How Chemical Pills Became the Go-To Abortion Method

Experts say the FDA has ignored data showing the dangers of Plan C

The abortion drug Mifepristone / Getty Images
February 28, 2022

Chemical pills accounted for a majority of abortions in the United States for the first time ever in 2020, according to a new study.

Mifepristone, known as Plan C, can be prescribed to terminate a developing fetus up to 10 weeks into a pregnancy and has four times the complication rate of surgical abortions. But its usage has steadily increased since it was approved by the FDA in 2000. A February study from the pro-abortion Guttmacher Institute found that the chemical pills accounted for 54 percent of abortions in 2020—a sharp increase from 39 percent in 2017.

Deregulation efforts from the Biden administration are expected to continue this trend. The FDA in December removed its requirement that women get an in-person doctor visit to receive a mifepristone prescription. The move came after more than 70 Democratic politicians in August signed a resolution, backed by Planned Parenthood Federation of America and NARAL, that called on the FDA to make permanent its pandemic policy that allowed women to get mifepristone via mail after a virtual doctor appointment.

Sue Liebel, the state policy director for the pro-life Susan B. Anthony List, said the deregulation efforts are a clear example of the cozy relationship between Democrats and the abortion lobby.

"The Biden administration is putting the lives of women and their unborn children at risk to boost the abortion industry's profits," Liebel told the Washington Free Beacon. "Ironically, the FDA is ignoring the science about the serious risks of chemical abortion."

The Obama administration in 2016 ended a requirement that mifepristone manufacturers report adverse events such as hemorrhages and ectopic pregnancies that did not result in death. The FDA cited the same database on adverse effects, which also never required emergency rooms to report complications from the drug, to justify its December deregulation.

Studies that track reports from emergency rooms show a complication rate up to 10 times greater than that of studies that rely on data from the drug's manufacturer. Tessa Longbons, a senior research associate at the Charlotte Lozier Institute, said it is unacceptable for the FDA to rely on data from companies that profit off the pills.

"I can think of no other public health issue in which self-reported industry data is considered acceptable by policymakers or parroted endlessly by the mainstream media," Longbons said.

The rate of emergency room visits related to the usage of chemical abortion medicine increased more than 500 percent between 2002 and 2015.

Longbons noted that the Guttmacher study on chemical pill usage provides an incomplete picture because it relies on data from abortion providers. States are not required to report data on abortions, and the study leaves out three blue states that account for an estimated one-fifth of abortions in the United States: California, Maryland, and New Hampshire. The study also does not track the use of black market chemical abortion pills, which have increased in usage in states with more regulations.

Republican legislatures are pushing their states' health departments to reestablish stricter regulations of mifepristone in response to the December FDA decision. Four states introduced legislation that would ban telemedicine for mifepristone. Nine other states have introduced bills that would limit access to chemical abortion pills, and an additional seven have proposed to outright ban the drug.

While the FDA has loosened restrictions, England has taken the opposite tack. On Wednesday, England ended its pandemic policy that allowed for mail-in orders of mifepristone. The country restored its policy that women take the drug at a clinic or hospital. Data from the country showed that women were three times more likely to need an emergency ambulance when taking mifepristone at home rather than in a clinic.

Black market mifepristone providers have thrived as states enact more abortion restrictions. Texas followed its six-week abortion ban with a ban on mail-in orders for mifepristone and limited its use to seven weeks. Aid Access, an international mifepristone provider that was sent a cease and desist order by the FDA in 2019, reported a 1,000 percent increase in orders from Texas after the law went into effect. Women can apply online for the illegal Aid Access pills, which are prescribed by European doctors. The FDA under the Biden administration has yet to regulate Aid Access and did not respond to a request for comment.