FDA rules mail-order abortions can stay

The Food and Drug Administration will permanently adopt a pandemic accommodation that allowed U.S. women to get abortion pills through the mail, the agency announced Thursday—despite recent evidence that drug-induced abortions are causing increasing negative health effects for women.

The FDA previously required providers to dispense mifepristone, the first pill in the abortion drug regimen, in person to mitigate safety concerns. The drug cocktail blocks the pregnancy-sustaining hormone progesterone and then causes early labor, which the woman typically undergoes at home. The FDA only allows providers to prescribe the drugs through the 10th week of pregnancy; after that, having the abortion at home poses too many health risks.

During the COVID-19 pandemic, the FDA has permitted abortionists to prescribe abortion pills without an in-person consultation. Earlier this year, the agency began a scientific review of the existing safety requirements for dispensing mifepristone.

“An in-person visit is medically necessary and sound medical practice because it ensures that every woman receives a full evaluation for any contraindications to a medication abortion,” the American Association for Pro-Life Obstetricians and Gynecologists said in a statement, noting that an in-person visit allows abortionists to make sure the woman is not too far along and doesn’t have a potentially life-threatening ectopic pregnancy. It also allows the abortionist to ensure the woman isn’t being pressured into the abortion.

A recent peer-reviewed study of Medicaid data from 17 states, released by the Charlotte Lozier Institute in November, highlighted the danger the pills pose to women. It found that women were more likely to end up in the emergency room following a chemical abortion than after a surgical abortion. Even with in-person dispensing requirements in place, the data showed that the rate of Medicaid patients visiting the emergency room within 30 days of a chemical abortion went up 507 percent between 2002 and 2015.

“This publicly available Medicaid claims data is more comprehensive than anything available from the FDA or the abortion industry,” lead researcher Dr. James Studnicki said on Thursday. He noted that the FDA since 2016 has only required abortionists to report deaths caused by the abortion pill, leaving other near-death experiences completely out of the picture.

“Today’s FDA decision ignores several sets of much more substantial data which confirms the abortion pill is a significant public health threat, and the real-world data suggests that threat is growing,” Studnicki said.

According to the Guttmacher Institute, eight states this year passed laws attempting to protect women from the dangers of unsupervised chemical abortions, although not all of them are in effect due to court challenges. Six of the laws prohibit abortionists from mailing the abortion pills, and seven forbid virtual appointments for prescribing them.

Sue Swayze Liebel, state policy director for the pro-life Susan B. Anthony List, has worked with states on such legislation. She said she emphasizes the importance of states requiring doctors to report chemical abortion complications and miscarriages. The recent Medicaid research found that reports often miscoded emergency room visits following drug-induced abortions as miscarriages. “We figured out that they were miscoded because it’s not physically possible for a woman to have an induced abortion and less than 30 days later have a miscarriage,” said Studnicki.

Without the government tracking adverse events related to chemical abortions, Liebel predicted that “the medical community crying uncle from emergency room visits” will eventually drive local public health groups to step in where the FDA stepped out and implement better safety protocols for the abortion pill.