeze, so it basically empties what's around your uterus, and it makes them squeeze. So it basically empties what's

in the uterus, which might sound kind of weird, but misoprostol is just a synthetic version of this chemical that we naturally make when we have our periods. Now, this whole process of taking these two different kinds of pills, it works well. About 97 to 98% of the time, the abortion will be complete. And now, let's go back to Heather, our mother of two dogs, two cats, two hamsters, five rabbits, and four children, to get a better idea of what all this can feel like. So Heather took the first pill while she was still at the clinic, and she didn't feel anything from it. And then a couple of days later, she took the misoprostol. By now, she was nine weeks along.

Her husband booked a hotel room for her that night, away from the hamsters and children, so that she could have her abortion in relative peace. And Heather and I talked about it. So you burnt a candle, right, in the room? Yes. Yeah. Don't tell the hotel. And you put the misoprostol in your mouth. And then when, was that a weird feeling? It's four pills, right? It's a lot of pills. Yes, it's gritty and nasty.

I mean, it's not totally nasty. I just remember being chalky and I couldn't wait to be able to just swallow it and rinse my mouth out. Within the hour, Heather could feel something. It just started feeling like that ache of beginning your period. So I was just like aware of my uterus and like I had some back pain, um, some pain in my thighs, which is all normal for me when I start my period. So I was still chatty and happy. But then the cramps got worse and Heather went into the bathroom. She wanted to have a warm bath.

And Heather was in the hotel with a friend of hers, Sarah, who's also an abortion doula, which means she helps people through abortions. So she's a very handy person to have around. I think I got in the tub pretty quickly and Sarah had, like, lit candles all around me and was, like, pouring cups of water on my back for me and stuff like that. It was really beautiful. The pain got worse and worse, though.

Heather said it was extremely painful for about five hours. Having gone through childbirth before, she said it was actually pretty similar to being in labor. Not like full-blown labor, but you don't get the lull of contractions either. It was just one big contraction the whole time it didn't let up so it wasn't even like the wave of breaks and sarah was sleeping for part of it and i wanted to just throw at her like wake up i'm in pain oh but there was nothing she could do, you know? Like, I just had to ride it out.

Because I also had horrific diarrhea and vomiting. Oh, man. Yeah. So I would momentarily have to get out of the tub to throw up or use the bathroom. And I was livid. I just got angry that I was in the position that I was in. And I was mad at my husband. And, like, I was just a grumpy, pissed off woman in a bathtub. Roughly 50% of the people who take abortion pills will describe the pain as moderately or extremely painful. Taking ibuprofen or maybe codeine might help. And yeah,

it's also pretty common to get nausea and maybe vomit after taking misoprostol. Now, for the some 40% of women who are getting abortions and who have never given birth before, Sarah says, expect this to be worse than your period. So on the upside, if you don't get painful periods, it might not be that bad. And in one study of hundreds of women, around one in ten said they felt no pain. So now let's talk about the bleeding and what to expect there. Because when it comes to how much blood is going to come out of you, Dr. Sarah Whitman says that that worse-than-your-period guideline,

it applies here as well. I think it's really important to say it is more than a period. And I think if you don't know that it's going to be heavier than a period, that is a shock because we're used to sort of our periods. You're bleeding like this because it's not just your period, right? That lining of the uterus has now gotten thicker, plus there's the embryo and placenta. And the further that you're along,

the more that you'll bleed. The heavy bleeding should let up within 24 hours. And after that, the bleeding should be more like a regular period. So that's what's typical. And for Heather, that's basically how it was. But sometimes things can go wrong and people can bleed a lot and it can be scary. They end up in the hospital. And this is what folks who want to restrict access to these pills focus on, stuff like hemorrhaging or where these large blood clots can fall out of you. Here's Sarah.

If you're passing grape size, blueberry size, that's probably normal. But if you go up to a lemon size, that is abnormal. A lemon-sized clot. Yeah, yeah. And we do use the word lemon. I mean, that would be so scary. That's so big. Yeah, it is big and you would really want to be seeking help.

So how often does that happen? How many of us are having lemon-sized blood clots and gushing so much blood that we need to go to the hospital. That's coming up just after the break. Welcome back. Today on the show, the abortion pill. We've just walked you through how it works, and now we want to know what happens when things go wrong.

So last year, a Texas judge made this really important ruling that basically said that the abortion pill was dangerous, and he implied that lots of women were hemorrhaging as a result of taking it and heading to emergency rooms. This case is now being heard by the Supreme Court and whatever they say could have implications throughout the US. Like I said, important. And the thing is, in that judge's decision,

he used scientific studies. Like, he cited this paper from Finland. And so senior producer Meryl Horne and I called up the guy who led that study. I've been working with Mifepristone for actually 40 years, so quite unbelievable. I didn't even know it existed for that long. Yes, me and Mifepristone go way back. This is Oskari Heikenhimo, a professor of obstetrics and gynecology at the University

of Helsinki in Finland. And for him, this study started in the year 2000, when Mifepristone was first approved in Finland. It's around the same time as the US. And researchers like Oskari weren't exactly sure how this would go. Because yes, this pill had been tested in clinical trials, but now you'd have all these women in Finland taking it. And so he wanted to know. Are there adverse events? What kinds of adverse events?

Are there serious complications? Serious complications which you may not see if you do a study, you know, with 100 patients. So in this paper we had some 42,000 women. Yeah, 42,000 women. It was basically every woman in Finland who got an abortion in the early to mid-2000s. And Oskari got that information because in Finland, all patients getting an abortion have their data entered into a registry. And so once Oskari got access to that registry, he could look and see.

How many of them came back to the hospital with questions or concerns? And he saw that quite a lot of women did come back to the hospital. And in fact, there was one diagnosis that they were given over and over again. Many people had the diagnosis of hemorrhage. Hemorrhage. Hemorrhage. In fact, almost 16% of the women in Oscari's study were diagnosed as having a hemorrhage. That's roughly one in six. That sounds scary.

But just as Jafar said in Aladdin, things aren't always what they seem. Because Oscari said that in his study, hemorrhaging just meant someone who was having any kind of bleeding and was concerned about it. Obviously, I see that the term hemorrhage seems certainly a worrisome term, but that's a diagnostic code. So anyone who came in with any kind of bleeding, that was like, boom, you're hemorrhaging. Exactly. Because that's the code. We only have one code for bleeding and it's hemorrhaging. Exactly. That's where the term came from. So it's not like someone's gushing blood.

No, no, no, no. Could have just been that they had some blood and they were really worried. And so they went to get checked out. Yes. Oskari told us that a lot of women that were coming to the hospital were actually totally fine. Their bleeding was normal, you know, given that they'd just taken the abortion pill. And so Oskari's like, don't use my study to suggest that tons of women

who use the abortion pill are in danger and bleeding out. Well, you know, I think it's a misuse of scientific data. If you go cherry picking and then you take one sentence from here and another sentence from there, you know, it's not serious work. You don't think they're being good researchers? Well, I don't know about them as researchers, but I think that's pure cherryicking to advance a political agenda. Oskari also told us that, you know, if you want to be a good researcher,

don't use his paper, which was tracking abortions that happened 20 years ago, because doctors have learned a thing or two in that time. So, to find out how many of us these days will lose dangerous amounts of blood after taking the abortion pills, we're going to need a different nerd. I love, love, love doing research. Oh, I found one.

My name is Dr. Ushma Upadhyay. Ushma is a professor and public health scientist at the University of California, San Francisco. And this year, she published a study of more than 6,000 people who took the abortion pill. And she carefully tracked the big things that went wrong. So we looked at blood transfusions, major surgeries, major infections.

And it's worth saying that in Ushma's study, these people actually got their abortion pills in the mail. So before taking the pills, they never actually saw a doctor in person. Instead, they either had a video chat with a doctor or did what was called the asynchronous model, which means that the entire communication process is over text. Wow.

I don't know what emojis they were sending each other. Somebody mentioned the emojis too, right? Love heart, strong arm. Yeah, exactly. And that kind of model of care where you don't see a doctor in person. Remember, this is exactly the kind of thing that the Supreme Court is questioning right now. But for Ashma, as thousands and thousands of patients started doing this, she was excited. Yes, yes. I mean, it's incredible how, you know, that there were so many patients,

that the data were coming in. And so what did you find? How many of them had serious side effects after taking these pills? A quarter of 1% of patients experienced a serious adverse event. Okay, a quarter of 1%, so... 0.25%. Two to three people out of a thousand. Yeah. So the risk of something like needing a blood transfusion or getting an infection is super small. Out of a thousand people, it'll happen to maybe three of us. And by the way, when we look at other research, we can see that that risk is pretty much the same whether you're just texting with a doctor or you saw them in person and maybe they even gave you an

ultrasound. It actually doesn't matter. And then there was something else that Ushma could see in the data, and it's actually really important. You see, every now and then people were going to the ER, sometimes thinking that they were bleeding too much, but they were actually totally fine and sent home pretty quickly. Now, the truth is, it can be tricky at times to know what's normal bleeding and what's not. There are guidelines, and they say that if you are filling two maxi pads in two hours or you're passing lemon-sized blood clots, like we talked about, that's too much. But speaking to Ushma, it's like, wait, what exactly is two maxi pads worth of blood? I was just at a meeting yesterday and someone was like, where did this guidance even come from? And like, who really knows how much

a pad actually, how much blood is that? And like does that mean and i just think that we haven't researched it enough it's just something that that has been written into lots of guidelines with no citation oh interesting it's the same in australia two maxi pads and i was like you go to the pad section today and there's like a million different maxi exactly'm like, is it the super? With wings, without wings? Which maxi pad are we referring to here? That's exactly, and this was a meeting of medication abortion experts, and we were all talking about this. Still, despite the maxi pad unit of measurement not being as precise as we might want it to be, Dr. Sarah Whitman over in Australia tells it to her patients and she says it is helpful. Like Sarah told me that she actually

had a patient who needed a blood transfusion and she told them, you know, beforehand, if you are filling two maxi pads in two hours, that's too much. They said to me, we were having that bleeding you talked about. So we went up to the hospital and they gave us a checkup, said, yes, you're bleeding a bit more than we'd like and your red blood cells has dropped. We're going to give you a transfusion. And that's what helped the bleeding slow down and helped the person feel better.

And were they all right in the end? Yeah, they were. They were all right. They said at the time they found the bleeding and the pain was scary for them as in, oh, this is more than we expected, but they knew what they were doing. And so that's the two things they sort of said is they were saying, oh, this is more than we expected. This is heavy, but we knew what to do because you'd said to us, go to the hospital. It's okay to go to the hospital. That's what we need to do.

Sarah also told us that a lot of her patients are worried about whether the abortion pill is going to affect their fertility later on in life when they're ready to have a baby. And the good news is that it doesn't. Okay, so those are some of the physical risks to your body when it comes to taking the abortion pill. But our final question is about the psychological risks of having an abortion.

Because you'll hear, and it definitely came up in that Texas court case, that abortions can be crappy for your mental health. In fact, the judge wrote, quote, Many women also experience intense psychological trauma and post-traumatic stress from excessive bleeding and from seeing the remains of their aborted children. So, is that true? Well, remember, this pill is generally used in early pregnancies.

In the US, it's up to 10 weeks. So the embryo is pretty small, maybe the size of a small strawberry. And we don't have a lot of research specifically on how people feel when or if they see it. But the little research we have shows that yes, for some people, this can be difficult. Like one study from 20 years ago found that out of almost 60 women who saw or thought they saw the contents of the pregnancy, just over half said they had strong negative feelings about it. Like they were shocked, sad or scared. Some people felt shame and guilt. But one in five women either felt neutral, curious or even positive.

I talked about what this was like for Heather when she had her abortion. Like we mentioned, she was nine weeks along. And take care while you're listening to this because for the next few minutes, we're going to get detailed. So remember, she was with her friend, Sarah, during her abortion. Did you see the the like embryo come out at the end do you can if whatever you feel comfortable talking about yeah um

so I was in the bathtub and I remember I was sitting cross-legged in the tub sitting up talking with Sarah and I remember feeling like a stronger contraction. And then I was like, I feel like there might be something between my legs. And yeah, I pulled out the little embryo. And I probably wouldn't have even noticed that the embryo was what it was because it just looked like a blood clot. It just felt different than a blood clot. This is really gross, but I don't know a better way of explaining it. And I'll preface it by saying that I'm a mother of four, but it feels like a crusty booger. Like it's slimy, but still has like some substance to it, you know? And it was kind of all, cause I didn't know what it was. So I think

I smushed a tiny bit and so I handed it off to Sarah and she kind of rearranged it so that I could see the different parts. And yeah, you could see like where, I mean, I don't know how much you want me to describe it. Please, please. No, no details. It's helpful. Okay. Yeah. So you could see like where like a little bit of an eye was forming. You could see a little bit of the umbilical cord. Really? Before, right before that, I had passed, I had felt that I passed what I thought was a large clot. But Sarah put on gloves and kind of went into the toilet to look and it was the placenta, like the early placenta. What did it look like, the early placenta? It looks like a little pink sponge, like feathery sponge-like circle, you know, like it

fits in the palm of your hand. Light, light pink. Yeah, it doesn't look like what a placenta for a full term pregnancy looks like at all. And how did it feel seeing it? I don't remember anything but curiosity. Like I was very curious to see it and it felt very cool to be able to see it, you know? Like, I didn't feel attached to it in any way. I didn't feel like, hmm, that's my baby, or sad in any way that I can remember. After her abortion, Heather actually trained to be an abortion doula herself. She also started a photography project

documenting other people going through medication abortions. And so I asked Heather, now having seen other people go through this, how do they respond to seeing the embryo? I have seen people that have just not wanted to see it whatsoever or have seen it and have had strong reactions to it. Well, one person comes to mind, her embryo fell out of her as she was walking across a yoga mat in her bedroom. And so it was this very dramatic moment where she was just walking and then boom, her waters broke, you know, like there was like a trickle of water and blood.

And then this embryo fell from her. And she dropped to her knees and begged for forgiveness. Like right then and there, she just kept saying, I'm sorry, I'm sorry, forgive me, forgive me. And I don't know who she was talking to, but she really like kind of cried and kind of with tears, you know, holding this embryo in her hands. And, you know, she quickly kind of pulled herself together and stood up and took a shower and got dressed. And that was really powerful to see. And such a stark contrast from my experience. But we're not a monolith, you know, like so many people have different experiences

and each one is valid. Like we mentioned, there's not a lot of research on how people specifically feel when they see the embryo. But what we do have is quite a lot of research, just more generally, on whether abortions affect your mental health, including medication abortions. And here's what it finds. So the careful studies that compare rates of depression before people got pregnant to then after their abortion find that on average, abortions do not affect the chance of you getting depression or feeling suicidal.

In fact, when Ushma looks at the research, she says that on average, in the long run, abortion has no impact on mental health. It's really surprising just our obsession with abortion and the trauma it's going to cause, but it's really not a mental health story, I think. No, not at all. In terms of regret, the data show that the vast majority of people, you know, over 95% feel confident about their decision, feel no regret about their abortion decision. For me personally, it's just been positive since the abortion. I've never looked back on it. Well, I won't say never. One time I looked back on it and I was kind of like, life has turned out a

little different than I thought it would after the abortion. Maybe I should have had that baby. But then I thought about it and I was like, no, I love my life, like what I'm doing now. I'm so thankful I'm not spending the next five years, like, attached to a child. I'm so glad that's not what I'm doing. And just finally, despite all of these fear campaigns around abortion pills, studies have found that many women prefer these pills to the other option that's out there, which is surgical abortions. That's where you often have to go to a hospital or a clinic and you get an anesthetic.

So some women prefer the abortion pills because of the costs. In the US, they tend to be cheaper. There are also shorter wait times. It's more private. You get to be in the comfort of your own home and you get to avoid surgery. One study found that almost 90% of women who got a medication abortion would recommend it to a friend. So, you know, with Yelp reviews like that, am I right?

So, bottom line, while taking the abortion pill is not like a day at Disneyland, Professor Oskari Heikenhimo, who's probably helped more than a thousand patients through medication abortions, says that he just doesn't see the evidence that the abortion pill is causing psychological or any other harm to loads of people. Seriously, medication abortion is used in more than 90% of all abortions in the Nordic countries. And obviously, if we had any thought that we would be putting our young women into harm's way by using medication abortion, we certainly wouldn't be doing it.

That's Science Versus. Hey, Meryl Horde, Senior Producer at Science Versus. Hey, Wendy. Hi. So how many citations are in this week's episode? I don't know. You told me. Well, there are many. There is 108 citations. Whoa, 108 citations. People want to read more about the science of medication abortions. Where should they go, Meryl? They can go to our show notes and then follow the links to the transcripts. Yes. And today on Instagram, we have photos from Heather Witten's project documenting

medication abortions. So these are photos of people as they're going through their medication abortions. The photos are really, really powerful. So please check it out. Just head to science underscore VS. The project, by the way, is called The Abortion Project. And Heather has actually moved on. She's not working on it anymore. She's still a professional photographer, though.

Yes. And also in this episode, we did talk about some kind of heavy stuff at times. So if it's making you feel a certain way and you want to talk to someone, we're going to put a link to some resources just in the show notes. All right. Thank you so much for listening. And thanks, Meryl.

Thanks, Wendy. This episode was produced by Meryl Horne and me, Wendy Zuckerman. You can find me on TikTok, by the way. I'm at Wendy Zuckerman. The episode was also produced with help from Rose Rimler and Michelle Dang. We're edited by Blythe Terrell, fact-checking by Diane Kelly, mix and sound design by Bobby Lord, music written by Bobby Lord, Emma Munger,

So Wiley, Bumi Hidaka and Peter Leonard. Thanks to all of the researchers that we spoke to for this episode, Emma Munger, So Wiley, Bumi Hidaka and Peter Leonard. Thanks to all of the researchers that we spoke to for this episode, including Dr. Tiffany Green, Dr. Ned Kalonj, Professor Jenny Higgins, Dr. Daniel Aaron, Dr. Beverly Winokoff

and Dr. Abigail Aiken. Also, thanks to Lauren Silverman, the Zuckerman family and Joseph Lavelle Wilson. Science Versus is a Spotify Studios original. Listen to us for free on Spotify or wherever you get your podcasts. And if you like the show,

please rate us, give us a five-star review. If you are listening on Spotify though, follow us and tap the bell icon so then you'll get notifications when new episodes come out. I'm Wendy Zuckerman. Back to you next time.