Americans United for Life’s series, “(Un)Happy Birthday, Chemical Abortion,” has been taking a close look at the central claims the abortion industry makes for RU-486. Today, we come to a claim that is critically important for women, and central to its asserted legitimacy. Unfortunately, the claim doesn’t hold up on close examination. Here’s why the so-called “abortion pill” is not necessarily “safe”. 

            Chemical abortion promoters make outrageous claims for the safety of the process. But chemical abortion is never “safe.” Even with current meager safeguards in place, around 5% of women end up at the emergency room with complications, and as often as 9% of the time the pills do not work, meaning the woman will still be pregnant. 

Chemical abortion serious complication rates actually compare poorly to procedures analogous to abortion.  The complication rate of colonoscopy, for example, is between .28% and .38%. Balloon angioplasty, a more invasive analog, is associated with nonfatal complications from 5% to 15%, while the rate after stent placement ranges from 2% to 5%. 

            Ohio is one of just a handful of states to collect and publicize records on RU-486 “adverse events,” a category that ranges from “incomplete abortion/no comment” to emergency transfer for blood transfusions. Americans United for Life received over 400 adverse events reports across an 8-year period, which speak loudly to the inherent risk in the chemical abortion procedure. Every single report recorded a chemical abortion gone wrong. Most included zero follow up information, even whether the woman carried her pregnancy to term. Many listed “completed surgically” as the outcome (meaning the woman had to go through the emotional and physical burden of a second abortion), while others listed events that required emergency care like “severe bleeding” and “hemorrhage” and “retained products [of conception].” “Retained products of conception (POC)” is medical-speak for when some of the pre-born baby’s tissue remains in the uterus and needs to be removed to prevent infection, and it occurs much more frequently after abortion than after completed birth. 

            Follow up visits and reporting are critical to ensure that if a woman has retained tissue, she gets the follow up care she needs, as reflected in the Ohio reports that specifically list treating or referring women to get immediate treatment for retained POC. Too often, as we see in the UK pilot program, abortion doctors abandon women once the pills are dispensed. Follow up reporting laws create a layer of accountability after the fact that should be commonsense in every state. 

            On October 31, 2019: “Patient took misoprostol incorrectly and failed the abortion. She was sent to Women’s Med Center in Dayton, Ohio for a D&C.” We only have this information because Ohio requires it be collected and made available to the public, and in-person chemical abortion protocol requires a follow up visit. How many more “failed abortions” will there be when abortionists wash their hands of responsibility and leave women to fend for themselves? How many more “failed abortions” would there be if all fifty states recorded and shared this information? 

            The federal Food and Drug Administration (FDA) manages a database called the FDA Adverse Events Reporting System (FAERS)[75] which tracks adverse events of medications, including mifepristone. Per federal regulation (21 C.F.R. § 312.32(a)), “Adverse Event” means any untoward medical occurrence associated with the use of a drug in humans, whether or not considered drug related.  

            Unfortunately, state contributions to the FAERS database are voluntary so we know there are limitations to the information it provides. Since 2016, prescribers are only required to report deaths associated with mifepristone. According to the most recent mifepristone reporting, there have been at least 24 deaths tied to the drug. The report lists: 

·      24 deaths 

·      4,195 adverse events 

·      1,042 hospitalizations (excluding deaths) 

·      599 blood loss requiring transfusions 

·      412 infections, and 

·      69 severe infections. 

These are not numbers; these are real women who died and/or suffered serious medical harms after taking mifepristone. It is worth noting that this reporting only addresses the physical impact and does not measure the emotional, psychological, or spiritual impacts of taking this drug and having a chemical abortion. Even with the limited numbers available, it is obvious that mifepristone is not a harm-free drug as its proponents claim, and deregulation would result in more women being harmed. 

Drug-induced abortion presents a much greater risk of life-threatening infections than does surgical abortion. For example, drug-induced abortion is associated with a greater risk of death from dangerous Clostridium sordelli bacterial sepsis than surgical abortion. Mark Fischer of the Centers for Disease Control and Prevention (CDC) reports the risk of death from C. sordelli infection during a mifepristone abortion is at least ten times the risk of death from all types of infection after surgical abortion. Other serious complications from using misoprostol for drug-induced abortion have been reported anecdotally, including acute hemolytic anemia, and fatal septic shock.  

From September 2003 through June 2005, the FDA reported four U.S. deaths due to C. sordellii bacterial infection in women, ages 18-34, who had undergone mifepristone abortions. All four patients were two months pregnant and received the off-label dosages and vaginal administration preferred by the Plaintiffs. All died within five to seven days following receipt of mifepristone, with identical clinical signs of shock, absence of fever, increase in leukocytes and red blood cells, and decrease in plasma volume. The time from hospital admission to death was a matter of hours, and one woman collapsed and died before reaching the hospital. These deaths demonstrated that severe infection occurs unpredictably, is difficult to identify, and is difficult to treat due to the absence of usual symptoms of infection (e.g., fever). Once identified, it can result in death in a matter of hours

Obviously, chemical abortion isn’t the “safe and easy” route that its proponents make it out to be. But there are equally grave concerns about the way the abortion industry offers RU-486 abortions that involve serious risks to a woman’s ability to have children in the future. We’ll examine those in a later article.