Mary Zwicker:

As the world increasingly shifts towards online services, with more and more people working from home than ever before, this same phenomenon can be seen in the abortion industry. Today, fewer women are choosing to have surgical abortions, and instead rely increasingly on online platforms to access abortion pills for chemical abortions that can be mailed to them for use in their own homes. 

Reliable statistics for the use of the abortion pill are scant in Canada, but Action Canada for Sexual Health and Rights (formerly Planned Parenthood Canada), recently noted “the landscape of abortion access in Canada has changed due to the uptake of medical abortion by primary care providers,” especially during pandemic restrictions. A study published in the New England Journal of Medicine in January, found that nearly a third of abortion in Ontario from November 2017 (when Health Canada lifted a number of restrictions on the mifepristone and misoprostol abortion pill combination) through March 2020 (when the pandemic led to changes in the way primary health care was delivered) were chemical abortions.

Yet even before the growing popularity of telemedicine, the abortion pill (chemical abortions, although the abortion industry prefers the term “medical abortion”) was closing the gap with surgical abortions in the United States and had overtaken traditional surgical procedures in some European nations.

Recent data reported by the pro-abortion Guttmacher Institute revealed that at least 54 per cent of abortions in the United States in 2020 were chemical abortions. The Food and Drug Administration approved the abortion pill, then known as RU-486, in 2000. In two decades, it became the most popular form of abortion.

Many European countries approved use of RU-486 prior to the United States and chemical abortions have made up the vast majority of abortions committed in European countries: England and Wales (62 per cent), France (64), Portugal (71), Switzerland (72), Scotland (83), Norway (87), Sweden (92), Finland (96). 

Why this popularity of the abortion pill over surgical abortions?

Angelina Steenstra, national co-ordinator for the Silent No More campaign, said in an interview with The Interim, that she believed numbers were rising largely because of the way that chemical abortions are advertised. “It looks like it’s innocuous,” she said. “Like it won’t be a big deal. It’s simple, not complicated, a quick fix. Nobody needs to know. You can hide it. (There are) no intermediaries.”

This desire to have an innocuous or secret abortion has increased dramatically with the fear of Covid, and then again with the overturning of Roe v. Wade in the United States in June. With government lockdowns forcing people to go more online for goods and services, abortion pills also became more available through different websites, and women who did not want to risk leaving their homes opted for this route. Similarly, the overturning of Roe v. Wade has now made surgical abortions inaccessible in many states, leaving chemical abortions the only abortive alternative for many women. Thus far, no state has figured out how to stop interstate sales of the abortion pill.
 However, while many might rejoice that they have an alternative should they no longer be able to procure a surgical abortion, what they do not realize are the dangers associated with chemical abortions.

Physical dangers

Many women choose to have a chemical abortion because they like the idea of the privacy that it allows. They feel that it would be more comfortable to do it in their own home instead of in an abortuary, where they would have to interact with many different people and perhaps even risk being spotted entering the abortion mill. However, while it is privacy that many women seek, it is ultimately this privacy that often proves extremely detrimental.

Although Planned Parenthood claims that chemical abortions are “safe and effective,” they fail to tell women of the significant risks involved in this method. 

Jakki Jeffs, executive director of Alliance for Life Canada told The Interim that chemical abortions are the exact opposite of the “healthcare” that organizations such as Planned Parenthood market it as. “How do you make this safe for women when you don’t require facilities to report on the demographics?” Jeffs asked. She went on to say that in 2019 in Canada, the Canadian Institute for Health reported only 3,600 chemical abortions for all of Canada. In order to see if this number was in any way accurate, Jeffs requested prescription claims for the pill and found that, in Ontario alone, 14,575 women had been prescribed chemical abortions. 

“These facilities are not required to report on these demographics,” Jeffs said, “so they don’t report them. In the areas where roughly 73 per cent of abortions are (carried out), we don’t have reports! So how do we follow women’s health before or after abortion?” She said that the whole idea of abortion is that it is so good for women, and yet the women who receive chemical abortions are not monitored by healthcare workers. “I don’t understand it,” she said. 

Jeffs went on to say how in a chemical abortion, women have to become their own doctor and assess their own symptoms. “These women have to actually remember their own length of pregnancy, diagnose whether they have an ectopic pregnancy or not, and diagnose whether or not they are feeling certain symptoms or not, and whether that is normal or a massive infection,” said Jeffs. “And we think it is ok to give these women these pills and that they are medically knowledgeable enough to know if they have an ectopic pregnancy!”

She compared chemical abortions to the back-alley abortion stories that everyone has heard, saying that chemical abortions abandon women to the same fate.

Jeffs quoted a six-year study done in Finland between 2000 and 2006, that monitored women who had chemical abortions, comparing the outcomes with those who had surgical abortions. What the study found was that there was a four times higher rate of adverse reports associated with chemical abortions in comparison to surgical abortions. “What about the safety analysis of these women?” she asked. “Are (pro-abortion people) ignorant of the fact, or are they consciously and willingly ignorant of something they publish as the gold standard of abortion?”

The American Association of Pro-life Obstetricians and Gynecologists said in a recent statement, “American abortion data is fundamentally flawed and is used to downplay the risk of maternal death while simultaneously touting the safety of abortion.” The AAPLOG added, “As physicians, we need to demand not only better reporting standards, but research into the root causes of maternal mortality.”

The pro-life Charlotte Lozier Institute states that as many as one in every five women who experience a chemical abortion will have complications. These complications include incomplete abortions that require a surgical abortion to finish the abortion, an increase in hemorrhaging, and infections. Over 50 per cent of women who receive a chemical abortion will also need to visit an emergency room. 

The Institute also noted the risk of women with an ectopic pregnancy who take Mifepristone, saying that “Mifepristone cannot treat an ectopic pregnancy and can mask the symptoms of tubal rupture, putting women at risk of severe bleeding and death. Approximately 2 per cent of all pregnancies are ectopic.” The maker of the abortion pill Mifepristone encourages women to have an ultrasound before taking the abortifacient pill to rule out an ectopic pregnancy. Health Canada, which originally required ultrasounds before prescribing the abortion bill has since abandoned that standard of care.

Jeffs doubts that doctors prescribing the abortion pill are warning women of the risks incumbent in them. “When we talk about informed consent, it seems to me that we are supposed to be told every likelihood of what can happen,” Jeffs said. 

Other risks

Jeffs also said that chemical abortions could heighten the risk of women being coerced into an unwanted abortion. She recounted the story of a girl she once talked to on the phone who was looking to buy an abortion pill. When Jeffs presented alternatives to abortion to the girl, she seemed genuinely open and interested, until a male voice in the background yelled at her, “did you get those pills yet?” The girl hung up in a hurry, and Jeffs does not know what happened to the baby. 

Aside from the physical dangers involved in a chemical abortion, women also experience deep psychological trauma after experiencing a chemical abortion. Steenstra commented that chemical abortions share a similarity to the clothes hanger abortion story that has been pushed on society in order to promote the legalization of abortion. She said that allowing women to go through such an ordeal and such trauma despite knowing the risks stems from such a deep-rooted hatred of women. “Talk about discrimination,” she said.

Easier to obtain

Health Canada approved the mifepristone and misoprostol combination in 2015 and soon thereafter, abortion advocates and medical bodies began lobbying to lift the restrictions the federal body imposed. In 2018, it lifted the seven-week gestation limitation for prescribing, ended the requirement that doctors take a training course in prescribing the abortion pill combination, and later ended its requirement that an ultrasound be done to ensure there is no ectopic pregnancy. While initially not all provincial public health care programs covered the abortion pill, all ten provinces and three territories do today. Both Jeffs and Steenstra said they are concerned about the normalization of the abortion pill as governments have made it easier, quicker, and cheaper to obtain.