The mail-order abortion regime

Rosalie Markezich said she sat on a towel in her garage, soaked in blood, all night long after her boyfriend poisoned her with the FDA-approved abortion drug he’d mailed to her house in Louisiana (where it is illegal) and then physically forced her to take. “Those drugs took my child’s life,” she said at a press conference held by Sen. Josh Hawley, R-Mo., two weeks ago on Capitol Hill. “The blood did not stop for over a week, but the mental agony has never left.” This murderous abuse was made possible by a Biden-era policy that allows for the mailing of abortion drugs without the recipient seeing a doctor first. And the very same week, the Trump administration filed a court order to support Biden’s mail-order abortion policy disaster.

As I have reported in greater detail before, the abortion pill has long been known to be dangerous—not only lethal for the gestating baby, but also potentially lethal for the mother herself. Last Spring, the Ethics and Public Policy Center (EPPC), where I am a visiting fellow, released the largest-known study of the abortion pill based on insurance claims including 865,727 prescribed mifepristone abortions. That study found that “10.93 percent of women—roughly one in ten—experience sepsis, infection, hemorrhaging, or another serious adverse event within 45 days following a mifepristone abortion.”

But new EPPC data released two weeks ago shows a statistically significant increase in the number of serious adverse events after the Biden administration permanently lifted the in-person dispensing requirement, allowing for the pills to be mailed directly to homes or businesses, even in states where it is illegal. There has been a 13% increase in serious adverse events for women who take the abortion pill without the previously required in-person doctor visit, and, shockingly, a 52% increase in mail-order abortion pill prescriptions for ectopic pregnancies, which can be deadly. These rates are significantly higher than the “less than 0.5%” rate of serious adverse events listed on the drug's label. Other drugs have been pulled from the market for far less.

In 2021, the Biden administration permanently expanded access to the abortion pill, which blocks the hormone progesterone and makes the uterine lining break down. The FDA made new allowances for women to receive the pill by mail by lifting the previous restriction that pills could only be dispensed in-person after a doctor’s visit. The restriction helped determine the age of the unborn child, ensured the pregnancy was not ectopic, and ensured women were not being coerced into abortion. Mail-order abortion undermines women’s health on all three points.

But perhaps most surprising is the Trump administration’s continued support for mifepristone. On March 6, the Trump administration’s Department of Justice moved to dismiss Missouri v. FDA, a move that protects the Biden administration’s mail-order abortion policy. One week later, the DOJ moved to dismiss cases brought by Florida and Texas, in a further attempt to protect a policy that significantly harms women. This, despite the fact that President Trump’s very own pollsters report that 70% of likely voters favor an required in-person visit for abortion drugs, and 90% support updating the label to reflect real-world risk.

Marc Wheat, general counsel for former Vice President Mike Pence’s think tank, Advancing American Freedom, said, “With mounting evidence that mifepristone is much more dangerous than the FDA ever acknowledged, it’s shocking that the Trump Administration has adopted such an aggressively pro-abortion stance: it approved a new generic mifepristone, it is claiming States should be barred from bringing their suit against mifepristone, and it is even fighting against Advancing American Freedom in court not to release mifepristone documents demanded by Congress.” Mr. Wheat was the staff director for a congressional subcommittee on drug policy in 2006 that held an investigation and hearing on the manifest harms of the abortion drug.

But where the White House fails, perhaps Congress may prevail. Two weeks ago, Sen. Hawley held a press conference to unveil a new bill that would ban the chemical abortion drug. Many women—including Ms. Markezich—shared their stories of being harmed by or coerced into taking the abortion pill. “The science is clear: The chemical abortion drug is inherently dangerous to women and prone to abuse. Yet major companies like Danco Laboratories are making billions off it,” said Sen. Hawley. The Safeguarding Women from Chemical Abortion Act would withdraw the FDA’s approval of mifepristone for abortion, make distributing and labeling mifepristone for abortion a federal violation, and create a pathway for women harmed by chemical abortion to sue manufacturers.

The abortion pill is the most common method of abortion in the United States, accounting for at least 63% of all abortions in the United States. The Guttmacher Institute estimates over 1,038,000 abortions occur per year in the United States alone. Abortion is often promoted as the safer option to pregnancy and childbirth—but one study conducted by the National Institutes of Health (NIH) shows that adverse events during pregnancy was 5.9%, and only 3.7% during childbirth. Both are well below the 13.51% of women—nearly 1 in 7—who experience a serious adverse event within 45 days after taking the abortion pill.

The ideological fog seems to have lifted from medical associations’ deliberations about sex-rejecting procedures for children in the wake of the Fox Varin lawsuit. But the ideological fog still seems to obscure Democrats’ (and the White House’s) honest evaluation of the harm mifepristone does to women. I’m hopeful that this new data from EPPC will help to pierce through that mist—before any more women lose their babies or their lives.