Oswald Clark:

The journal Nature Medicine published a study on Feb. 15 that supposedly shows that telemedicine medical (chemical) abortions pose little health risks to women, but pro-lifers point to flaws in the study that undermine its claim of being safe and effective.

The study, “Effectiveness and safety of telehealth medication abortion in the USA,” by Ushma D. Upadhyay, Leah R. Koenig, Karen Meckstroth, Jennifer Ko, Ena Suseth Valladares, and M. Antonia Biggs, acknowledged that there is “limited” information regarding the “effectiveness and safety” of the abortion pill. Upodhyay and her colleagues examined data collected from three virtual abortion facilities that send the abortion cocktail of mifepristone and misoprostol to “pregnant people” in 20 states and Washington D.C. between April 2021 and January 2022.

The study examined “effectiveness” defined as “complete abortion without additional intervention” and “safety” defined as “the absence of serious adverse events.”

The authors used survey data from more than 6000 women who had chemical abortions and they said 97.7 per cent “were complete without subsequent known intervention or ongoing pregnancy after the initial treatment” and that 99.8 per cent of abortions were “not followed by serious adverse events.” About 0.25 per cent of patients – one in 400 – experienced “a serious abortion-related adverse event” but that 1.3 per cent of abortion were followed by a visit to the emergency department.

The authors said that complication rates were similar to women who obtained abortion drugs after an in-person visit with a physician.

Michael J. New, an associate scholar at the Charlotte Lozier Institute and research associate at the Busch School of Business at the Catholic University of America in Washington, said that the “main methodological problem with the study is that it relies on survey data and therefore fails to track health outcomes from all of the women who had obtained chemical abortions.” New said that a study that followed the medical history of women who had telehealth abortions would yield a fuller picture than one that relies on survey responses.

New said that only 4613 women of 6154 who obtained chemical abortions through telehealth were successfully contacted for a follow-up, meaning that the research team did not have data for nearly a fourth of the women in the study. New said this “clearly biases the results, as women who suffered adverse effects after obtaining a chemical abortion would probably be less likely to respond to a follow-up survey.”

Even “taking the findings at face value,” New said, “the study does find that many women suffer serious physical health consequences after obtaining chemical abortions,” with 81 women admitting to visiting an emergency room, 15 having serious complications, ten were hospitalized, six received blood transfusions, and two were treated for serious infections.

New also noted that “all of the authors of the study work for groups that support legal abortion.” Valladares is a member of California Latinas for Reproductive Justice and the other five are affiliated with Advancing New Standards in Reproductive Health; Meckstroth has received compensation from Danco Laboratories, the manufacturer of mifepristone.

New said the “timing of the release of this study is unsurprising” because the U.S. Supreme Court will hear oral arguments on March 26 in the appeal of Judge Matthew Kacsmaryk’s decision overturning the Food and Drug Administration’s approval of mifepristone. New said, “The decision by the Biden administration’s FDA to allow women to obtain chemical abortion pills without an in-person medical exam is one of the policies that will be litigated.”

Last February, Nature published an editorial opposing the legal challenge that led to Kacsmaryk’s decision.

New said contrary to the author’s claim that there is limited data on the safety and effectiveness of the abortion drug, “separate studies using comprehensive data from Finland and the California Medicaid system find that chemical-abortion pills have a complication rate that is four times higher than that of surgical abortions.”

While Nature Medicine had no problem publishing a study in which all six authors were affiliated with pro-abortion groups, earlier last month, Sage Journals, publisher of Health Services Research and Managerial Epidemiology, retracted three articles it published in 2019, 2021, and 2022 which demonstrated the risks associated with using abortion pills because its authors were associated with one or more of three pro-life groups: the Charlotte Lozier Institute, the Elliot Institute, and/or the American Association of Pro-Life Obstetricians and Gynecologists. Those studies found that chemical abortions were as risky or riskier than surgical abortions.

James Studnicki, vice president and director of data analytics at the Charlotte Lozier Institute, and Tessa Longbons, senior research associate at the institute, issued a statement saying the retractions were “a baseless attack on our scientific research and studies.” They said the publisher has “advanced no valid objection” to their research, instead focusing on the potential bias they may have as pro-lifers.

Randall K. O’Bannon, director of education and research at the National Right to Life Committee, wrote a three-part report in January responding to abortion activists’ claims that the abortion pill is as safe as penicillin or Tylenol. O’Bannon wrote that unlike penicillin and Tylenol, which are used to fight infections and pain, “Mifepristone interrupts a healthy pregnancy, takes lives, causes incredible pain and copious bleeding, and puts a mother’s life and health at risk.”

The pro-life scholar Michael New concluded his analysis of the Nature Medicine study stating that “Overall, pro-lifers should not be distracted by this study” because “Our concerns about the safety of unregulated chemical abortion drugs are rooted in the best interest of mother and child.”

Within days of the study’s publication, Live Action reported that an American woman, identified only as “Amberly,” was found “lying alone and helpless in a puddle of (her) blood,” after being prescribed mifepristone to “help” complete the miscarriage she suffered at the ten-and-a-half-week mark of her pregnancy. Mifepristone causes contractions which expel a dead baby, whether after an abortion or miscarriage. “It was the worst and scariest thing that we’ve been through as a family,” Amberly told Live Action News. Carole Novielli, a Live Action News researcher, has reported that mifepristone is not approved by the Food and Drug Administration for miscarriage care.