Medical abortion made up almost 1 in every 3 of total abortions in 2014, but recent advocacy for it to be completely unfettered from medical and government oversight is a grave mistake and puts women and girls at risk of serious complications and even death.
Popular women’s magazines like Glamour and Cosmopolitan are painting the picture of a safe, convenient and private way to abort a child sandwiched between articles on weight-loss and make-up trends. Established media outlets likewise have published several articles in just the last two months (here, and here, and here) touting the same. Before swallowing this idea hook, line, and sinker, reviewing the current regulations and why they are in place is in order.
Currently, medical abortions are performed using a combination of the drugs Mifepristone and Misoprostol and can only be administered legally in the United States by following FDA guidelines. The drugs must be prescribed by a licensed medical provider who has evaluated the patient clinically and who will re-assess the patient after the abortion. The FDA requires close physician oversight when this drug is administered, not so that the patient will have assistance during the painful process, but because of two dangerous complications. One is sepsis, or overwhelming infection, and the other is ectopic pregnancy, or the implantation of a fetus in an abnormal location. The FDA has documented maternal fatalities due to these complications, as well as hundreds of hospitalizations related to excessive bleeding. The FDA additionally warns not to buy these drugs over the internet, noting that by doing so a woman will "bypass important safeguards designed to protect [her] health (and the health of others)."
Some states, responding to the growing prevalence of medical abortion, and encouraged by women's safety advocates, are making sure that FDA requirements regarding the procedure are being met. Many states specifically prohibit its administration through “telemedicine” and require that a medical doctor meet their patient face-to-face in order to better provide adequate care. Only three states – Iowa, Minnesota, and Maine – permit “telemedicine abortions.”
Flying in the face of common sense are groups advocating for these drugs to be sold over-the-counter and without medical supervision at all. One such group, Plan C, goes so far as to suggest that women obtain these pills, illegally, on the internet and from foreign sources. They even recommend buying the pills from pet-medicine websites as the drug is also used for stomach ulcers in dogs. They warn, however, that some pet-medicine websites require prescriptions from veterinarians out of concern for the safety of the dogs. What? The safety of the dogs?
Still another outfit, Women on Web, mail these drugs to anyone who answers a quick and superficial questionnaire, and lives in a country where abortion is restricted. A study using data provided from this group is being used by abortion advocates as "proof" that the procedure is safe, even without physician oversight. The study involved an initial group of 1,600 women or girls who received the pills, but tracked only 1,000 of them through online follow-up questionnaires. All the data was self-reported and there is no way of knowing if the 600 women who did not follow-up suffered complications or worse. If any of these cases resulted in maternal mortality, the study authors would not have the information. In short, the study meets none of the basic requirements of a proper clinical inquiry, like unbiased patient selection, confirmation of data, and absence of conflicts of interest.
In truth, the procedure is not easy or pleasant. Abby Johnson, former Planned Parenthood director includes in her book “The Walls are Talking: Former Abortion Clinic Workers Tell Their Stories” recounts the harrowing experience of a former abortion center worker who underwent a medical abortion. This excerpt is worth reading for its accurate and detailed account of a self-induced abortion.
Those pushing to make chemical abortion available all the time and for anyone with zero regulatory or medical oversight are pointing to unscientific studies to support this call rather than deferring to the serious assessment and warnings given by the FDA. Such advocacy with no concern for safety is the furthest thing from promoting the well-being of women.
Dr. Grazie Pozo Christie, Policy Advisor with The Catholic Association and Andrea Picciotti-Bayer, Legal Advisor with The Catholic Association Foundation.