What the popular telehealth abortion ‘CHAT’ study claims to prove — and why it can’t be trusted

When certain studies are repeatedly cited as evidence for the alleged safety or benefits of abortion, it is always important to pay attention to the details. It is not unusual for those who make their living committing abortions to author these studies.

It’s also not unusual for those studies, regardless of flawed methodology or conflicts of interest, to be cited again and again… and again…  as supposed “proof” that abortion doesn’t do any harm to anyone, ever, and that virtually no woman ever regrets it (unless she suffers from mental illness which, of course, is never connected to the abortion) and only suffers if she cannot get access to abortion. (You get the idea.)

The CHAT study (an acronym for the “California Home Abortion by Telehealth” Study) is one of those studies that has been cited multiple times by the media and portrayed as a solid study showing the safety of telehealth abortion. Yet, those overseeing the study have been funded by investors in the manufacturer of the abortion pill — leaving some to question the reliability of the study, which was reportedly completed in 2023. But the CHAT study has even bigger issues than this.

What is the CHAT study?

CHAT is described as a “patient-centered, clinically supported, prospective study among people in the United States seeking medication abortion” which “aims to build the evidence-base for safely expanding access to medication abortion by mail using a simple online or phone app-based telemedicine model.” The study website claims that “CHAT is the first study-of-its-kind in the U.S. that will evaluate abortion medication by mail without the need for a doctor’s visit or ultrasound.”

The clinical trial website for the study also claims that the researchers aimed to “reach a diverse sample of medication abortion patients across the country in states where care is provided including California, New York, and Washington…” and the study donation page claims, “In our first year, we’ve expanded beyond California to include the evaluation of telehealth medication abortion across 21 states.”

At one time, the CHAT study was even recruiting “females ages 13 years and up.”

UCSF abortion pill study 66K chemical abortions in California a year recruits girls as young as 13

CHAT Study Sponsors and Investigators

Online, the CHAT study claims to be “[l]ed by [University of California San Francisco] UCSF’s Advancing New Standards in Reproductive Health (ANSIRH) in partnership with California Latinas for Reproductive Justice (CLRJ).”

It is no secret that original investors in abortion pill manufacturer Danco Laboratories have invested and funded the University of California (UC) system — namely, the David and Lucile Packard Foundation, the Buffett Foundation, and billionaire George Soros‘ Open Society Foundations.

• The Buffett Foundation gave $78 million to UC — and according to the New York Times, is the primary financier of the Bixby Center’s Ryan Residency Program at UCSF, which trains abortionists. Buffett is also collaborator in abortion pill clinical trials.
• Billionaire George Soros also pumped millions of dollars into the UC and has funded Planned Parenthood and Gynuity Health Projects.
• The David and Lucile Packard Foundation, which invested $14.2 million into Danco in 1996 and later invested millions into the generic version of the drug made by GenBioPro, Inc., is also pumping dollars into UC.

In addition, the CHAT study received nearly $5 million from the Buffett-funded Society of Family Planning (SFP).

Live Action News previously documented that ANSIRH was founded by abortionist Felicia H. Stewart (previously awarded by the Population Council), who served on the executive committee of the Association of Reproductive Health Professionals and boards of NARAL and the National Abortion Federation. She was medical director and staff physician at Planned Parenthood facilities in California.

ANSIRH is also funded by the Packard Foundation and is part of UCSF’s Bixby Center for Global Reproductive Health. The Bixby Center prides itself on abortion as a focus and claims that their work has “led to new methods of abortion and expanded the abortion care workforce.” Bixby trains abortion providers though its Ryan Residency Training Program.

“In 2002, the Bixby Center launched the [ANSIRH] Program… to enhance access to abortion. With seed funding from the Packard Foundation, ANSIRH established a Planned Parenthood training site for motivated residents and practicing physicians to learn early abortion procedures,” the Bixby Center for Global Reproductive Health claims online.

To be clear, ANSIRH was established to “enhance access to abortion,” and ANSIRH led the CHAT study.

ANSIRH launched by Bixby funded by Packard mission enhance access to abortion

While the CHAT study is sponsored by University of California, San Francisco (UCSF), it was supervised by Ushma Upadhyay, who served as principal investigator. Upadhyay is an associate professor at ANSIRH. In 2019, well before the COVID-19 pandemic, Upadhyay advocated a “no test/no touch” abortion pill protocol; she and her colleagues suggested that abortion providers should simply “believe the woman” about the gestational dating of her pregnancy. That protocol eliminated important preliminary labs, testing, and ultrasounds — potentially placing women in harm’s way.

In addition, Upadhyay has argued that the FDA should “remove as many barriers as possible” on the abortion pill, and wrote on Twitter/X in 2021: “It’s worth trying every tool we’ve got to enable all states to benefit from FDA’s recent decision allowing mail-order pharmacies to dispense abortion pills….”

CHAT’s “Team” and “Partners” 

Live Action News previously documented how UCSF began CHAT by partnering with multiple virtual abortion pill dispensaries to recruit teens and women for the CHAT study. Those partners included virtual abortion pill websites Choix Inc., HeyJane, and Abortion on Demand (AOD).

In January of 2022, Choix Inc.’s co-founder Cindy Adam told Ms. Magazine, “There’s also an option to receive a $50 electronic gift card for folks who are interested in participating in a University of California, San Francisco research study.”

Today, three years later, the CHAT study website lists California Latinas for Reproductive Justice (CLRJ) as a partner.

The CHAT study team consists of multiple pro-abortion individuals working in varioius ways with the abortion industry.

Karen Meckstroth, the CHAT study‘s Co-Investigator, is a UCSF staffer and director of Women’s Options Center, an abortion facility which commits abortions up to the 23rd week of pregnancy. It is also one of the sites that participated in a pharmacy-dispensed abortion pill clinical trial. Meckstroth has reported that she receives “personal fees from Danco Laboratories, a distributor of mifepristone….”

Leah Koenig, CHAT’s Research Data Analyst, works at UCSF with ANSIRH on studies that “focus on testing new models for abortion services,” according to her online bio. Her LinkedIn page reveals she previously worked for the Bill and Melinda Gates Foundation, a known financier of pro-abortion organizations including DKT International, a global distributor of the abortion pill and abortion kits. In addition, Koenig also previously worked for the Guttmacher Institute and the Population Council (the latter of which brought the abortion pill into the U.S. and set up Danco as a manufacturer).

Koenig also received financial support for the CHAT study from the Society of Family Planning (SFP). Live Action News previously documented that SFP was founded in 2005 with a generous contribution from the Packard Foundation and receives millions from the Buffett Foundation. Over past years, abortion philanthropist and abortion pill investor Warren Buffett (the Susan Thompson Buffett Foundation) has poured over $15.3 million into SFP.

“Telehealth can bring an otherwise impossible abortion within reach,” Koenig wrote in an op-ed she penned with Upadhyay.

The CHAT Study’s “Supporters”

Supporters (likely financial supporters) of the CHAT study include the BaSe Family Fund, Jess Jacobs, and Emily Birmingham, PhD.

Additional supporters include:

• Isabel Allende Foundation, which grants dollars to secure “reproductive rights” to organizations like Planned Parenthood and NARAL Pro-Choice America, among others.
• Preston-Werner Ventures, which has committed to “providing USD 1 million per year over the period of 2022-2025 towards the global goal of universal access to sexual and reproductive health and rights by 2030.”
• The Grove Foundation, which receives funds from the Packard Foundation. The Grove Foundation funds Planned Parenthood (and has for years) as well as UCSF. Grove currently partners with multiple pro-abortion organizations. Grove’s Chairman, Karen Grove, who is president of the Grove Action Fund, served on the board of Planned Parenthood Mar Monte (PPMM) — another a clinical trials site for studies on abortion pill expansion.
• The Lisa and Douglas Goldman Fund lists “Reproductive Health & Rights” as its priority with a goal to “Protect and expand access by strengthening the abortion service delivery ecosystem.” The Fund recently awarded “$1,000,000 in emergency grants to seven organizations providing immediate assistance to women who reside in states where abortion is now outlawed or restricted.” Their “strategies” include “Advanc[ing] and expand[ing] access to medication abortion,” along with “Improv[ing] abortion seekers’ ability to access care,” as well as “Promot[ing] activities that increase abortion provider training,” and “Support[ing] Northern California-based health clinics that offer abortion services.”

 

The CHAT Study’s Claims

The telehealth or “self-managed” abortion scheme essentially involves no in-person medical professionals, and by definition leaves women alone to “manage” whether their abortions are complete (without retained tissue), whether they are bleeding too much (hemorrhage), or whether they are experiencing a potential emergency.

Published percentages for ER visits on the abortion drug’s 2023 label states that 2.9 to 4.6% of women who take mifepristone end up in the emergency room, indicating that abortion pill ER visits could be in the tens of thousands every year.

In addition, the FDA’s medication guide acknowledges that as many as seven percent (7%) of women will need surgery after taking mifepristone “to stop bleeding” or to complete the abortion.

The “self-managed abortion” scheme was planned and implemented by the abortion industry years before the fall of Roe v. Wade. Even in the early days of the abortion pill’s approval, the industry acknowledged that ERs would be a necessary link in the “self-managed” abortion chain, despite the claim that the drug is “safe.”

The abortion industry shifted responsibility for abortion pill clients from abortion providers to often overcrowded emergency rooms. Today, bad actors inside the abortion industry even instruct abortion clients not to call them, but to instead present to emergency rooms for abortion pill complications. Some have even suggested that clients lie about abortion pill complications and claim they are experiencing a natural miscarriage.

Why does this matter? Because it falsifies the true dangers of the abortion pill for women, instead blaming those dangers on natural pregnancy complications.

So, it was no surprise to find that while the CHAT study trial claimed one measurement of success would be “The proportion of participants who have a successful abortion defined as complete abortion without continuing pregnancy, need for manual vacuum aspiration or an additional round of treatment to complete the abortion,” the study also defined “major adverse events” not as an abortion resulting in an ER visit, but as “any abortion requiring blood transfusion, surgery, or hospitalization.”

Big Abortion profiteers have floated the lie that women are only presenting to ERs after taking abortion pills to “ask questions.” This plays into their warped reality that untrained and non-medical abortion patients, many who could be teenagers, are capable to manage abortions at home. But instead of truly caring for women, many abortion profiteers simply hand off their clients (who are instructed to lie) to ER and urgent care doctors.

The CHAT Study’s Sleight of Hand 

One published study in Nature, which relied on the CHAT study for data, claimed that CHAT patients were screened “using a published, standardized no-test protocol, primarily relying on patient medical history to assess medical eligibility.” The study also claimed a much-lower-than-normal rate of ectopic pregnancies.

But, upon closer investigation, it becomes clear that something isn’t quite right with this study.

Buried in the CHAT study is the fact that “[p]atients who had any risk factors for or symptoms of ectopic pregnancy or were potentially beyond the gestational limit of the virtual clinic were referred for pre-abortion ultrasonography,” and only after that, “[e]ligible patients received 200 mg mifepristone and 800 or 1,600 μg buccal or vaginal misoprostol via mail order pharmacy.”

But this means that a “standardized no-test protocol” was NOT actually used in the study, since these patients were screened and then referred for testing to rule out ectopic pregnancy before they received the abortion pills! This is almost certainly the reason why the study shows such an unusually low rate of ectopic pregnancies compared to that of the general population.

This isn’t like a real-life scenario.

When a woman is not participating in a closely-tracked study, she isn’t screened in this way and isn’t referred for any pre-abortion ultrasound — hence the name “no-test protocol.” Opponents of “self-managed” abortion have raised concerns about the “no-test” protocol for failing to rule out ectopic pregnancies before the abortion pill is administered. Even some pro-abortion doctors have warned ER staff to be on guard for undiagnosed ectopic pregnancies among women who have taken the abortion pill, so it’s clear that the CHAT study authors carefully designed their study with extra safeguards to prevent complications.

But those safeguards just aren’t in place in real life.

The FDA’s Risk Evaluation Mitigation Strategy (REMS) safety system requires prescribers of the abortion pill to have the “ability to assess the duration of pregnancy accurately” and the “ability to diagnose ectopic pregnancies.” But the language here, too, even seems to mislead; after all, requiring a prescriber to have the ability to assess and diagnose isn’t the same as requiring a prescriber to actually provide an assessment or diagnosis of ectopic pregnancy to an abortion pill client.

The CHAT study appears to be yet another example of how biased researchers — funded by biased donors who are determined to promote abortion at any cost — are willing to deceive the public. And it’s women and preborn children who end up paying the price.

Tell President Trump, RFK, Jr., Elon, and Vivek:

Stop killing America’s future. Defund Planned Parenthood NOW!