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Amid the ongoing COVID-19 pandemic and an opioid crisis that has taken 100,000 American lives this year alone, the Food and Drug Administration (FDA) is spending its time loosening up the already inadequate regulations governing chemical abortion pills.

The FDA has approved just one drug regimen to abort a child early in pregnancy, and since its approval in 2000, it has been subject to regulations required for “dangerous drugs.” It can only be used during the first 70 days of pregnancy and must be prescribed by a certified provider—a physician who’s proved that they are competent to manage drug use and registered with the FDA—and administered in person.

At the behest of pro-abortion trade groups like the American College of Obstetricians and Gynecologists (ACOG), the Biden Administration directed the FDA to revisit these decades-old rules in furtherance of the abortion industry’s desire to send pills through the mail.  

Long gone are the days of a “woman and her doctor.” Now it’s pregnant people and “whomever they choose,” even if that person is a stranger on the internet.  

In a chemical abortion, the woman first takes mifepristone, a progesterone blocker that starves the child of nutrients. A day later, she takes misoprostol, an ulcer medication that has the side effect of inducing early delivery. According to the FDA, she should expect to have bleeding or spotting for 9-16 days following the second pills, and that’s if things go according to plan.

Complications can include hemorrhaging, infection, or incomplete abortion—necessitating the need for a second, traumatizing abortion (that she will still have to pay for). 

Women have died taking chemical abortion pills. Yet in 2016, the last time the FDA reviewed the Mifepristone regulations, it removed the requirement to report any complications except death. This lack of reported complications is now cited as proof that there are no reported complications—you can’t make this stuff up! 

In European countries that actively track complications, the numbers tell a troubling story. One Finnish study found that the complication rate for chemical abortion was four times higher than that of surgical abortion. In the U.S. states that collect and publish data, the numbers are similar. 

A recent peer-reviewed study of Medicaid claims data demonstrates that emergency room visits following a chemical abortion are on the rise and occur as frequently as 35 ER visits per 100 abortions. And these are abortions done under the supervision of a doctor. 

Yet this new push toward fully remote, pills by mail abortion does not account for medical needs that can only be accomplished by multiple in person visits to a doctor’s office. 

Before an abortion, the woman needs to be screened to determine that she is even a proper candidate for the drugs. If she has an IUD or an ectopic pregnancy, she cannot take these drugs. If she has a negative blood type, she needs a RhoGAM injection, or she may face infertility in future pregnancies. She needs to be screened for coercion or abuse from a parent, partner, or trafficker. The physician needs to ensure that she is not seeking the drugs for someone else. 

After an abortion, the woman must confirm that there is no retained fetal tissue or other complication. In fact, the Mayo Clinic states on its website that  “medical abortion isn’t an option if you … can’t make follow-up visits to your doctor or don’t have access to emergency care” [emphasis in original].

Injecting politics into the process is old news. The Clinton FDA cut short the approval process to get the drug approved before the 2000 elections by invoking an exception to normal rules called Subpart H, even though the drug combination was never studied for safety or efficacy for minors. Under President Obama, the regulations were loosened, extending the approved timeframe from 49 to 70 days’ and eliminating complication reporting except for death, even though complication rates increase through each week of pregnancy.  

Now the industry, abortion activists, and even members of Congress have adopted pills without limits as their platform, going so far as “taking” abortion pills (later reported to be a stunt) on the steps of the United States Supreme Court. Don’t expect a campaign from the Ad Council telling women to seek medical help for complications—the official line is that nothing ever goes wrong with these dangerous drugs.

When women go to these websites that sell one product, who can they ask for real advice? If they suffer complications at their home a thousand miles away from the prescribing telehealth service, who can they rely on for emergency care? She is left to get herself to the ER with incomplete information and no medical records while the pill provider is collecting money from the next girl. 

It’s a perfect situation for abortion pill mills. In the absence of in-person care, a woman suffering any complication will go straight to the emergency room. The prescriber’s mistakes or carelessness are filtered through the public health system with nobody to report them to the public—or public officials. Without a sidewalk, there is no sidewalk counselor. Nobody sees the ambulance because it never reaches the clinic, and nobody can share other options or support with a girl who sits alone in front of a computer screen. 

The new back-alley is in every woman’s back pocket now that your iPhone can order abortion pills in three easy steps! 

Perhaps in hindsight, this move will backfire. Abortion activists have been pushing mail-order abortion for years, even before Robin Marty’s Handbook for a Post-Roe America was published in 2019. By endorsing mail-order abortion, the Biden Administration eviscerates any reasonable claim that overturning Roe will result in “the back-alley” or that women rely on Roe for “safe and legal abortion.” 

This is not medicine. It’s not empowerment. It’s just abortion.