Introduction: What is Chemical Abortion and how does it work?
A review of the media these days reveals multiple pieces on medical abortion, emphasising the supposed safety and security in the Mifepristone and Misoprostol-based abortion method. Such a conclusion, however, is wrong. Before delving into the diverse health and moral concerns associated with medical abortion, we must first understand what this type of abortion entails.
The term “medication” is meant to be understood as “any substance used to treat an illness or disease” [1]. Pregnancy is neither an illness nor a disease, and the drug Mifepristone was not developed to treat or cure any illnesses or diseases. It is a self-induced abortion pill used to end a child’s life in its mother’s womb. Consequently, the term “medical abortion” is misleading, and the term “chemical abortion” is more appropriate.
Chemical abortion is a two-drug process. It begins with Mifepristone (brand name Mifeprex, legally known as RU486), which blocks the hormone progesterone, which is essential in maintaining a woman’s pregnancy by preparing the body for conception and regulating her monthly menstrual cycle [2]. Blocking this hormone deteriorates and breaks down the uterine lining and prevents adequate nutrition transfer to the developing unborn child, resulting in death. Misoprostol (brand name Cytotec) is taken 24 – 48 hours after taking Mifepristone to cause uterine contractions in the body with the main objective of emptying the uterus.[3] All of this is done within the first trimester of pregnancy. A child’s heartbeat is detectable at that stage, and his or her brain and lungs are also developing [4].
When does life begin according to science?
Mifepristone consumption and the chemical abortion process generally are neither safe, secure, nor something that can be supported with a good conscience. First, we must recognise that life truly begins at conception. Regarding conception, the American College of Pediatricians, a national medical association of licensed physicians and healthcare professionals, made a statement which focused on the scientific evidence of when an individual human life begins by stating “The predominance of human biological research confirms that human life begins at conception—fertilization. At fertilization, the human being emerges as a whole, genetically distinct, individuated zygotic living human organism, a member of the species Homo sapiens, needing only the proper environment in order to grow and develop. The difference between the individual in its adult stage and in its zygotic stage is one of form, not nature” [5].
Furthermore, Maureen Condic, Ph.D., a neuroscientist and member of the United States National Science Board [6], when writing about the scientific view of the beginning of human life had this to say: “The conclusion that human life begins at sperm-egg fusion is uncontested, objective, based on the universally accepted scientific method of distinguishing different cell types from each other and on ample scientific evidence. Moreover, it is entirely independent of any specific ethical, moral, political, or religious view of human life or of human embryos” [7].
In a 2017 survey, 4107 Americans were asked when they believed a human’s life began. Respondents represented a diverse demographic and political spectrum: 62% held pro-choice views and 66% identified as Democrats; 57% were women and 43% – men; 63% had graduated from college, resulting in a highly educated sample. When asked who was most qualified to determine when a human life begins, 80% chose biologists over philosophers, religious leaders, voters, and Supreme Court Justices. When asked to explain their answer, 91% of those choosing biologists said it was because they are objective experts in the study of life. The same study surveyed 5,557 biologists from 1,058 academic institutions. 63% of the participants were non-religious, 63% were male, 95% had a PhD, 92% were Democrats, and 85% were pro-choice. The sample also included biologists born in 86 different nations around the world. When asked when they believe human life begins, 95.7% of biologists agreed with the underlying biological view that it begins with fertilisation [8].
Biology is the study of life. It derives its meaning from the Greek words “bios” (meaning life) and “logos” (meaning study). Biologists study the origin, growth and structure of living organisms [9]. When the people who study about life inform us that a human’s life begins at fertilisation, shouldn’t we do everything in our power to protect the life of the child growing within its mother’s womb?
Abortion pill abuses in the past
Every abortion takes a human’s life, but chemical abortion can also harm a mother’s life, even unto death. If chemical abortion becomes legal, abortion pills may end up in the hands of traffickers, abusive partners, and other people planning to use them for nefarious purposes. Legalizing chemical abortion may increase the number of forced abortions, and there have already been reports of pregnant women being given abortion pills without their knowledge or consent. In 2006, a man from Wisconsin gave his girlfriend a drink which he spiked with Mifepristone. She became ill the next morning and miscarried her 14-week-old foetus [10]. In 2013, a man deceived his pregnant girlfriend by giving her an abortion pill supposedly for treating her infection resulting in the loss of her child [11]. In 2014, a Kansas man was arrested for buying Mifepristone pills online and placing them in his girlfriend’s food, causing foetal death [12]. In 2015, a Norwegian man slipped abortion pills into his ex-girlfriend’s smoothie and caused her to have a miscarriage. She lost the baby in her 12th week of pregnancy [13]. In 2017, a Virginia physician was charged with slipping 4 Mifepristone pills (800mg instead of the standard 200mg) into his girlfriend’s tea, resulting in the death of her unborn child. He pleaded guilty to foetal homicide and received a three-year prison sentence while also losing his medical license [14]. A Michigan man attempted to murder his unborn child in 2018 by secretly spiking his girlfriend’s water bottle with Mifepristone. His girlfriend became suspicious and turned over the water to police, who determined that it contained the abortion-inducing drug. He obtained the Mifepristone from a New York dealer who was later indicted and convicted [15].
A 2018 study titled “Exploring the feasibility of obtaining mifepristone and misoprostol from the internet” identified 18 online sites selling abortion pills without a medical prescription or any relevant medical data such as medical history. The study concluded that obtaining abortion pills from rogue pharmaceutical websites is feasible in the US [16]. Do we really want to include the possibility of someone looking to buy abortion pills online and employing them for malign purposes, such as abusing their pregnant partners and killing their children?
What scientific studies tell us about the health effects of chemical abortions
When evaluating chemical abortion from a medical standpoint, we must examine the negative effects on the health of mothers who undergo the procedure. A Finnish study of 42,619 abortions found that chemical abortion has four times the complication rate of surgical abortion and that one-fifth of all chemical abortions result in complications. Overall, the study discovered that chemical abortion resulted in roughly four times the number of adverse events as surgical abortion. At least one type of adverse event took place in 20% of women who underwent a chemical abortion and 5.6% of women who had a surgical abortion. Haemorrhage was reported as an adverse event by 15.6% of chemical abortion patients compared to 2.1% of surgical abortion patients [17].
Similarly, a journalistic audit titled “Abortion Pill ‘Less Safe Than Surgery”” published in The Australian investigated approximately 6,800 surgical and chemical abortions. According to the audit, 3.3% of women who used Mifepristone in the first trimester of their pregnancy went to the emergency room, compared to 2.2% who used a surgical method. Furthermore, it was discovered that 5.7% (1 in 18 patients) of Mifepristone users needed to be readmitted to the hospital, compared to 0.4% (1 in 250) of surgical abortion patients. Usage of Mifepristone in second trimester abortions resulted in 33% of women requiring some form of surgical intervention, while 4% suffered a significant haemorrhage [18] [19].
At the same time, a Californian retrospective observational cohort study utilising American Medicaid data found a complication rate of 5.2% for chemical abortion versus a complication rate of 1.3% for first trimester surgical abortion. It also mentioned that the risk of complications present in the consumption of an abortion pill was four times that of a surgical abortion [20].
Furthermore, it had been detected in a 2016 Swedish study which interviewed 119 women who had undertaken chemical abortion, that nearly half of them (43%) bled more than expected, and one-fourth (26%) bled for more than four weeks [21]. Additionally, Ingrid Skop, M.D, Director of Medical Affairs for Charlotte Lozier Institute, and a practicing obstetrician-gynecologist with over 25 years’ experience [22], wrote this regarding the Mifepristone-Misoprostol chemical abortion regimen “The average women undergoing a chemical abortion will bleed for 9-16 days and 8% will bleed longer than a month. Most will experience side effects of labor like cramping, heavy bleeding, nausea, vomiting, fever, chills, headache, diarrhea and dizziness. Many will experience the emotional devastation of observing their aborted child’s body” [23]. She further explained that Mifepristone contributes to an impaired inflammatory response by blocking glucocorticoid receptors, increasing the risk of Clostridium sordellii infection and sepsis, sometimes resulting in death [24]. This was affirmed in a pharmacotherapy study which found Mifepristone’s propensity to develop infection, possibly leading to lethal septic shock [25].
In conclusion, the research results of the Finnish, Australian, American, and Swedish and other medical studies along with the personal experiences of Ingrid Skop all corroborate each other’s observations: Chemical abortion causes adverse health effects in women.
One might argue that selective biases swayed the various scientific/medical research performed on the adverse effects and risk factors associated with Mifepristone. It is quite telling, however, that both Mifepristone’s manufacturer, Danco Laboratories, and the American Food and Drug Administration (FDA)
acknowledged Mifepristone’s health risks to women; “Nearly all the women who receive Mifeprex and misoprostol will report adverse reactions, and many can be expected to report more than one such reaction” [26].
A Congressional report submitted to the United States House of Representatives Government Reform Committee titled “The FDA and RU486: Lowering the Standard for Women’s Health”, brings to attention physical risk to women taking the RU-486 regimen. These included reactions such as “abdominal pain; uterine cramping; nausea; headache; vomiting; diarrhea; dizziness; fatigue; back pain; uterine hemorrhage; fever; viral infections; vaginitis; rigors (chills/shaking); dyspepsia; insomnia; asthenia; leg pain; anxiety; anemia; leucorrhea; sinusitis; syncope; endrometritis/salpingitis/pelvic inflammatory disease; decrease in hemoglobin greater than 2 g/dL; pelvic pain; and fainting”. The same Congressional report casts doubt on the safety of Mifepristone and recommends the withdrawal of it from American markets by stating “The integrity of the FDA in the approval and monitoring of RU-486 has been substandard and necessitates the withdrawal of this dangerous and fatal product before more women suffer the known and anticipated consequences or fatalities. RU-486 is a hazardous drug for women, its unusual approval demonstrates a lower standard of care for women, and its withdrawal from the market is justified and necessary to protect the public’s health” [27]. The FDA also warned healthcare practitioners about sepsis infection and recommended a high index of suspicion for serious infection and sepsis in those undergoing chemical abortion [28].
Medical issues caused by Chemical Abortion are under-reported
As of 2018, the FDA has been aware of 24 deaths, 4,195 adverse events, 1,042 hospitalizations, 599 cases of blood loss requiring transfusions and 412 cases of infections associated with Mifepristone [29].
The true figures of the various issues and adverse events caused by Mifepristone may be much higher due to issues with the FDA’s Adverse Events Reporting System (FAERS). A report by The Heritage Foundation sheds light on this issue; “As a condition of becoming a certified prescriber, the prescriber agreement originally required prescribers to report serious adverse events and complications to Danco, who, in turn, submits regular reports to the FDA. These adverse events…are compiled in the FDA’s FAERS. But when a woman experiences an abortion complication, she will likely report to an emergency room or other outpatient facility rather than the practitioner who prescribed the abortion pill regimen…There is no way to know how often emergency rooms and other facilities fail to report complications to Danco or the FDA, as they may not know the woman is undergoing an elective chemical abortion as opposed to a miscarriage” [30]. Also, women who seek medical treatment for adverse reactions after taking Mifepristone may be too sick or refuse to disclose that they have taken the RU-486 drug regimen because they may not want that on their medical record [31]. Medical professionals who may not oversee chemical abortion procedures but who may treat infected or haemorrhaging patients, have no obligation to report adverse events for Mifepristone, regardless of if said healthcare worker is aware a patient has taken the RU-486 drug regimen. Physicians in charge of chemical abortions may also remain unaware of adverse events that take place after they administer RU-486, relieving them of reporting requirements [32].
The Government Reform Committee’s report on Mifepristone also explained reporting disincentives present in the system; “Although RU-486 is approved for use through 49 days of pregnancy, it is commonly prescribed in the United States up to 63 days of pregnancy. Physicians also commonly prescribe a dosing regimen that is different from that approved by the FDA. Therefore, it has been suggested that in fact there is a disincentive on the part of prescribing physicians to report adverse events that may be attributed to a physician’s negligence or willingness to prescribe a regimen that is outside the FDA-approved regimen for RU-486” [33]. In 2016, the FDA reduced the reporting requirements so that only deaths were required to be reported to the FDA [34].
Conclusion
After considering numerous scientific and government sources, it is obvious that chemical abortions hurt everyone. Chemical abortion is not medicine because medicine heals, whereas abortion kills. It is not safe due to its history of causing health complications in women, including septic shock, infections, and prolonged or severe bleeding. It is not socially safe because abortion pills have been procured without a prescription for malicious ends such as murder of preborn children without their mothers’ knowledge. The lax oversight and deficiencies in the FDA reporting system imply that the true damage caused by chemical abortions is still uncertain and that the number of women significantly harmed by the abortion pill regimen may be substantially higher than expected. The reality is that we cannot permit chemical abortion to be legalised.
Why legalise something that has been shown to be dangerous, with cases of it being obtained unethically and used deceitfully against women, while we lack a complete understanding of its true causalities? Each human life has inherent dignity and must be treated as such. A free society is one where human beings are accorded the same dignity irrespective of their age, gender, health condition or other vulnerability. If we fail to respect, value, and protect life from conception, we shall fail to support, nurture, and defend someone’s life long after they have been born. Let us make a contribution to a free and moral society by doing our part to ensure that chemical abortion is not legalised. ✸
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