FACT CHECK: Dispelling 5 Common Myths about Chemical Abortion
Since the Supreme Court’s decision in Dobbs vs. Jackson Women’s Health Organization that overturned the egregiously wrong Roe v. Wade, the Biden administration has been doing everything in its power to expand the use of chemical abortion.
This past week, President Biden issued an executive order. According to the White House, as a result of this order, “HHS will take additional action to protect and expand access to abortion care, including access to medication that the FDA approved as safe and effective over twenty years ago. These actions will build on the steps the Secretary of HHS has already taken at the President’s direction following the decision to ensure that medication abortion is as widely accessible as possible.”
For years, the abortion industry has made unsubstantiated claims about the safety of chemical abortion carried out with the use of mifepristone and misoprostol. Below are five common myths about chemical abortion and the science that dismantles them.
1. Myth: “Chemical abortion is a safe procedure.”
Between 2000 and 2021,4,207 adverse events related to chemical abortions were reported to the FDA. These events include 26 maternal deaths, 97 ectopic pregnancies, 603 patients who required blood transfusions, and 1,045 hospitalizations. In the many women who required surgery, it was performed by the abortion business only 40% of the time, demonstrating that abortion businesses frequently do not provide medical care for the complications from their procedures.
A recent study by the Charlotte Lozier Institute examining confirmed abortion complications in 423,000 women revealed that between 2002 and 2015, abortion-related emergency visits following a chemical abortion increased by over 500%, affecting one in 20 women. Over 60% of these complications were miscoded as due to a miscarriage, demonstrating the flaws in U.S. abortion complication data collection. This is further evidence of why in-person follow-up appointments are so critical after a chemical abortion.
With the recent removal of the FDA’s Risk Evaluation and Mitigation Strategy (REMS) in-person restrictions, allowing distribution of chemical abortion pills without physical examination, ultrasound, and laboratory testing before provision of the abortion pills, the number of complications will undoubtedly rise.
Notably, ectopic pregnancies, which occur in 2% of pregnancies but account for 4-10% of all maternal deaths, cannot be ruled out without an ultrasound. Half of women with ectopic pregnancies have no risk factors, and ectopic pregnancies that go undiagnosed may rupture, leading to life-threatening hemorrhage. A woman is more likely to die from a ruptured ectopic while undergoing abortion as she may assume that pain and bleeding is a sign that the medication is working, rather than a warning sign that her life is in danger.
Additionally, without verification of gestational age, a woman may consume chemical abortion pills at a more advanced gestational age when the pills are far more likely to fail due to the large size of the baby that must be expelled. One study of 18,000 second trimester chemical abortions demonstrated that 39% required surgery to fully remove the baby’s body.
Furthermore, Rh negative women who do not receive prophylactic Rhogam may experience isoimmunization causing their immune system to attack future pregnancies. When left untreated, 14% of affected infants are stillborn, and half suffer neonatal death or brain injury.
Finally, the potential for misuse is high when there is no way to verify who is consuming the medication, and whether they are doing so willingly. This will benefit sex traffickers, incestuous abusers, and coercive boyfriends, but not women who desire their pregnancies but are tricked or coerced into taking these pills.
2. Myth: “For most patients, the most intense pain from chemical abortion lasts only a few hours and is tolerable with over-the-counter pain medication.”
Disturbingly, the physical trauma that happens to a woman’s body as a result of a chemical abortion is considered a sign that the “treatment is working.” According to the Mifeprex medication guide:
Cramping and vaginal bleeding are expected with this treatment. Usually, these symptoms mean that the treatment is working… Bleeding or spotting can be expected for an average of 9 to 16 days and may last for up to 30 days…You may see blood clots and tissue. This is an expected part of passing the pregnancy.
Many women also experience nausea, vomiting, diarrhea, abdominal pain, and headache. Some women describe the pain of medical abortion as being similar to labor because intense uterine contractions are necessary to expel the baby’s body.
Although biased studies based on voluntarily reported data published by the U.S. abortion industry report few complications from chemical abortions, high quality records-linkage studies from European countries demonstrate that one in five women suffer complications from chemical abortions. Between 5-8% will fail to fully expel the baby’s body, resulting in hemorrhage, infection, and the need for surgical completion.
3. Myth: “Most women are relieved after they have an abortion and don’t feel any shame or regret about their decision.”
Although a woman may feel some amount of short-term relief after an abortion, her negative feelings often grow over time. A review in The British Journal of Psychiatry analyzed 22 studies of women who had abortions and found that post-abortive women had higher rates of substance abuse, anxiety, depression, and suicidal thoughts than non-abortive women. Additionally, some subgroups of women have been documented to be at much higher risk of mental health complications, such as those who had feelings of attachment to the pregnancy, underwent coercion, had an abortion for maternal or fetal health reasons, were teenagers, those who had multiple abortions, and those who had later abortions.
Studies in the rat model demonstrate that the mifepristone group had significantly decreased body weight, food intake, and activity and sucrose consumption, which are all animal proxies for depression and anxiety. Chemical abortions are uniquely traumatic in that a mother must personally dispose of the remains of her aborted child, who may be visibly recognizable as a baby. At eight to 10 weeks gestation when chemical abortions are often carried out, the baby is approximately the size and shape of a gummy bear with easily recognizable head, hands, feet, fingers, and toes.
4. Myth: “Attempts to reverse chemical abortion are dangerous for the woman and her unborn child.”
If a woman has only taken the first pill (mifepristone) in the two-pill chemical abortion regimen, and if she changes her mind about her desire for an abortion before consuming the second pill, misoprostol, the chemical abortion can be reversed in some cases. Medical professionals administering the natural hormone progesterone have a 64-68% success rate of reversing chemical abortion, allowing the fetal life to continue.
Mifepristone blocks the release of the hormone progesterone which is critical for the pregnancy’s progression. Mifepristone causes deterioration of the uterine lining — thereby leading to the unborn child’s death. Progesterone supplementation will compete for the progesterone receptors and override the effects of mifepristone.
Neither mifepristone nor progesterone is associated with birth defects in an unborn baby, and reversal of the chemical abortion pill process can give a woman a choice to have a second chance.
5. Myth: “Chemical abortion is necessary for women to live a fulfilling life.”
No study has ever proven that women benefit from abortion. While women are increasingly represented in the upper echelons of business, politics, academia, sports, and other illustrious careers, many have done so while also enjoying their roles as wives and mothers.
But the narrative of abortion as solely a “woman’s choice” has led to the worsening of many social and relationship factors, as the rates of unmarried childbirth and single motherhood have increased, with resultant poverty, domestic violence, and childhood trauma. The abortion industry has dishonestly sold abortion to women as a necessary factor in their success and has destroyed many families in the process.
In the wake of increasing state level restrictions on abortion, abortion advocates have redefined their terms. In years past, “self-managed abortion” was frequently used to scare women and legislators with the implication of danger and harm if abortion were restricted, but now “self-managed chemical abortion” is being promoted widely to women experiencing unintended pregnancies.
The abortion industry has demonstrated that its priority is fetal death, not women’s safety. The end goal is over-the-counter chemical abortion provision dissociated from the medical system entirely (except, of course, for the emergency physicians who will be called upon to care for complications). As a society, we must become educated and push back against these myths, with the realization that while chemical abortion benefits those who profit from death, chemical abortions can only cause harm to women who fall into this action in crisis.
Ingrid Skop, M.D., practices obstetrics and gynecology in San Antonio, Texas, and serves as Senior Fellow and Director of Medical Affairs of the Charlotte Lozier Institute.
Mary Szoch is the Director of the Center for Human Dignity at Family Research Council.