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Falling Short Of Honest Dialogue On The Abortion Pill

An article on how the abortion pill has not revolutionized abortion falls short.


Last week, New York Magazine published a post which covered RU-486, also known as mifepristone or the abortion pill, and how it has not revolutionized abortion as once expected. Ostensibly about the fact that a lack of an honest dialogue on abortion hurts women, the piece offered a word of correction to each side. The author noted that abortion proponents weren’t forthcoming about the extreme pain of medicine-induced abortion, and pro-lifers overstate the risks. But the piece fell short of a truly honest dialogue.

A few highlights from the post:

[T]here are eight cases [since 2000] of women dying from an infection after taking mifepristone.

When reading data in news reporting, the qualifying prepositional phrases, such as “from an infection,” are often very enlightening. There were eight cases of women dying from sepsis, yes, but an additional six reported deaths from other complications (including two from ectopic pregnancies that should not have been treated with the abortion drug) along with 612 hospitalizations (excluding the 14 total deaths) and 339 women “experienced blood loss requiring transfusions” listed in the FDA’s after market summary. The footnotes also mention five non-US deaths reported but not included in the total and state that the FDA cannot conclusively determine precise causal correlation due to practical things like reporting methods or individual doctor interventions.

The pro-choice movement relies upon these research qualifications to understate the risks in abortion. To get an honest dialogue, we must address the entirety of the footnotes, not just the qualifications that lower the ugly statistics.

And even though the World Health Organization says the pill is safe to be administered by medical professionals who aren’t doctors, many states have passed bills that say only a physician can administer it — in person.

Why might states have passed rules about restrictions? Because legally they must follow our own FDA, not the WHO. So why does the author reach for the WHO? Perhaps because the FDA things such as, “[T]he treatment procedure is contraindicated if a patient does not have adequate access to medical facilities equipped to provide emergency treatment of incomplete abortion, blood transfusions, and emergency resuscitation during the period from the first visit until discharged by the administering physician.” That is from the medical providers guidelines.

Not only is the FDA more relevant than the WHO to state regulation, but their guidelines also make more sense. The complications don’t occur immediately upon administration of the drug. Note the 339 women who required blood transfusions. But for medical intervention, the number of deaths could be much higher. And the seemingly superfluous “–in person” requirement might be due to the need to rule out preexisting contraindications such as ectopic pregnancy.

Even after counseling at a clinic, many women are unprepared for the experience. “I took one pill at home, and I remember at one point actually feeling my cervix open. It was a terrifying feeling,” says Katie, who had a medication abortion in 2004. Another woman described pain that was “so intense that it’s hard to really remember. You sort of feel like you’re tripping or something.”

Either the counseling is cursory and wholly inadequate or abortion supporters have flooded the culture with so many assurances that abortion is easy, that women ignore the cautions as overdone, common sense safety warnings. To the author’s credit, she covered this point.

All of the above are relatively standard abortion debating tactics. It was the following statement that first caught my attention:

A nurse at an abortion clinic once told me, “Women who have done both will go back to surgical. I’ve never had anyone who’s done both go back to medical.”

The pro-choice movement often tsk-tsks concerns that women will use abortion as birth control. But to get to “go back to medical” a woman has to be on at least her third abortion. And for a nurse to make such an unqualified generalization, that suggests that third timers are at least not-rare.

Finally, let’s look at one last quote, from the introduction, that set the tone of the piece:

Advocates hoped — and anti-abortion groups feared — that the abortion pill would be prescribed by regular doctors, family practitioners and OB/GYNs, allowing women to have an abortion in the privacy of their home, far from the picket lines.

For the record, concern about the convenience of these pills wasn’t that women could do it away from the picket lines, but that their separation from medical care could jeopardize their safety. It’s difficult to manage an open and honest dialogue on the incredibly weighty subject of abortion, but a good first step is to put the best construction on others’ arguments, including that care for women underlies pro-life motivation.