Thursday night, the Biden administration removed the U.S. Food and Drug Administration's (FDA) in-person dispensing requirement for the distribution of the drug mifepristone (Mifeprex; also known as RU-486 or simply "the abortion pill"). These safety regulations -- known as Risk Evaluation and Mitigation Strategies (REMS) -- are meant to prevent life-threatening complications that can occur when using mifepristone as part of the two-step chemical abortion regimen.
An in-person dispensing requirement was in place so that a health care provider could assess patient eligibility, diagnose ectopic pregnancies, and provide or facilitate emergency surgical intervention in the case of an incomplete abortion or severe bleeding. This regulation was first put into place by the pro-abortion Clinton administration in 2000, formalized in 2011 and kept -- by the Obama administration. Yet, the Biden administration made the decision to do away with the requirement and once again put politics ahead of women's lives.
The abortion industry and pro-abortion advocates make many claims about the safety of chemical abortion. Below are five common myths about chemical abortion and the science that dismantles them.
1. Myth: Chemical abortion is a safe procedure.
Between 2000 and 2021, 4,471 adverse events related to chemical abortions were reported to the FDA. These events include 26 maternal deaths, 103 ectopic pregnancies, 481 patients who required blood transfusions, and 1,186 hospitalizations. It is important to note that these numbers only represent the adverse events reported to the FDA, as such reports are only made on a voluntary basis.
Most states do not require abortion complication data to be broken down based on abortion type. However, Arkansas passed legislation in 2019 requiring this breakdown. The 2020 data shows that 88.9 percent of abortion complications in Arkansas are the result of chemical abortions.
A recent study by the Charlotte Lozier Institute has revealed that between 2002 and 2015, abortion-related emergency visits following a chemical abortion increased by over 500 percent. This is further evidence of why in-person and follow-up appointments are so critical after a chemical abortion.
With the removal of the REMS, the number of complications resulting from the failure to be assessed by a doctor before and after the ingestion of abortion pills will undoubtedly rise.
Notably, ectopic pregnancies, which occur in 2 percent of pregnancies but account for 13 percent of all maternal deaths, cannot be ruled out without an ultrasound. Half of the women with ectopic pregnancies have no risk factors, and ectopic pregnancies that go undiagnosed due to lack of an in-person visit may rupture, leading to life-threatening hemorrhage. A woman is more likely to die from a ruptured ectopic while undergoing abortion as she may assume that pain and bleeding is a sign the medication is working, rather than a warning sign that her life is in danger.
Additionally, Rh negative women who do not receive prophylactic Rhogam may experience isoimmunization, when their immune system attacks future pregnancies. When left untreated, 14 percent of affected infants are stillborn, and half suffer neonatal death or brain injury.
Finally, the potential for misuse is high when there is no way to verify who is consuming the medication, and whether they are doing so willingly. This will benefit sex traffickers, incestuous abusers, coercive boyfriends, but not women who desire their pregnancies that are tricked or coerced into taking these pills.
2. Myth: For most patients, the most intense pain from chemical abortion lasts only a few hours and is tolerable with over-the-counter pain medication.
Disturbingly, the physical trauma that happens to a woman's body as a result of a chemical abortion is considered a sign that the "treatment is working." According to the Mifeprex medication guide:
"Cramping and vaginal bleeding are expected with this treatment. Usually, these symptoms mean that the treatment is working... Bleeding or spotting can be expected for an average of 9 to 16 days and may last for up to 30 days...You may see blood clots and tissue. This is an expected part of passing the pregnancy."
Many women also experience nausea, vomiting, diarrhea, abdominal pain, and headache. Some women describe the pain of medical abortion as being similar to labor. This is because the same contracting process is occurring in the uterus.
3. Myth: Most women are fine after they have an abortion and don't feel any shame or regret about their decision.
A review in The British Journal of Psychiatry analyzed 22 studies of women who were post-abortive and found that post-abortive women had higher rates of substance abuse, anxiety, depression, and suicidal thoughts than non-abortive women.
These numbers do not separate out abortion by type, and so it is challenging to accurately assess how chemical abortion itself impacts a woman's mental health compared to surgical abortion. However, what makes chemical abortions uniquely traumatic is that a mother sees and must personally dispose of the remains of her aborted child, who may be visibly recognizable as a baby. To put this trauma into context, Planned Parenthood advertises using chemical abortions up to 11 weeks -- at which point the baby already has a head, hands, feet, fingers, and toes. At eight to 10 weeks gestation, the baby is approximately the size and shape of a gummy bear.
4. Myth: There is no link between chemical abortion and breast cancer.
It has been widely acknowledged by major medical organizations that giving birth at a young age protects a woman from breast cancer, compared to giving birth at an older age or never becoming pregnant at all. The interruption of a normal pregnancy might also increase a woman's risk for breast cancer later in life.
In early pregnancy, dramatically increased estrogen levels promote the development of undifferentiated, immature type one and type two lobules in the breast, which have an increased potential to develop into cancer. Delivery at term and breastfeeding the infant will complete the breast development into mature type three lobules, which are more resistant to cancer. If pregnancy is interrupted prior to 32 weeks gestation, this maturation does not occur, leaving breasts in a state more prone to breast cancer development.
5. Myth: Attempts to reverse chemical abortion are dangerous for the woman and her unborn child.
If a woman has only taken the first pill (mifepristone) in the two-pill chemical abortion regimen, and if she receives proper medical care in time, in some cases, the chemical abortion can be reversed. Medical professionals administering the natural hormone progesterone have a 64-68 percent success rate of reversing chemical abortion and the pregnancy continuing.
Mifepristone is a synthetic steroid that acts as an anti-progestin to block the release of the hormone progesterone, a chemical critical for the pregnancy's progression. Progesterone is needed to stabilize the uterine wall and nourish the developing child. Mifepristone blocks progesterone from functioning as required, which leads to the deterioration of the uterine lining -- thereby causing the unborn child's death. Abortion pill reversal uses progesterone to compete for the receptors and override the effects of mifepristone.
Neither mifepristone nor progesterone is associated with birth defects in an unborn baby. For some women, taking progesterone may cause sleepiness, lack of energy, lightheadedness, dizziness, gastrointestinal discomfort, and headaches.
This column appeared originally here.
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