Dr. Caitriona Henchion:

There are a number of risks. The first is that the medication may not be what it is supposed to be. That is particularly the case if ordered from a provider that is not reliable. I have seen women who have taken medication they ordered online themselves and nothing has happened. The did not have bleeding or pain or they had had very little bleeding. It is clear that whatever they were given did not contain any active ingredients. We have no idea of the conditions in which that sort of medication is being made. It may not be safe. It may contain ingredients which are not safe for people to take. It is certainly misleading and it gives women the impression, particularly if they have a small amount of bleeding afterwards, that they may have ended their pregnancy when in fact they have not. In the event of someone being at a later stage of gestation than she thought, there is a greater chance of the medication not working and, therefore, a greater chance that the pregnancy will continue. It is dangerous to expose a pregnancy to some of those medications if it then continues.

There is not a huge number of complications in these cases, but there is one very simple thing about which I would be concerned when women are accessing pills online. If anybody who has a miscarriage, abortion or full-term delivery is rhesus negative, which is a blood type, she needs to get anti-D immunoglobulin to prevent damage to any subsequent pregnancies. These women are clearly not getting that because they are not seeing a health care provider. My final concern, which I have already mentioned, is the fear that the small number of women who have excessive bleeding are delaying coming to see somebody because they are afraid of getting into trouble.