The Abortion Pill is Not Safe for Women

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JEANNE MANCINI

Those who really care about women’s health and safety should be deeply concerned about the latest push to expand chemical abortion via telemedicine and look for ways to communicate the serious risks involved.

The use of chemical abortion was already on the rise in the United States, but calls to expand access have become even louder during the coronavirus pandemic. In October, the Guttmacher Institute (originally the research branch of Planned Parenthood) reported that the use of chemical abortion over the past two decades has ballooned. “Medication abortions increased from 5% of all abortions in 2001 to 39% in 2017, even while the overall number of abortions declined,” reads the report. In 2001, there were approximately 71,000 chemical abortions; in 2017, this number climbed to 340,000. It will very likely increase during the pandemic.

Billed as safe and effective by the abortion industry, chemical abortion is arguably much harder on women’s health than surgical abortion — and there’s certainly less medical oversight. A study out of Finland showed that women are four times more likely to suffer severe complications as a result of chemical abortion than they are as a result of surgical abortion.

Chemical abortion is grueling and takes a nasty toll on a woman’s body, in addition to ending the life of her unborn child. It is a two-step regimen. The first step requires a woman to take a drug called mifepristone, which blocks progesterone and prevents an unborn baby from receiving vital nutrients, effectively starving the baby to death. The second drug, misoprostol, causes strong uterine contractions that expel the unborn baby from the uterus. With both drugs come vaginal and abdominal bleeding and cramping, according to the Mayo Clinic, and the clinic advises that anyone who has an at-home chemical abortion to get access to a doctor and emergency services.

The use of telemedicine only to prescribe a chemical abortion eliminates critical medical oversight afforded by an ultrasound. Ultrasounds should always be performed to determine the gestational age and location of the baby; if not, chemical abortions can pose potentially fatal risks to women. Perhaps the most dangerous possibility of all is if a woman uses chemical abortion when she has an ectopic pregnancy — that is, when the baby has attached to her fallopian tubes rather than the uterine wall. It’s a life-threatening situation that ultrasound can either rule out or accurately diagnose.

The gestational age is also important because, for safety reasons, the Food and Drug Administration has approved chemical abortion only up until 10 weeks into pregnancy. And an ultrasound is generally needed to date a pregnancy accurately because many pregnant women aren’t certain about the date of their last menstrual period.

peer-reviewed study from 2015 on the safety, efficacy, and acceptability of self-administered abortion pills through 70 days showed that almost 30% of the 40 women taking chemical abortion did so after the FDA-approved time frame of 63 days. Very sadly, 62% of these women had incomplete abortions. Surgical evacuation was required for 68% of these patients, and 23% of these women had a failed abortion. For 12.5% of them, they received surgical evacuation with blood transfusion. The authors concluded that “unsupervised medical abortion can lead to increased maternal morbidity and mortality.”

When chemical abortion was approved by the FDA in 2000, the drugs required a “black box warning” because of mifepristone’s known ability to suppress the immune system and issues with bleeding. In the years since chemical abortion was approved, the FDA has reported adverse events, the latest information shows that at least 24 women have died as a direct result of chemical abortion in the U.S. between 2000 and 2018, and there have been thousands of serious adverse event reports submitted to the FDA including hospitalizations and blood transfusions. With increasing numbers of women using telemedicine to obtain a chemical abortion, the number of complications and deaths caused by chemical abortion will very likely increase.

In light of the many risks associated with chemical abortion, it is profoundly troubling that anyone would advocate for telemedicine abortion — or demand that the FDA relax the policies designed to mitigate those risks. No one claiming to champion women should prioritize “access” above their health and safety.

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