By Tim Mllea
Catholic Health Care Today
Since its approval by the FDA in 2000, chemical abortions have increased in frequency while surgical abortions have decreased. According to the Guttmacher Institute, the research and policy organization developed by Planned Parenthood, chemical abortions comprised 63% of abortions in America in 2023. In our post-Roe v Wade times, when the hope was to see abortions decrease, the opposite has occurred. Guttmacher estimates more than 1 million abortions took place in 2023, an 11% increase from 2020.
The proponents of chemical abortion tout several aspects for its use: safety, effectiveness, convenience and ease of access. However, a full review of these claims show they are unsupported. The growing data within the medical literature increasingly calls into question the use of mifespristone, which is the first of the two-drug regimen used for chemical abortions. In addition, the seemingly political and ideological rationales promoting its use are raising eyebrows.
Mifespristone was developed in 1980 by Roussel-Uclaf, a French pharmaceutical company, and originally named RU-486. In 2000, under the Clinton administration, the FDA approved it for use in the United States. However, the FDA categorized it as a “restricted access” drug with several requirements, including usage only until the seventh week of pregnancy and the prescription had to be dispensed in-person by a physician. In addition, the woman had to receive a written disclosure of side effects and undergo an ultrasound to rule out an ectopic pregnancy. She was required to take the mifespristone pill in the clinic and to return for the second pill (misoprostol) two days later. The final required step was a return appointment two weeks later to confirm the abortion was complete, by ultrasound or physical examination.
Over the past few years, the FDA has not only relaxed restrictions on mifepristone but has nearly removed them. From a scientific perspective, those actions are difficult to understand as the evidence from large studies around the world demonstrate the risks associated with mifepristone use. In 2016, the FDA approved the drug for up to 10 weeks of pregnancy and in 2021 removed several requirements: in-person dispensing, prescriptions by physicians, ultrasounds and the two-week follow-up visit. More concerning, the Biden administration allowed chemical abortion drugs to be prescribed through telehealth visits and mailed to the recipient. Since that decision, a growing number of websites (mostly foreign-based) have arisen that mail the drugs to the “customer” without medical oversight or prescription. The sole requirement? The customer pays for them.
The relaxation of the restrictions on mifepristone use is inexplicable. In court cases, the FDA maintains that the “science and safety” of its use supports the agency’s decisions. However, even a brief review of the medical literature calls that into question, including data from the American College of Obstetricians and Gynecologists (ACOG), which supports and promotes abortion. In 2020, the ACOG Practice Bulletin reported the following “adverse events:” nausea (43-66% of cases), vomiting (23-40%), diarrhea (23-35%), headache (13-40%) and fever or chills (32-69%). Of greater concern is the need for blood transfusion due to excessive bleeding, which is 10 times higher with chemical abortions than surgical abortions. Similarly, the likelihood of an incomplete abortion is more than four-fold higher with chemical abortions.
Other Western countries with high-quality medical care and long-standing approval for abortion are also sounding the alarm. A study from Finland reviewed more than 27,000 women who underwent chemical abortion, including 3,000 adolescent girls. Hemorrhage occurred in 13% of the teens and 15% of adults. Teens experienced an incomplete abortion requiring a surgical procedure in 7% of cases, with a 10% rate in adult women. A Swedish study of nearly 5,000 abortions was equally troubling. The complication rate with chemical abortion increased from 4.2% in 2008 to 8.2% in 2015. The researchers attributed this doubling of complications to a single factor: an increasing number of at-home abortions without medical supervision.
The FDA even seems to dismiss American studies, such as one published in 2021 that analyzed 423,000 abortions over a 17-year period. Women who underwent chemical abortions were 53% more likely to seek emergency care in the 30 days post-abortion than those who underwent surgical procedures. Of further concern is a finding that perhaps reveals data the FDA chooses to ignore. More than 60% of chemical abortion-related emergency department visits were miscoded as “treatment for a miscarriage.” A miscarriage is an unintentional death of an unborn person. Abortion is intentional.
Increased attention to chemical abortions at the state and federal levels lies ahead. The debate will be wide-ranging, including the medical, legal, political and moral arenas. We must recognize two facts attributable to every abortion. It puts a woman at significant risk and ends the vulnerable life of an unborn child. Neither should be acceptable from a medical or religious perspective. We are called to save souls and opposition to abortion is a critically important part of that mission.
(Dr. Tim Millea is president of the St. Thomas Aquinas Medical Guild and a member of St. Paul the Apostle Parish in Davenport.)
