Analysis

AGs from 21 states and DC claim restricting abortion pill will cause ‘spike in mortality’

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Pro-abortion attorneys general from 21 states and the District of Columbia are arguing that restricting the use of the abortion pill would lead to an “unprecedented spike” in maternal mortality.

On behalf of the group of pro-abortion attorneys general, New York Attorney General Letitia James wrote in a February 10 filing in the case Alliance for Hippocratic Medicine v. FDA, “Accordingly, impeding access to medication abortion, the method currently accounting for the majority of all abortions, would undoubtedly lead to an unprecedented spike in mortality, worsening a crisis already disproportionately faced by Black women.”

The abortion pill is the real danger

The filing from the attorneys general comes as a federal judge considers overturning the FDA’s approval of the abortion pill regimen in Alliance for Hippocratic Medicine v. FDA. Mifepristone, the first drug taken in the abortion pill regimen, has potentially severe adverse side effects, and the FDA reports 28 maternal deaths associated with its use since it was approved in 2000.*

A 2015 study found that the complication rate for women who took the abortion pill was 5.2% compared to 1.3% for women who underwent a first-trimester surgical abortion. The rate of severe complications for the abortion pill was .31% compared to .16% for first-trimester surgical abortion — nearly double.

According to a report from the Charlotte Lozier Institute, “Chemical abortion is not as safe as the abortion industry claims, with meta-analyses and international records linkage studies demonstrating failures requiring surgery in 3.4 to 9.9 percent of women who attempt chemical abortion in the first trimester… rising to 39% if inadvertently used in the second trimester…. When failures occur, women often present emergently to hospitals for urgent treatment of retained pregnancy tissue, hemorrhage and infection.”

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The abortion pill has been found to be four times more dangerous than a first-trimester surgical abortion. But because dispensing the abortion pill is more cost-effective for abortion providers, it has rapidly become the abortion method of choice — accounting for more than half of all abortions in the U.S. That percentage is expected to rise as the abortion industry shifts to dispensing the abortion pill through the mail, and due to the FDA’s decision to allow retail pharmacies to prescribe and dispense the drugs. As more women take the abortion pill at home without a prior medical examination, the chances of complications and injuries for women, including infection and death, will likely also rise.

It’s important to remember that the purpose of the abortion pill is to kill. As of June 2021, the abortion pill has tragically ended the lives of nearly five million preborn babies since its approval in 2000.

The push for dangerous misoprostol-only abortions

The abortion pill works in two main steps. The first drug, mifepristone, blocks the natural pregnancy hormone progesterone, thereby depriving the developing child of nutrients with the intention to kill her. The second drug, misoprostol, then causes the contractions meant to expel the baby’s body. Women have spoken about the horror of seeing the babies they had just killed. The combination of the two drugs was approved as the abortion pill more than two decades ago, though it is an off-label use of misoprostol.

If the abortion pill approval is revoked, the abortion industry has a possible backup plan: to give women misoprostol (the second drug of the abortion regimen) alone. The World Health Organization has pushed for misoprostol-only abortions, and Atlantic magazine promoted the idea back in September 2022.

Yet, numerous studies have found there are increased risks for women who use misoprostol alone to cause an abortion. A 2010 study revealed that using misoprostol alone has a 23.8% failure rate that requires the woman to undergo a second surgical abortion procedure. A 2013 study found a failure rate as high as 38.8% when misoprostol alone was used vaginally and 29.8% when it was placed under the tongue. An incomplete abortion, especially if undetected by the woman who has taken the abortion pill at home with no medical team to follow up with, can cause a deadly infection.

Legal abortion may work to increase maternal mortality

James and her fellow attorneys general wrote that revoking FDA approval of the abortion pill regimen would lead to a spike in maternal mortality — but this would only be likely if abortion proponents continued to push misoprostol-only abortions. Abortion is not a solution for the U.S.’s high maternal mortality rate and attempts to paint it as such are flawed.

Dr. Monique Wubbenhorst, who has over two decades of experience as both a practicing OB/GYN and a clinical researcher and who previously held the position of Deputy Assistant Administrator in the Bureau for Global Health at the U.S. Agency for International Development (USAID), explained that there are reasons that abortion is not the answer to the U.S.’s high maternal mortality rate.

“Number one, abortion does not address risk factors. If you want to control a public health outcome or control a specific public health outcome, you focus on the risk factors. Abortion does not address any of those risk factors,” she said. “Number two, we cannot estimate in any given patient what her risk for mortality is. We can say, ‘based on population-level data,’ [but] we can’t say ‘Sally, you’re going to die’… If you say, ‘well, if we do an abortion, that’s going to prevent maternal mortality,’ you don’t know whether that woman was going to die or not. And then the solution then becomes, what percentage of pregnancies do we abort? Do you abort 50% of pregnancies and therefore prevent some mortality? You don’t know. Do you abort 100% of pregnancies?”

Pro-life nations, in fact, tend to have lower maternal mortality rates (MMR) than pro-abortion nations like the U.S. In 1971 and 1972, before Roe, the MMR in the U.S. was 18.8 per 100,000 live births.1 Since then, the MMR has gone up, not down. In 2020, the MMR reached 23.8. While legalizing abortion may or may not be the cause of the rising MMR (deaths from abortion are included in the numbers), it clearly did nothing to lower it.

American doctors trained to kill rather than heal

Roe‘s reign lasted nearly 50 years, and in that time thousands of doctors were erroneously trained to believe that induced abortion (intentional killing) is health care. Now that Roe is overturned, some doctors seem incapable of providing real care to pregnant women who are facing health complications.

As a result, some doctors have begun neglecting their patients out of fear for their own careers or out of loyalty to the abortion industry. For example, People Magazine reported on the story of Amanda Zurawski, who said she “was dilating prematurely due to an incompetent cervix” and was told that “miscarriage was inevitable.” Her doctors wrongly claimed there was nothing they could do and they waited until she was suffering a dangerous sepsis infection before performing a “premature delivery” — a completely legal medical procedure, not an induced abortion. This was medical negligence and showed a complete lack of compassion or concern for Zurawski’s life or the life of her preborn daughter.

Induced abortion has never been and never would be the treatment for premature labor and incompetent cervix. Neither is it the treatment for miscarriage or ectopic pregnancy or any other condition, and preterm delivery and emergency C-sections are not induced abortions either.

The only procedures prohibited by pro-life laws are the ones that involve intentionally killing the child before delivery. 

If the maternal mortality rate in the U.S. rises, it likely won’t be because of pro-life efforts and pro-life laws. Instead, it is more likely that the actions of those who appear obsessed with abortion are putting women in danger from risky, at-home abortions rather than helping them to overcome the obstacles they face for successful parenting.

*THE FDA HAS RECEIVED REPORTS OF SERIOUS ADVERSE EVENTS IN PATIENTS WHO TOOK MIFEPRISTONE. AS OF JUNE 30, 2022, THERE WERE 28 REPORTS OF DEATHS IN PATIENTS ASSOCIATED WITH MIFEPRISTONE SINCE THE PRODUCT WAS APPROVED IN SEPTEMBER 2000, INCLUDING TWO CASES OF ECTOPIC PREGNANCY (A PREGNANCY LOCATED OUTSIDE THE WOMB, SUCH AS IN THE FALLOPIAN TUBES) RESULTING IN DEATH; AND SEVERAL FATAL CASES OF SEVERE SYSTEMIC INFECTION (ALSO CALLED SEPSIS). THE ADVERSE EVENTS CANNOT WITH CERTAINTY BE CAUSALLY ATTRIBUTED TO MIFEPRISTONE BECAUSE OF CONCURRENT USE OF OTHER DRUGS, OTHER MEDICAL OR SURGICAL TREATMENTS, CO-EXISTING MEDICAL CONDITIONS, AND INFORMATION GAPS ABOUT PATIENT HEALTH STATUS AND CLINICAL MANAGEMENT OF THE PATIENT. A SUMMARY REPORT OF ADVERSE EVENTS THAT REFLECTS DATA THROUGH JUNE 30, 2022, IS HERE. THE FDA HAS REVIEWED THIS INFORMATION AND DID NOT IDENTIFY ANY NEW SAFETY SIGNALS. THE FDA INTENDS TO UPDATE THIS SUMMARY REPORT AS APPROPRIATE.

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