Today, the U.S. Supreme Court heard oral arguments in a major case that threatens to restrict access to medical abortion across the country.
A central issue in the lawsuit is the safety of mifepristone, the first of two pills used to induce an abortion. This drug blocks hormones needed for pregnancy and has been approved by the U.S. Food and Drug Administration since 2000.
The FDA’s approval is being challenged by the Hippocratic Medical Alliance, a coalition of anti-abortion doctors and activists, who are calling for the pill to be removed from the market. The group argues that mifepristone is dangerous to patients. 2021 survey The study found higher rates of emergency room visits after medical abortions. However, the study was retracted in February after an independent review found problems with the way the authors analyzed and presented their data.
During Tuesday’s arguments, the justices’ main questions were about emergency room visits after using mifepristone and whether there had been an increase in emergency room visits as a result of the FDA’s recent deregulation of the drug.
“I think a visit to the emergency room is definitely the wrong option when it comes to safety,” says Michael Belmonte, an obstetrician-gynecologist and fellow of the American College of Obstetricians and Gynecologists. “It’s important to recognize that the vast majority of people who go to the emergency room are doing it just for reassurance, not for real safety concerns.”
Belmonte said the more important measure is serious adverse events, which are extremely rare in medical abortions. “Adverse events occur with any drug or procedure, but frankly, adverse events with these drugs are very rare compared to what we use every day,” he said. Masu.
Serious adverse events include hospitalization, blood transfusion, infection, and death. 2013 peer-reviewed research found that of 233,805 medical abortions performed in 2009 and 2010, these serious adverse events or outcomes were reported in 1,530, less than 1%.
“Many women may go [to the ER] Because they may have experienced heavy bleeding, similar to a miscarriage, and just need to know if there are complications,” U.S. Attorney General Elizabeth Preloger, defending the FDA, said in oral arguments Tuesday. mentioned in.
Belmonte says it’s worth noting that prescription abortion pills are intended to cause bleeding and convulsions. These effects may be bothersome to some patients, but they are a function of the drug and a sign that it is working. “Mifepristone actually just prepares the uterus for evacuation, so essentially mifepristone alone doesn’t tend to cause bleeding, cramps, or other side effects,” he says. The second drug used in medical abortion, misoprostol, is the one that causes bleeding and convulsions.
Ushma Upadhyay, a public health social scientist at the University of California, San Francisco, who studies medication abortion, says that many patients who come to the emergency room after a medication abortion are concerned about bleeding from the medication, but they are This does not mean that the woman has had an abortion. Serious adverse events. “People who get a medical abortion go through it alone, and they don’t have a health care provider to ask questions,” she says. “People go to the ER to understand whether the bleeding they’re experiencing is normal and to evaluate whether the medication is working.”
