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The Push to Expand Chemical Abortion in the
Tessa Longbons | 07 November 2019
Due to pressure from the abortion industry, chemical abortion was introduced into the United States at the beginning of the 21st century, promising to revolutionize abortion provision. Nearly 20 years in, pro-life advocates must take care that this favorite tool of the abortion industry does not undo gains we have made over the past two decades.
Mifeprex, the first step in the two-pill chemical abortion regimen, was first approved in September of 2000 by the U.S. Food and Drug Administration (FDA). As a dangerous drug, Mifeprex has a Risk Evaluation and Mitigation Strategy (REMS) in place to regulate how, where, and by whom the pill may be administered. Currently, Mifeprex is only available in abortion clinics, not pharmacies. But even as the U.S. abortion rate has fallen over the past two decades, chemical abortions have risen from 70,500 abortions in 2001 to 339,640 abortions in 2017, according to estimates from the Guttmacher Institute. Danco Laboratories, the only legal distributor of mifepristone for pregnancy termination in the United States, states that over 4 million women have used the drug.
A recent review of state-level abortion data from 2017 showed that chemical abortion may be slowing the U.S. abortion decline. Among 25 states that published chemical abortion data continually from 2008 through 2017, total abortions fell by 23 percent, while chemical abortions increased by 68 percent. Total abortions in these 25 states declined by just 0.3 percent between 2016 and 2017, the second-lowest annual drop of the decade.
This is no accident. The abortion industry has pushed chemical abortion aggressively both in the United States and internationally. In July, 76 pro-abortion organizations issued a blueprint for abortion expansion in the United States, declaring that “Policymakers should promote and ensure improved access to medication abortion.” The most recent annual report of the Planned Parenthood Federation of America (PPFA) listed “medication abortion available in 357 health centers” at the top of its list of medical and research achievements. The International Planned Parenthood Federation, PPFA’s international counterpart, performed more than 700,000 chemical abortions around the world in 2018. This concerted effort from the abortion industry threatens to change the nature of abortion provision in the U.S.
For decades, the pro-life movement has worked to set health standards for abortion facilities and require them to abide by minimum safety standards. If we cannot save the baby, the reasoning has gone, at least we can save the baby’s mother. Now the abortion industry is changing the paradigm and bypassing the abortion facility altogether. Planned Parenthood, the largest abortion chain in the U.S., has emerged as a leader in pushing telemedicine abortion on American women, administering the abortion pill via telemedicine in 14 states, with the doctor on one end of a webcam and the patient on the other. Eighteen states have laws that prohibit telemedicine abortion – but 32 states do not. Planned Parenthood has partnered with other abortion advocates in the large TelAbortion Project to methodically test the feasibility of telemedicine abortion across eight states. Studies on the safety of this process have been hampered by the loss to follow-up of large numbers of the women undergoing telemedicine abortions, but safety concerns have been waved away.
Recently, efforts have been afoot to leave the abortion clinic even further behind. California has decided to mandate the distribution of the abortion pill in the health centers of all its public universities, despite concerns over the inability of these health centers to handle the serious complications that can arise as a result of chemical abortion, including excessive bleeding and the need for follow-up surgical procedures. Efforts will not stop there. Gynuity, one of the abortion organizations behind the TelAbortion Project, is planning a pilot study to send patients home with chemical abortion pills to have on hand “just in case” of a missed period. Ultimately, the abortion industry seeks to make Mifeprex available in pharmacies. Other abortion organizations have already moved past the pharmacy by selling abortion pills online and directly shipping them to American women in violation of U.S. law. The Charlotte Lozier Institute recently identified a list of 39 websites that advertise abortion pills. Aid Access, an affiliate of a large international abortion organization, acknowledges illegally shipping pills to more than 7,000 American women.
Of course, efforts to expand chemical abortion will always be limited as long as the REMS are in place, so the abortion industry has undertaken a court battle to overturn the REMS. The American Civil Liberties Union and a Hawaii abortion provider are suing the FDA to get the REMS lifted, and if this lawsuit is successful, the gates will be open to new and ever-riskier chemical abortion pipelines in the United States.
Steps must be taken now to prevent that from happening. A bill sponsored by U.S. Congressman Bob Latta, the Support and Value Expectant (SAVE) Moms and Babies Act, is a good start. The bill codifies the Mifeprex REMS that are currently in place and prohibits the dispensing of the abortion pill in pharmacies or via telemedicine. In-person examinations of expectant mothers remain the appropriate standard for any medical intervention regarding a possible pregnancy. The bill also requires medical professionals to report to the FDA any chemical abortion-related complications they treat and prohibits the FDA approval of any new abortion drugs. Essentially, the SAVE Moms and Babies Act seeks to maintain the status quo and prevent chemical abortion from eroding pro-life progress any further.
Another important protection currently in place is Protecting Life in Global Health Assistance, which establishes that international organizations that receive U.S. tax dollars are not allowed to promote or perform abortions. However, this rule almost certainly will be reversed by the next pro-abortion administration, and next year’s election will be critical for maintaining pro-life momentum.
Robust laws must be coupled with vigilance from pro-life advocates at the grassroots level. Pro-lifers have always sought to change hearts and minds, but on the ground will need to educate the public on the risks and dangers of chemical abortion and the alternatives that are available. Now more than ever, alternatives counseling is needed not only outside clinics but also on screens and in dorm rooms. One initiative launched by the Charlotte Lozier Institute seeks to provide women who are searching online for information on chemical abortion with important safety information and to ensure that a link to an abortion pill rescue hotline is readily accessible.
As the abortion industry uses chemical abortion to advance its agenda at home and abroad, lives are on the line. Chemical abortion has claimed the lives of millions of young Americans and, tragically, the death toll continues to rise. The abortion industry used to claim they wanted abortion to be safe, legal, and rare, but now the industry uses chemical abortion to undermine all three principles. With so much at stake, we must be alert and ready to fight back against one of the deadliest drugs in America.
Tessa Longbons, Research Associate, Charlotte Lozier Institute