By: Kalani Phillips, MPH, CPH
Medication abortion pills have been restricted by the FDA for decades, yet research shows time and again that abortion pills are safer than Viagra, penicillin, and acetaminophen (or Tylenol). For instance, research emphasizes that medication abortion is extremely safe and highly effective, with a success rate of over 95%. The utilization of telehealth, self-administration, and provision of medication abortion by non-physician clinicians have also been shown to be both safe and effective. Despite this, the FDA and various states across the United States (U.S.) have passed numerous laws restricting access to medication abortion. While we continue to navigate access to safe reproductive care such as abortion pills in a post-Roe landscape, policymakers should consider the heavy fact that abortion pills are safer than many common household drugs.
"...stigma associated with medication abortion can affect policymakers’ decisions regarding reproductive health... these decisions to restrict medication abortion are not based on science or clinical research..."
Typically involving the use of two different types of medications (mifepristone and misoprostol), medication abortion has proven to be safe and effective when taken, on average, within 10 to 11 weeks of gestation. Side effects include bleeding, cramping, nausea, headache, dizziness, and more. However, research shows these side effects are usually tolerable and do not require any additional medical treatment. Serious adverse events are not likely and occur in less than one-third of one percent of medication abortions.
Although the abortion pill is undeniably safe, limits to access on medication abortion have been ongoing throughout the U.S. since its approval in 2000. For example, there have been extensive restrictions throughout the nation on whether telehealth can be used for abortion pills, what types of providers can offer abortion pills, and whether abortion pills can be self-administered. These restrictions have led to decreased access to reproductive care and increased costs of treatment. For instance, Ohio restricted medication abortion to only be available to those within 7 weeks of gestation. As a result, research showed that women in that state had 3 times the odds of requiring additional medical treatments to complete the abortions, compared to women receiving it within 10 weeks of gestation before the policy change. Some states also mandate that physicians must administer abortion pills to patients for a medication abortion. This is unnecessary. Research underscores that self-administration is safe and can be supported by trained health professionals including nurses, midwives, nurse practitioners, and physician’s assistants rather than physicians themselves.
Viagra, known to treat erectile dysfunction, on the other hand is easily accessible, despite the fact that it has been proven to be dangerous in some contexts. For example, research shows that some men die after taking Viagra, at a higher rate than people taking mifepristone. This higher risk of mortality is usually due to the patient having a risk of cardiovascular disease; however, the FDA continues to state that the drug is safe when used correctly.
Research also shows that acetaminophen (or Tylenol) can also be dangerous. Acetaminophen (Tylenol) overdose and its reactions with other drugs are some of the most frequent causes of acute liver failure, which can be fatal if left untreated. Furthermore, research also highlights that medication abortion has a better safety record than penicillin.
While these comparisons may be arbitrary, they reveal how the stigma associated with medication abortion can affect policymakers’ decisions regarding reproductive health. It is clear these decisions to restrict medication abortion are not based on science or clinical research, but are rather influenced by other factors. However, these decisions have implications for the future of reproductive health access across the nation. Not being able to access medication abortion at pharmacies and clinics can be detrimental for those living in rural or hard-to-reach communities. The barriers to access increase for those that are financially struggling as well. It is abundantly clear that abortion pills are medically safe. Policymakers should focus on making decisions based on science and ensure access to medication abortion throughout the country because abortion care is healthcare.
Sources:
Hill, A., & Rodrigueez, K. (2020, July 10). Abortion pill restricted by FDA for decades has better safety record than penicillin and Viagra. USA Today. https://www.ansirh.org/sites/default/files/publications/files/medication-abortion-safety.pdf
Hsieh, Y.-P., Wang, Y.-J., Feng, L.-Y., Wu, L.-T., & Li, J.-H. (2022). Mifepristone (RU-486®) as a Schedule IV Controlled Drug—Implications for a Misleading Drug Policy on Women’s Health Care. International Journal of Environmental Research and Public Health, 19(14), 8363. https://doi.org/10.3390/ijerph19148363
Mitka, M. (2000). Some Men Who Take Viagra Die—Why? JAMA, 283(5), 590. https://doi.org/10.1001/jama.283.5.590-JMN0202-2-1
Safety and effectiveness of first-trimester medication abortion in the United States (Evaluation of Abortion Restritctions). (2016). ANSIRH. https://www.ansirh.org/sites/default/files/publications/files/medication-abortion-safety.pdf
Ostapowicz, G. (2002). Results of a Prospective Study of Acute Liver Failure at 17 Tertiary Care Centers in the United States. Annals of Internal Medicine, 137(12), 947. https://doi.org/10.7326/0003-4819-137-12-200212170-00007