Examining Access to Mifepristone in the US Supreme Court: Evaluating the Safety of the Abortion Pill
In a highly anticipated case, the US Supreme Court will hear arguments regarding access to mifepristone, a pill commonly used in abortions. The Food and Drug Administration (FDA) had previously made it easier for women to obtain mifepristone, including through mail-order pharmacies. However, concerns over its safety have arisen, leading to legal action and retracted studies.
Medical professionals have hailed mifepristone as “one of the safest medications” ever approved by the FDA. However, a Christian conservative group has filed a lawsuit against the FDA, claiming “tens of thousands” of “emergency complications” associated with the abortion pill. The conflicting views on its safety have sparked controversy and raised questions about its usage.
The safety of mifepristone, often used alongside misoprostol in abortion drugs, is an important consideration. Since its approval by the FDA in 2000, strict safety limits have been imposed. Only specially certified physicians are allowed to prescribe and distribute mifepristone, and patients must undergo three mandatory in-person appointments. Furthermore, doctors must be prepared to perform emergency surgery to address excessive bleeding if the drug fails to terminate the pregnancy.
However, a recent FDA decision in 2021 removed all in-person requirements, allowing mifepristone to be mailed without any restrictions. The FDA’s stance on the pill’s safety has remained consistent over the years, reaffirming its belief in its effectiveness and relatively low risk.
Opponents of abortion argue that the removal of restrictions has led to an increase in “emergency complications.” However, this argument fails to differentiate between individuals who experienced problems directly related to mifepristone and those who simply had questions or concerns. Obstetricians and gynecologists emphasize that mifepristone is not associated with major or serious side effects.
Medical organizations, including the American College of Obstetricians and Gynecologists, have stated that the likelihood of major adverse events, such as infections, excessive blood loss, or hospitalization, is less than 0.32% based on a study of over 50,000 patients. Serious adverse events, as defined by the study’s authors, include blood transfusions, major surgery, hospital admissions, and death. However, such events are rare and occur in a small percentage of cases.
The packaging for mifepristone tablets provides slightly different statistics for what it terms “serious adverse reactions.” Transfusions occur in 0.3% to 0.5% of cases, sepsis in 0.2% of cases, and hospitalizations range from 0.04% to 0.6% for medication abortions. These figures are based on various studies conducted in the field.
It is important to note that medical groups do not consider visits to the emergency room (ER) as serious or major adverse events, whereas mifepristone’s labeling does. The current FDA labels advise individuals to seek medical attention if they experience prolonged heavy bleeding, severe abdominal pain, or a fever.
The Supreme Court case regarding access to mifepristone will undoubtedly have far-reaching implications for women’s reproductive rights and healthcare. It is crucial to carefully evaluate the available evidence and consider the perspectives of medical professionals and organizations when making decisions that affect the lives of countless individuals.