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Ignoring the Health Risks of Abortion Pills Is Not Caring for Women

When women don't disclose their chemical abortions, deadly conditions like ectopic pregnancies or retained fetuses can be easily missed.
Denise Harle
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A new start-up called Choix (pronounced "Choice") has begun offering abortion pills to women... who aren't even pregnant. The idea is to expand abortion pill access so that women can attempt to give themselves at-home abortions on demand. If that sounds like unethical medicine—and a disaster waiting to happen—that's because it is.

In recent days, activists have made repeated calls for expanded access to abortion pills by mail, especially in states that have chosen to protect life now that the U.S. Supreme Court has reversed Roe v. Wade. One oft-recited claim is that these pills are "safe"—so safe, perhaps, that no doctor need be involved in the abortion at all, and a pregnant woman can simply give herself a chemical abortion at home.

What's not mentioned is that the Food & Drug Administration has never bothered to find out what happens to women after they take abortion pills.

If you wanted to know how dangerous a drug was, perhaps the most important step would be to carefully monitor adverse incidents among those taking it. You'd want to track severe side effects, hospitalizations, and deaths. You'd also need to know how many people are taking the drug in the first place. Many of us assume the FDA gathers this information as part of ensuring the safety of pharmaceuticals in the U.S.—and for the most part, it does.

But not when it comes to abortion drugs. Despite being tasked with the critical duty of gatekeeping for drug safety, the FDA requires no reporting on non-fatal adverse events for the chemical-abortion drug mifepristone (also known as RU-486) even though, since its introduction to the market in 2000, it's on the short list of drugs so dangerous that they warrant heightened regulations known as Risk Evaluation and Mitigation Strategies. Instead, reporting of adverse effects is required only for maternal deaths—ignoring life-threatening and traumatic incidents like emergency surgeries, hemorrhaging, blood transfusions, ruptured ectopic pregnancies, and sepsis.

Yet we know that women are suffering severe complications from abortion pills in alarming numbers. Publicly available records, which capture only a sliver of the real picture, show hundreds of significant adverse outcomes, ranging from massive bleeding to emergency uterine surgeries. The FDA has decided that none of those severe complications merit documentation.

And who is tasked with reporting the deaths? The drug manufacturer—the player with arguably the least incentive to rigorously record adverse effects of its multi-million-dollar product. Worse yet, the drug manufacturer relies on those who facilitate abortions to self-report maternal fatalities from RU-486—something abortionists benefit little from doing.

Further masking the dangers of abortion pills is the fact that—because women are sent home to bleed out and birth their dead child, or are sold the pills online and never see a doctor at all—the abortionist often has no follow-up to find out what happened. Instead, a pregnant woman who experiences severe pain or excessive bleeding may seek care at an emergency room without her medical records noting that abortion drugs are causing the trouble.

When women don't disclose their chemical abortions, deadly conditions like ectopic pregnancies or retained fetuses can be easily missed, resulting in septic shock, emergency hysterectomies, or worse. And, again, unless the woman dies, these medical tragedies go unreported.

The FDA also doesn't track the number of chemical abortions in any meaningful sense. Reporting is voluntary. The same goes for the U.S. Centers for Disease Control and Prevention, whose voluntary reporting system is known to undercount the number of abortions by hundreds of thousands every year.

In fact, the "best" data we have on the number of abortions comes from the pro-abortion Guttmacher Institute, named for a former Planned Parenthood president, which collects information from abortionists who choose to participate. According to Guttmacher, in 2020, nearly 1 million unborn children were killed through abortion in the U.S. About 500,000 of those babies were poisoned and starved to death, then expelled from their mother's bodies, through the chemical-abortion process.

Guttmacher doesn't ask any questions about how many women hemorrhaged, were hospitalized, lost their uteruses, or died as a result of these abortions.

In light of this problem, how could anyone claim with a straight face that abortion pills are safe? Dangers are buried and ignored via a useless "tracking" system. Given that the pharmaceutical company behind mifepristone is so shrouded in secrecy that it refuses to disclose its executives, office locations, manufacturing sites, or investors, transparency in voluntarily reporting deaths is unlikely at best. At every turn, women's health and safety is disregarded.

So, are abortion pills safe? Of course not. But the abortion industry and the FDA have no interest in finding out just how unsafe they are. They should receive no support for pushing a deadly chemical at the expense of women's health.

Denise Harle
Senior Counsel, Director of Center for Life
Denise Harle serves as senior counsel with Alliance Defending Freedom, where she is the director of the Center for Life.