The Charlotte Lozier Institute (CLI) recently updated a publication about the side effects of chemical abortion, providing new findings on the physical and emotional complications most women are unprepared for. The institute also advises the U.S. Food and Drug Administration (FDA) to review safety guidelines once put in place for these drugs. As chemical abortions continue to account for the majority of abortions in the United States, researchers say renewed oversight and clearer patient warnings are urgently needed.
Updated report
Research shows as many as 65 percent of abortions are done using the drugs mifepristone and misoprostol. In 2020, the percentage of chemical abortions was about 53 percent. In their updated report, Risks and Complications of Drug-Induced Abortion, CLI researchers Elyse Gaitan and Tessa Cox discuss the various physical and emotional risks of these drugs, stating, “Women ought to be fully informed of the risks that abortion drugs can carry.” This does not always happen.
In their report, the researchers note, “Mifepristone carries a boxed warning, the highest level of safety warning imposed by the FDA, alerting users and prescribers of the possibility of ‘serious and sometimes fatal infections or bleeding.’” The CLI researchers also note that complications for chemical abortion can be “two to four times that of surgical abortion.”
And yet, these drugs remain on the market with little medical supervision. A physician’s oversight is no longer required as it was when the FDA first approved mifepristone in 2000. Websites sell these drugs, encourage bypassing state laws, and send them through the mail. The purchaser may not even be the pregnant woman. Several cases of abortion drugs being unknowingly slipped into a pregnant woman’s food and drink by boyfriends, husbands, and others have garnered media attention in recent years.
“It's vitally important that the FDA look at these drugs again to determine what safeguards are needed or if they are deemed too dangerous to be on the market,” said Christa Brown, Senior Director of Medical Impact for Heartbeat International and Executive Director of APRN LLC. “The FDA also must take responsibility to record adverse events for abortion drugs. It's become far too common for women to experience complications such as hemorrhage and severe infections, but the general public has no way to know this.”
Side effects of abortion drugs
Gaitan and Cox highlighted four physical side effects from chemical abortion: heavy bleeding/hemorrhaging; infection; incomplete abortion; and death. Their studies included countries and Canadian provinces with government-controlled health care systems because these nations possess stronger patient data within those systems.
For example, a study of abortions in Finland between the years 2000 and 2006 found “15.6% of women who had drug-induced abortions sought follow-up care for hemorrhage ….” However, Gaitan and Cox go on to say, “the authors acknowledge that this high rate may be due to the generally heavy bleeding associated with abortion drugs and suggest that surgical evacuation for hemorrhage may be a more reliable measurement of bleeding severity.”
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In that study, “2.9% of drug-induced abortions resulted in surgical evacuation for bleeding,” according to CLI’s Gaitan and Cox. A more recent study conducted in Ontario, Canada, found that 1.2 percent of chemical abortions “resulted in hemorrhage,” the CLI report notes.
Last year, the American Journal of Obstetrics and Gynecology published a study regarding patients who experienced heavy bleeding and severe pain after a first-trimester abortion. The majority of respondents, 67 percent, had used abortion drugs. More than one-third said they experienced more bleeding and more pain than they expected. Therefore, according to Gaitan and Cox, “the misalignment between women’s expectations and their experiences suggests that many women are not fully informed regarding what the drug-induced abortion process will entail.”
An incomplete abortion is another potential complication. The 2023 Ontario study found that 1.1 percent of drug-induced abortions resulted in an incomplete abortion, and the Finnish study found that 6.7 percent of such abortions were incomplete. Many of these cases resulted in a subsequent surgical abortion. The risk of incomplete abortion increases with gestational age, and some women may inaccurately report or intentionally misrepresent gestational age. “One 2015 systematic review, which reported that 3.4% of drug-induced abortions were incomplete, noted that the rate jumped to 6.9% when looking at a small group of women who had abortions between 64 and 70 days of pregnancy,” Gaitan and Cox write in their published report.
Infection and death are other potential results of chemical abortion. Those who prescribe abortion drugs are required to report all deaths to the drug manufacturers, and they, in turn, are required to report those deaths to the FDA. From 2000 through December 2024, 36 total deaths associated with the drugs were documented by the agency. Thirteen of those were attributed to sepsis, a major infection that can affect a person’s vital organs and cause death. In their report, Gaitan and Cox write, “The mifepristone boxed warning cautions users and prescribers that although no causal relationship has been proven, mifepristone is associated with fatal infections …”
The CLI report provides additional studies showing the rate of emergency room visits after an abortion. The researchers cite a 2021 study that focused on abortion by mail. They discovered that 6 percent of women went to an emergency room or urgent care for abortion-related reasons and 7.8 percent “pursued another form of follow-up.”
A woman’s mental and emotional health is also at risk after a chemical abortion. The CLI researchers note two different studies, including one from France, that indicate women who went through a chemical abortion “experienced significantly higher levels of negative emotions, grief, and trauma” than those who had a surgical abortion. Oftentimes, women who take abortion pills go through the experience alone, and many witness the outcome of their decision: their dead fetus.
“This [new CLI] report is incredibly sad for the thousands of women being harmed and the thousands of children who continue to lose their lives every single day,” Brown said. “It speaks to the lack of concern for the physical or mental well-being of women by the abortion industry. With the use of chemical abortion pills becoming more and more common, yet with fewer safeguards, the dangers continually increase.”
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Hope with Heartbeat’s APRN
There is hope for women who take the first abortion pill. For more than a decade, physicians and pregnancy help clinics, along with Heartbeat International, have provided a particular medical protocol to save women and their unborn children from the physical and emotional pain of chemical abortion. Through the Abortion Pill Rescue® Network (APRN), managed by Heartbeat International, women who have taken the first abortion pill and regret that decision can reach out for help via a website and hotline. More than 1,500 medical providers around the United States are part of APRN and can prescribe progesterone in an effort to stop the chemical abortion process. To date, statistics show more than 8,000 unborn lives have been saved through Abortion Pill Reversal (APR).
“At Abortion Pill Rescue Network, 50 percent of our callers have obtained these chemicals online,” Brown told Pregnancy Help News. “Often there is no human contact, no medical or mental assessments prior to the abortion, and the woman is left to start and complete her abortion alone.”
Today, Heartbeat is in the crosshairs of two lawsuits regarding APR in New York and California, and yet, mothers and their children are living testimonies to the life-saving protocol.
Chemical abortion causes “potentially serious risks” to women, the CLI researchers conclude. They recommend the FDA “re-examine the evidence and restore important regulatory standards,” including in-person medical visits. The agency has a responsibility to protect public health, they note, including “the health of women.”
The researchers also suggest the FDA “restore its serious adverse events reporting requirement so it can more accurately track complications and better analyze the safety of abortion drugs.”
Brown agrees. “These drugs have never been safe, and as their use continues to increase, the emergency departments will continue to receive the victims of these drugs,” she said. “Those selling these drugs take no responsibility when women experience complications and take no measures to protect those they sell to from those who might abuse or poison them.”
She added, “They are misleading women down a perilous path of no return with these dangerous chemical abortion pills.”
