A group of 20 Republican senators asked the Food and Drug Administration this week to classify a medication used in early abortions as dangerous and ban its sale in the U.S. ― even though the FDA itself has found the pill to be safe.
“[G]iven the devastating impact this drug has had on American women and children, we must now urge the FDA to exercise its authority ... and classify the abortion pill as an ‘imminent hazard to the public health’ that poses a ‘significant threat of danger’ and remove this pill from the U.S. market,” the senators wrote in a letter sent to the agency on Tuesday.
Medication abortion ― or the abortion pill as it is often called ― is actually two drugs taken in combination, mifepristone and misoprostol. The pills, which are usually swallowed at home, trigger a miscarriage. The protocol is approved for pregnancies up to 10 weeks. Many patients prefer medication abortion to surgical abortion as it allows them to control the setting and timing of the procedure and is non-invasive. In 2017, medication abortion accounted for 39% of all abortions in the U.S., according to the Guttmacher Institute.
The letter notes that medication abortion has caused 24 maternal deaths since it was first approved by the FDA in 2000. However, over 3.7 million women in the U.S. have used medication abortion in that time. By comparison, about 700 women in the U.S. die as a result of pregnancy or delivery complications each year. According to a report by the research group ANSIRH (Advancing New Standards in Reproductive Health), medication abortion is safer than continuing a pregnancy to term or using many other common medications.
In recent months, medication abortion has emerged as a lightning rod in the abortion debate. The new letter to the FDA, even if unlikely to succeed, represents another effort by Republicans to limit access to abortion.
Mifepristone, the first of two drugs taken to induce an abortion, is highly regulated by the FDA. Under longstanding rules, patients seeking a medication abortion must visit health care providers in person to acquire the pills, even though they can ingest them at home.
For years, reproductive rights advocates and medical groups such as the American College of Obstetricians and Gynecologists have urged the FDA to lift the in-person dispensing restriction, arguing that it forces patients to travel unnecessarily for a drug that could easily be sent in the mail. For women in rural areas, the rule often leads to hours or days of driving time, adding another barrier to timely care.
The coronavirus pandemic, which has made travel even more fraught, brought new urgency to the advocates’ efforts. In July, after several reproductive health groups sued the FDA, a federal court ruled that the agency must suspend the in-person dispensing requirements during the pandemic. Currently, patients in some parts of the country can obtain the pills through the mail, although a handful of states have existing laws that ban the use of telemedicine for abortion.
The Trump administration has asked the Supreme Court to reinstate the in-person rule.
“Pregnancy is not a life-threatening illness, and the abortion pill does not cure or prevent any disease. Make no mistake, Mifeprex is a dangerous pill,” Sen. Ted Cruz said in a tweet on Wednesday, using a brand name for mifepristone. The Texas Republican is one of the signers of the letter to the FDA.
It is unlikely the FDA will act on the letter. The agency itself noted the pill to be safe in a 2016 report, writing that “its efficacy and safety have become well-established by both research and experience, and serious complications have proven to be extremely rare.”
While childbirth is also generally safe, a 2012 study found that women were about 14 times more likely to die during or after giving birth to a live baby than to die from complications of an abortion.
“Bottom line: medication abortion expands access to abortion and that’s why these zealots are hellbent on keeping it out of the hands of people who want it,” Megan Donovan, senior policy manager at Guttmacher, said in a tweet on Wednesday. “It’s about control, no more & no less.”