Testimony of Bradley N. Kehr, Esq. Policy Counsel, Americans United for Life

In Support of Senate File SF0109, “AN ACT relating to abortions; prohibiting chemical abortion drugs for abortions as specified; providing criminal penalties; providing definitions; specifying exceptions; making conforming amendments; and providing for an effective date.”

Dear Chairman Baldwin and Members of the Committee:

My name is Brad Kehr, and I serve as Policy Counsel at Americans United for Life (AUL). Established in 1971, AUL is a national law and policy nonprofit organization with a specialization in abortion, end-of-life issues, and bioethics law. Our vision at AUL is to strive for a world where everyone is welcomed in life and protected in law. As Policy Counsel, I specialize in life-related legislation, constitutional law, and abortion jurisprudence.

Thank you for the opportunity to testify in support of SF0109, “AN ACT relating to abortions; prohibiting chemical abortion drugs for abortions as specified; providing criminal penalties; providing definitions; specifying exceptions; making conforming amendments; and providing for an effective date.” This bill would prohibit chemical abortions, commonly known as RU-486 in the state of Wyoming.

I have examined this bill, and I urge you to support it for the following reasons: 1) Wyoming has a significant interest in protecting the health of both the mother and the child and 2) the bill is consistent with the American legal tradition on abortion.

Wyoming Has a Significant Interest in Protecting Both the Mother and the Child

The Supreme Court declared in Dobbs v. Jackson Women’s Health Organization that a law regulating abortion must be upheld where the state legislature has a rational basis that it would serve legitimate state interests. Wyoming has a legitimate interest in protecting unborn life, as well as protecting the life and health of women.

The “chemical abortion pill” (also known as a “medical abortion”) is a regimen of two drugs, mifepristone and misoprostol. According to the FDA label, the woman takes mifepristone first, most often at the clinic directly from a doctor or clinician. Mifepristone blocks the hormone progesterone, resulting in a breakdown of the uterine lining, ending the pregnancy. Several hours later she then takes misoprostol at home, which causes contractions and expulsion of the deceased fetus without medical involvement or supervision. Chemical abortion has risks, which is why the FDA only approved it with a Risk Evaluation and Mitigation Strategy (REMS), a drug safety program required for medications with serious safety concerns. In its 2016 review, the FDA determined that the REMS, which includes an in-person dispensing requirement, remained necessary.

Studies from Scandinavian countries, which record pregnancy and medical events more accurately than the United States due to their centralized record- keeping and single payor healthcare systems, give a better picture of chemical abortion complications than U.S. data. In a study of 42,619 Finnish women receiving chemical abortions up to nine weeks gestational age, the overall adverse events were fourfold higher in chemical (20.0%) versus surgical abortions (5.6%). Women hemorrhaged more commonly after chemical abortion (15.6% compared with 2.1%). They also had incomplete abortions more often in chemical abortions (6.7% versus 1.6%). The rate of surgical (re)evacuation was higher after chemical abortions (5.9%) than surgical abortions (1.8%).

Another study examined first and second trimester chemical abortions of 18,248 Finnish women. Women undergoing chemical abortions needed surgical evacuation in 9.9% of cases. Women specifically undergoing second trimester chemical abortions needed surgical evacuation in 39% of cases. Later in pregnancy, the likelihood of serious complications significantly increases, something that cannot be controlled for when pills are sent through the mail and taken at the woman’s discretion.

In a systematic review of chemical abortions, one international study examined 47,283 women undergoing chemical abortions in optimal conditions up to nine weeks gestation. Of these women, 4.8% had treatment failures. The data showed ongoing pregnancies in 1.1% of cases.

A separate U.S.-based systematic review examined 33,846 women undergoing chemical abortions through ten weeks gestation. As a best-case scenario, the study showed 3.4% of chemical abortions failed and required surgery. Of the total women, 0.8% had ongoing pregnancies.

In the United States, state reporting of adverse events from chemical abortion pills is voluntary, and the FDA limited adverse event reporting to only deaths in 2016. Even so, the FDA has received Mifeprex reports of 24 deaths, 4,195 adverse events, 1,042 hospitalizations (excluding deaths), 599 blood loss requiring transfusions, 412 infections, and 69 severe infections.

States have limited reporting requirements. Arkansas, Texas, and Missouri provide a limited snapshot of complications following chemical abortions. In Arkansas in 2020, forty out of the forty-five reported complications occurred following a chemical abortion (versus a surgical abortion). The majority of these complications occurred in women undergoing their first abortion.

In Texas, out of 56,358 total induced abortions, 29,013 were chemical abortions. Although there were 263 reported complications, the state does not sort the data by type of procedure.

Out of 112 total abortion complications in 2019, Missouri reported sixty-five medical abortion complications, even though only fifteen medical abortions occurred in the state. Presumably, these complications occurred from women presenting in Missouri after receiving abortion-inducing drugs from out-of-state providers.

The evidence shows chemical abortions have a greater risk of complications than surgical abortion.

The Bill is Consistent with the American Legal Tradition on Abortion

As the Supreme Court explained in Dobbs, nothing in the American or English legal tradition protects abortion as a fundamental right. Rather, these traditions have criminalized abortion. The Supreme Court in Dobbs stated that “[u]ntil the latter part of the 20th century, there was no support in American law for a constitutional right to obtain an abortion.” When the United States adopted the Fourteenth Amendment, the majority of states had statutes criminalizing abortion at all gestational ages. Nothing in the writing or discussion around the Fourteenth Amendment suggested that any member of congress or state lawmaker expected that it would create a national right to abortion. Accordingly, the Supreme Court in Dobbs overturned Roe v. Wade and held that “[t]he Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision.”

With the overturning of Roe, the Supreme Court stated, “the authority to regulate abortion is returned to the people and their elected representatives.” Given that chemical abortion is a form of abortion, regulation of it lies within your authority as elected representatives of Wyoming.


In sum, Wyoming has a significant interest in protecting the health of both unborn children and their mothers. This bill does that by ensuring that chemical abortions, which are intended to kill the unborn child and have potentially severe consequences for the mother, are not performed in the state of Wyoming, all of which is consistent with Dobbs and the American legal tradition. For these reasons, I urge the Committee to support SF0109.