WASHINGTON — While the United States’ death toll in the coronavirus pandemic climbed to 53,625 Thursday, abortion groups and their political allies have urged the U.S. Food and Drug Administration (FDA) to lift restrictions on mifepristone (Mifeprex), a drug used for chemical abortion.
The FDA has restricted mifepristone under its “Risk Evaluation and Mitigation Strategies” (REMS) drug-safety program since 2000, only permitting that it be prescribed by a certified health-care provider and dispensed in a clinic, hospital or medical office.
Abortion advocates claim that these restrictions are unnecessary and, particularly in this pandemic, “self-managed abortions” using this drug should be widely accessible through pharmacies and even online. However, pro-life advocates have pointed out the risks of complications and even death that can result from this drug.
Recently, Sens. Elizabeth Warren, D-Mass., Patty Murray, D-Wash., and Tammy Baldwin, D-Wis., wrote to FDA Commissioner Stephen Hahn, “People who need an abortion cannot delay care and should not needlessly risk coronavirus exposure. Given the years of scientific evidence indicating that medication abortion is a safe and effective treatment, we ask that FDA take immediate steps to temporarily exercise enforcement discretion on in-person dispensing requirements, so that people can more easily access abortion care without putting themselves or their health-care providers at risk of infection from COVID-19.”
Twenty-one Democratic attorneys general, led by California’s Xavier Becerra, made a similar request, which came after Planned Parenthood and NARAL repeatedly pushed the FDA to lift restrictions on medication abortions while coronavirus restrictions were first being put in place.
Pro-life leaders, including Susan B. Anthony List President Marjorie Dannenfelser, Associate Director Greg Schleppenbach of the U.S. bishops’ Secretariat of Pro-Life Activities, and March for Life President Jeanne Mancini, sent a letter in March to the U.S. Department of Health and Human Services warning against this push to loosen restrictions on medication abortion.
They wrote, “At a time when hospitals are overloaded, the abortion industry is putting women at risk of incomplete abortion, hemorrhage and infection. Women undergoing chemical abortions are especially vulnerable, experiencing four times as many adverse events as women undergoing surgical abortions. As many as five to seven percent of all women obtaining chemical abortions will require surgical procedures. Three percent could end up in the emergency room.”
Dr. Grazie Pozo Christie, a radiologist and policy adviser for The Catholic Association, told the Register that the existing FDA guidelines are partly due to two serious complications that can arise from mifepristone being used for abortion.
“There are two very important complications that cause fatalities in chemical abortion,” Christie said. “One of them is ectopic pregnancy, and the other is sepsis.” She pointed out that “there’s no way to know if your pregnancy’s ectopic without doing an ultrasound. What most people do before they administer a chemical abortion agent is they do an ultrasound to determine that the pregnancy is a normal, regular pregnancy inside the uterus.” Sepsis can occur because “when a woman has a chemical abortion, it’s very easy for her to get an infection, and the infection gets really bad, really fast, and then she dies of sepsis.”
Christie said problems could also occur with establishing how far along the pregnancy is if medication abortions are unrestricted, as “how old the baby is is a very important issue with these drugs. You can only do them up to 13 and a half weeks, and it’s very common for women to have no idea how far along they are. If you try to have a chemical abortion, and you’re further along than you think, it’s very dangerous. … You’re basically having a huge miscarriage.”
Problems With Data
While the senators’ letter cites studies by the pro-abortion Guttmacher Institute and others claiming that complications arising from medications abortions are rare, Christie argued that many of these studies are flawed and there are reporting issues when it comes to complications arising from medication abortions.
“These studies they report are studies based on women responding to a questionnaire,” she said. “Nobody’s confirming the answers of the patient; and, also, there’s conflicts of interest when the people who are making these studies are looking for information that confirms their hypothesis, which is that it’s safe.”
She pointed out one widely-cited 2016 study, finding that about 3% of women were unhappy with their medication abortions, “had a group of 1,600 women who were given the pills. They tracked only 1,000 of them through online follow-up, and all of the data was self-reported, so 600 of the women never wrote back.”
Among the studies included in the Guttmacher Institute’s evidence that the senators cited was a 2017 study by abortionist Dr. Daniel Grossman, who serves as a board member of the abortion advocacy group NARAL and has worked as a Planned Parenthood consultant. That study found “0.18% of telemedicine patients with any adverse event [95% CI 0.11-0.29%] and 0.32% of in-person patients.”
The data on adverse events came from required reporting forms from the mifepristone distributor; however, the study had a 35% response rate from emergency departments when they checked with them for unreported adverse events.
“If you go to the hospital after a botched, self-administered abortion, you’re not going to tell them what happened,” Christie pointed out, regarding reporting problems. “You’re going to tell them you’re miscarrying. It’s never going to show up on any studies. They’re never going to report that outcome, which is the case for a lot of abortion statistics.”
Dangers of Buying Online
“The FDA also regulates it heavily because there is a danger of people obtaining drugs online that aren’t vetted by the FDA or not approved,” Christie explained. “When they tested the drugs that you can obtain online, many of them were faulty. They didn’t have the right dosages; some of them weren’t the drug at all. The FDA’s very heavy on not buying drugs online.”
The FDA cautions in guidance on its website, “You should not buy Mifeprex over the internet because you will bypass important safeguards designed to protect your health. Mifeprex has special safety restrictions on how it is distributed to the public. Also, drugs purchased from foreign internet sources are not the FDA-approved versions of the drugs, and they are not subject to FDA-regulated manufacturing controls or FDA inspection of manufacturing facilities.”
The Catholic Association’s Christie pointed out that some abortion-pill websites advise going to a veterinarian for misoprostol, which, along with Mifeprex, brings about a chemical abortion, but she said these websites sometimes warn that veterinarians may require a prescription for misoprostol for the safety of the dog. They’re “actually recommending for a 14-year-old girl to buy medicine that people can’t buy for their dogs because it’s too dangerous,” she said.
“The FDA recognizes that the people who are going to be trying to access these drugs, a lot of them are going to be desperate young women with no good, adult oversight,” she added. “You can access these drugs online very easily because there are people online pushing them on girls and women in a very unethical and dangerous way.”
A 2017 report by Vice News found that among 20 abortion pills ordered online, “none of the packages came with instructions for use.” They also found of the misoprostol pills ordered, “three-quarters of the packages had over 400mcg total in their pills, meaning they would likely be very effective. (The pills in the other five packages had less than that, meaning they could be less effective.)”
“The reason that has been given for many, many decades to legalize abortion and to make abortion more accessible was women’s safety,” Christie noted. “But now they’re asking for the opposite; for the same reason to make abortion more accessible, they’re going back on women’s safety. In a way, you’re going back to the back alley by talking about self-managed abortion and putting abortion in the hands of non-trained people, which is where it used to be.”
An Abortion Industry Goal
Melanie Israel, a research associate at the DeVos Center for Religion and Civil Society at the Heritage Foundation, told the Register that the abortion industry’s push to loosen restrictions on medication abortion amid a pandemic is their move not to “let a good crisis go to waste.”
“It’s unfortunate to see that this pandemic is being exploited to achieve that goal of loosening those restrictions, which for a long time has been on the wish list of abortion proponents,” Israel emphasized, “long before the coronavirus was on anyone’s radar.”
Last July, a coalition of nearly 80 pro-abortion groups, including Planned Parenthood and NARAL, released a blueprint of goals that included “self-managed abortion” and said that “awareness about self-managed abortion, safe methods and means of access — achieved through culturally competent communications accessible to people of all educational levels — will help destigmatize self-managed abortion.”
Israel said, “A lot of what we need to focus on doing right now is encouraging the Trump administration to maintain those restrictions and not weaken them, but really let people understand why those restrictions are needed: that they’re there for people’s safety.”
Israel noted that mifepristone first came on to market “under the Clinton administration; it came in under this protocol for the additional restrictions, and it stayed that way. And even under the Obama administration, they loosened those restrictions somewhat, but they didn’t remove them entirely.”
“We know that some women have, unfortunately, died after using these drugs,” Israel said. “We know that it can be very dangerous if the person prescribing them has not accurately dated the pregnancy. That’s why those face-to-face interactions are important.”
“If you’re suffering from severe blood loss or perhaps the abortion was incomplete and you have to have another round of drugs to resolve it, that’s all going to require additional follow-up during a pandemic when people are needing to isolate and maintain social distance,” she pointed out, “when hospitals in certain areas are being overwhelmed, when there’s an issue of personal protective equipment supply, resources. It’s sad that the abortion industry is focused on expanding something that could actually end up helping to compound those problems in the effort to fight the coronavirus.”
In February, the pro-life group Live Action, using Guttmacher’s 2017 data on the number of women obtaining medical abortions annually (339,640) and Planned Parenthood’s own percentage range (2% to 9%) for failure rates found that “abortion-pill failures could affect 7,000 to 31,000 women annually.”
Dr. Christina Francis of the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG) stated on EWTN Pro-Life Weekly that she thinks “we will see a rise” in women seeking medication abortions in this pandemic.
She said, “Unfortunately, women are influenced by fear right now, and this is being perpetuated by the abortion industry.”
Register staff writer Lauretta Brown reports from Washington.