Published February 15, 2021
As part of a broader effort to expand access to chemical abortion, House Democrats are demanding that the Food and Drug Administration remove safety protocols for mifepristone, a drug most commonly prescribed for abortions during the first three months of pregnancy.
Under its current policy, the FDA requires women to obtain the first of two chemical-abortion pills in person from a health-care professional rather than via telemedicine. The in-person mandate is intended as a safety precaution to ensure that women are monitored and have access to follow-up care as needed.
Last week, several Democratic congresswomen on the House Oversight Committee wrote to acting FDA commissioner Janet Woodcock, demanding that the agency “immediately eliminate the medically unnecessary in-person dispensing requirement for mifepristone.”
The congresswomen claim that “imposing this requirement in the midst of a deadly pandemic — one that has disproportionately impacted communities of color across the United States — needlessly places patients and providers in harm’s way, and further entrenches longstanding health inequities.”
The letter is the latest move in a year-long effort from Democratic politicians and pro-abortion groups to eliminate safety requirements on chemical abortion during the COVID-19 pandemic, pushing to allow women to obtain the drug via telemedicine.
Last March, a coalition of Democratic attorneys general urged the FDA to undo the safety guidelines for the duration of the pandemic. In May, the American Civil Liberties Union sued the Trump administration on behalf of a coalition of abortion-advocacy groups, demanding an emergency order to lift the FDA safety policy, which the groups asserted was “medically unnecessary.”
Over the summer, a federal judge sided with the ACLU, calling the FDA’s safety standards an unconstitutional “substantial obstacle” to the supposed right to abortion because of the conditions created by the pandemic and related lockdowns.
“By causing certain patients to decide between forgoing or substantially delaying abortion care, or risking exposure to COVID-19 for themselves, their children, and family members, the In-Person Requirements present a serious burden to many abortion patients,” U.S. district judge Theodore Chuang wrote in his ruling.
That decision stood until just last month, when the Supreme Court overturned Chuang’s decision and ruled 6–3 that the FDA could reinstate its safety standard. The Court’s reversal has sent progressives back to the drawing board, now leading efforts — such as this letter from House Democrats — to lobby the newly installed FDA commissioner.
The debate is especially interesting because data suggest that an increase in the rate of chemical abortion is a central reason for the recent increase in the overall U.S. abortion rate. As Michael New recently pointed out on National Review Online, the number of chemical abortions women have obtained has risen consistently since the FDA first approved mifepristone for abortions in 2000.
“Between 2015 and 2018, the percentage of total abortions that were chemical abortions increased from 25 percent to 40 percent,” New notes. “Among the 42 states that reported data on type of procedure in both 2017 and 2018, the number of chemical abortions increased by more than 10 percent.”
That rise in the number of chemical abortions is likely a major reason why the Centers for Disease Control reported a rare increase in the overall abortion rate in 2018, even though the rate of abortions in the U.S. had been dropping fairly steadily since 1980.
Meanwhile, the Democratic campaign to undo safety requirements on mifepristone ignores the risks to women who take the drug, especially without adequate supervision or access to follow-up care. Many of the drug’s possible side effects and complications require subsequent in-person care or emergency-room treatment, which can be especially difficult to access during the pandemic.
According to one study, between 5 percent and 7 percent of women who undergo a chemical abortion will require a follow-up surgical abortion. Another survey found that more than 3 percent of women who took mifepristone required emergency-room admission to manage complications. A recent paper in Issues in Law and Medicine, cataloguing FDA reports of adverse events after chemical abortion, found that “significant morbidity and mortality have occurred following the use of mifepristone as an abortifacient” over the last two decades.
As abortion-rights activists have pushed to loosen the FDA safety protocols, pro-life advocates have begun pushing in the opposite direction, rightly noting the potentially grave hazards to women’s safety.
The American Association of Pro-Life Obstetricians and Gynecologists filed a citizen petition with the FDA in 2019, emphasizing the serious risks of mifepristone. The petition noted that abortion-related injuries are under-reported, because most treatments are provided in emergency rooms rather than in abortion clinics.
Last September, a group of Republican senators asked the FDA to “classify the abortion pill as an ‘imminent hazard to the public health’ that poses a ‘significant threat of danger’ and remove this pill from the U.S. market.”
“We believe this deadly pill should never have been approved, yet the abortion industry was politically rewarded with an accelerated approval process normally reserved for high-risk drugs that address life-threatening illnesses like AIDS,” the letter added. “As you are surely aware, pregnancy is not a life-threatening illness, and the abortion pill does not cure or prevent any disease.”
As Democrats intensify their efforts to remove all precautions from the chemical-abortion drug, the pro-life movement should direct its attention to this new challenge in the abortion fight, which takes the lives of unborn children and puts their mothers at risk.
Alexandra DeSanctis is a staff writer for National Review and a visiting fellow at the Ethics and Public Policy Center.