Controversial Abortion Pill Study Retracted Amid Ongoing Debate

Sage Journals Retracts Three Abortion Studies Amidst US Legal Battle

In a significant move, renowned scientific publisher Sage Journals has retracted three papers on abortion, including a controversial 2021 study on mifepristone, the medication at the center of an ongoing legal dispute in the United States.

Mifepristone: A Brief History

The Food and Drug Administration (FDA), the federal agency responsible for evaluating the safety and efficacy of drugs, approved mifepristone in 2000. Since then, it has been used by millions of people in the US for early pregnancy termination and miscarriage management.

Retracted Studies and Concerns

The three retracted studies were published in the journal Health Services Research and Managerial Epidemiology between 2019 and 2022. In July 2023, Sage issued expressions of concern for all three papers, citing potential issues with the studies’ methodologies and conclusions.

Ushma Upadhyay, a professor of obstetrics, gynecology, and reproductive sciences at the University of California, San Francisco, has voiced concerns about the 2021 study since its initial publication. She points out that the study’s primary flaw lies in its conflation of emergency department visits with serious adverse events.

In my mind, the largest problem with the paper is that it conflates emergency department visits with serious adverse events.

Upadhyay clarifies that a serious adverse event related to medication abortion includes requiring a blood transfusion, needing major surgery, or being admitted to the hospital—none of which were examined in the study.

Authors’ Response and Counterarguments

In their response to Sage Journals, the authors of the paper argue that emergency room visits serve as a “broad proxy indicator” for abortion-related complications. However, Upadhyay counters this claim, stating that it is expected for some individuals to visit the ER after receiving a medication abortion due to the bleeding caused by the pill regimen. Additionally, patients who take the medication at home and do not live near an abortion provider may visit the ER to inquire about side effects or confirm the success of the abortion.

Mifepristone’s Safety and Ongoing Legal Battle

Extensive research spanning decades has consistently demonstrated that mifepristone is a safe and effective medication for early pregnancy termination. Despite this, a federal judge in Texas recently invalidated the FDA’s approval of the drug, a decision that was later blocked by the Supreme Court. The high court is expected to hear the case next month, leaving the future of mifepristone uncertain until then.