Effects of Chemical Abortion

Risks and Complications

Chemical abortion has a complication rate four times that of surgical abortion, and as many as one in five women will suffer a complication. 3 to 7 out of every hundred women who choose chemical abortion early in pregnancy will need follow-up care to finish the abortion, with as many as 7-10% needing follow-up care in the first trimester after 63 days of pregnancy and up to 39% requiring surgery if the regimen is accidentally taken in the second trimester.
As many as 15% of women will experience hemorrhage, and 2% will have an infection. The risk of incomplete abortion and infection increases with increasing gestational age.
In a study of the Medicaid population in states that fund abortion for low-income women, the rate of chemical abortion-related emergency room visits increased over 500% between 2002-2015.
Chemical abortions are over 50% more likely than surgical abortions to result in an ER visit within 30 days, with one woman experiencing an abortion-related ER visit for every 20 chemical abortions.
Some abortion advocates encourage women to lie to their doctors if they need urgent care following a chemical abortion and to say they are having a miscarriage. However, if a chemical abortion is miscoded as a miscarriage in the ER (which occurred 60% of the time in one study), the woman is at significantly greater risk of needing multiple hospitalizations and follow-up surgery.

When abortion pills are ordered online and sent through the mail with no medical oversight, no ultrasound is provided to confirm gestational age. Many pregnant women do not accurately estimate their gestational age, and chemical abortion complications increase as pregnancy advances.
Only ultrasound can rule out an ectopic pregnancy. Mifepristone cannot treat an ectopic pregnancy and can mask the symptoms of tubal rupture, putting women at risk of severe bleeding and death. Approximately 2% of all pregnancies are ectopic and half of women have no risk factors.
If an Rh-negative woman is not administered Rhogam at the time of her chemical abortion, she could experience isoimmunization, which would pose serious risks to future pregnancies.

Abortion pills can fall into the hands of traffickers and abusive partners. Already, there are accounts of women being given abortion pills without their knowledge or consent. The risk of forced abortions will increase if the pills are available online without an in-person visit with the woman’s doctor, visits during which it might be determined whether the woman is being coerced in an abusive situation.
Women have reported that their chemical abortion experiences left them feeling unprepared, silenced, regretful, or left with no other choice.
Many online abortion pill vendors do not provide women with a real-time conversation with the abortion provider, jeopardizing her ability to ask medical questions prior to purchasing the pills or discover options that would support continuing her pregnancy, and ultimately provide her the opportunity for informed consent.

Abortion pill-related adverse events submitted to the FDA shows significant underreporting. Planned Parenthood independently reported over twice as many adverse events as the FDA in 2009-2010, despite the fact that FDA’s data is supposed to reflect complications from all abortion providers. FDA’s data is estimated to be missing as many as 95% of all serious adverse events. Since 2016, FDA no longer requires abortion providers to report any complications other than death.
FDA’s own data shows that chemical abortion has resulted in at least 26 deaths and thousands of adverse events since the drug was first approved.