WASHINGTON — While the abortion pill mifepristone is being described as safe and easy to use, women and pro-life groups are pushing back strongly against those claims, as more than half of U.S. abortions are now being done by pill, according to recent data from the pro-abortion Guttmacher Institute. 

Kelly Lester, a former abortion-business-worker-turned-pro-life advocate, told the Register that her abortion through medication was “the most traumatic by far” compared to her three surgical abortions. She had the abortion at home alone and described it as “more painful than any of my other procedures” because “I was medicated during those other procedures, and for this one I was not. I was fully awake and fully conscious.”

Lester, who now works as the director of outreach for And Then There Were None and Pro-Love Ministries, said that the emotional trauma of the experience lingered after the three days of severe pain and heavy bleeding. 

“I had to deal with seeing the parts of the fetus — and not only seeing it that day, but every time I would go back to that bathroom, I would have to relive that experience,” she said.

 

Abortion Providers’ Misinformation

The information that Planned Parenthood provides about the pill on its website includes telling women that after taking the pill, “Most people go back to normal activities the day after a medication abortion” and comparing it to “having a really heavy, crampy period.” In terms of the emotional aftermath, the Planned Parenthood website says that while “people can have a range of emotions” after an abortion, “most people feel relief.” 

Lester said she was told similar things prior to her abortion, that she would experience “mild cramping, basically like a period,” and it would be “quick and easy and pretty much painless.” When she instead had “three days of nonstop, constant pain, cramping, bleeding, throwing up and headaches,” she called the facility and experienced a “dismissive” tone. She was told that “nothing was wrong, that it would be fine” and that “after a week if it continued like that then go to the emergency room.” 

Lester said that what makes such situations especially traumatic is that “the abortion industry is telling you it’s not a big deal; it’s super easy,” and “if you have an experience that is contrary to that — which most people will — you think, ‘What’s wrong with me?’”

She highlighted other concerning advice to women from abortion groups, including instructing women who have complications to say that they’re having a miscarriage. Due to this deception, serious complications from a medication abortion would go undetected. In a section on “self-managed” abortion, the abortion advocacy group Reproaction says, “the treatment of any complication of abortion is exactly the same as the treatment for complications of a miscarriage. There are no tests that can detect misoprostol, and there is no reason to tell a medical provider that a woman has managed her own abortion with pills.”

James Studnicki, vice president and director of data analytics for the pro-life Charlotte Lozier Institute, found, in an analysis of Medicaid claims data, “an increasing trend of women being treated in the emergency room for a miscarriage within 30 days of a confirmed chemical abortion — a sequence of events which is impossible, and was therefore either mistakenly or purposefully miscoded. By 2015, fully 60.9% of abortion-related emergency room visits following a chemical abortion were miscoded as treatment for a miscarriage.” 

Abortion groups like Planned Parenthood and NARAL describe medication abortion as “safe and effective” and even “safer than Tylenol.” They have long advocated for the removal of the U.S. Food and Drug Administration’s past requirement, in place since 2000, that the pill needed to be dispensed through an in-person visit. Responding to this pressure, the FDA made two changes to its safety requirements on the abortion pill in December, first “removing the requirement that mifepristone be dispensed only in certain health care settings, specifically clinics, medical offices, and hospitals,” and “adding a requirement that pharmacies that dispense the drug be certified.”

 

ER Visits and the Risk of Coercion

Since the in-person requirement has been lifted, concerns have mounted over the risks associated with the abortion pill, as well as problems with tracking data on complications arising from it. 

Tessa Longbons, senior research associate at the Charlotte Lozier Institute, told the Register that “of the states that have so far released data for 2020, chemical abortions are now over half, and, in some states, it’s as high as two-thirds or even higher.” She saw the increased number as likely associated with the COVID pandemic and “the abortion industry using the pandemic to push for weakened regulations on chemical abortion.” 

Longbons pointed out that the U.K. took “very similar steps” to the Biden administration during the pandemic, with its “Pills by Post” program, which temporarily permitted abortion pills through the mail. One study found “29 serious incidents resulting from chemical abortion between April and November 2020. Seventeen of these very serious complications were caused by pills-by-post, including 11 cases in which the woman went to the hospital after taking the pills beyond the legal gestational limit.” Additionally, “emergency calls for chemical abortion increased 54% when extrapolated across England and Wales, and ambulance responses rose by 19%” between 2019 and 2020.

According to the U.K.’s Department of Health and Social Care regarding the decision to end the program, “domestic abuse was raised as an issue in the public consultation,” and “the well-being and safety of women requiring access to abortion services has been, and will continue to be, our first and foremost priority.”

Longbons also noted that a BBC poll of more than 1,000 women in the U.K. revealed that 15% said that in their lives they had felt pressured to have an abortion and 3% had been given an abortifacient like a pill or a tablet without their knowledge or consent. 

“Chemical abortion just completely paves the way for and enables this huge problem of coercion and forced abortions,” she said. 

She said that in addition to the possibility of coercion, chemical abortion carries significant risk of complications, citing a Charlotte Lozier Institute analysis of Medicaid claims data that showed a 500% increase in chemical abortion-related emergency room visits between 2002 and 2015 and a “53% greater risk of ER visit for an abortion-related reason” in the case of chemical abortion compared to surgical abortion.

 

A Way to Bypass State Laws

In a recent Bloomberg article, University of Pittsburgh School of Law assistant professor Greer Donley suggested that a case in which a U.S. district judge ruled that Massachusetts could not ban the FDA-approved opioid Zohydro could “provide the framework for a legal argument against state bans on mail-order abortion pills,” which “could also mean the pill remains available in places that ban abortion altogether.”

“Chemical abortion is in many ways a response to the success of the pro-life movement,” Longbons said. “The abortion industry is looking to it as their alternative if states have more latitude to restrict abortion and pass pro-life laws.” If Roe v. Wade is overturned in the Dobbs v. Jackson Women’s Health Organization case before the Supreme Court, efforts by the abortion lobby to make the abortion pill widely available will likely increase.

Randall O’Bannon, education and research director at National Right to Life, told the Register that the rise in the use of the abortion pill “has been coming for a long time, and it’s not an accident. It’s very much a strategic, organized campaign that the abortion industry has been conducting since they first came to the FDA to get the approval for this.” He said that “they’re looking for this as a way to work around any sort of abortion limits, to simply bypass whatever the law or the rules are and to ship them directly to women’s homes.” 

He noted the risks inherent in dispensing the abortion pill without having an ultrasound to date the pregnancy, as many women can miscalculate how far along they are. “The FDA originally said it was supposed to be seven weeks,” he said of when the abortion pill was meant to be used; “then they changed it up to 10 weeks,” in 2016. 

The FDA warns that “a woman should not take Mifeprex if it has been more than 70 days since the first day of her last menstrual period.” He pointed out that Planned Parenthood advertises “medication abortion for up to 77 days (11 weeks) after the first day of your last period” on its website, despite the current FDA requirements.

O’Bannon discussed how abortion groups are disregarding the laws in Texas, despite the recent ban on abortions past six-weeks’ gestation, when the heartbeat is detectable, and the ban on abortion pills being sent through the mail. A University of Texas at Austin study found that the abortion group Aid Access “received 1831 requests from Texas for self-managed abortion in September 2021.” 

In 2019, the FDA wrote a warning letter to Aid Access over its “interstate commerce of misbranded and unapproved new drugs”; the letter stated that “the substitution of unapproved drugs for FDA-approved prescription drugs poses significant health risks to U.S. consumers. For example, in this case, use of the unapproved drug would not be subject to the same protections as use of the FDA-approved product.”

 

Response From the States 

As the abortion lobby ramps up its campaign to broaden distribution of the abortion pill, states with pro-life governments are enacting protective measures.

“The abortion industry would like to use chemical abortion to get around some of these state laws, and it’s something that’s cheaper and easier for them to do; but when states do step up, it makes it more difficult for them,” Longbons said. In the case of Texas, she pointed out that the Lone Star State’s ban on abortion by mail may have at least possibly slowed down access to medication abortion.

“It’s estimated that it takes several weeks to order the abortion pill from Aid Access and have it shipped internationally into Texas, whereas, with some of these domestic groups, it could take only a few days,” she said. “It’s certainly concerning that it’s happening at all, but also an example of how there’s going to continue to be this interplay between state pro-life laws and the abortion industry both reacting to this new environment.” 

Ingrid Duran, director of state legislation at National Right to Life, told the Register about other state efforts to respond legislatively to concerns about the abortion pill. 

One way states have responded to increasingly available chemical abortions, she said, is with “laws requiring that a physician is present when they are administering the abortion pill.” She said that 24 states have “enacted laws requiring the abortionist to be in the same room; and, of those 24 states, 19 of those laws are in effect.”

Reversal Legislation

And they are also helping getting the lifesaving word out.

Duran noted that 14 states have enacted laws that require abortion facilities to tell mothers about the possibility of reversing the intended effects of a chemical abortion. Iowa, Ohio and South Carolina recently introduced abortion-pill reversal legislation. She said it’s important that women who have taken the first part of the chemical abortion regimen mifepristone, but not the second part misoprostol, have information about the possibility that they can reverse the abortion at that point.

“We can actually get this important lifesaving information to expectant moms” on abortion-pill reversal, she explained. “It’s an informed-consent law that requires abortion facilities to inform pregnant mothers about the possibility of reversing the intended effects of a chemical abortion.”