Supreme Court Hears Arguments on Abortion Pill Safety
On Tuesday, the Supreme Court of the United States heard oral arguments in a consequential case that could impact access to medication abortion. The case, brought by the Alliance for Hippocratic Medicine, challenges the FDA’s approval of mifepristone, one of the drugs used in medication abortion.
Emergency Room Visits: A Misguided Measure of Safety
During the arguments, justices focused on emergency room (ER) visits following mifepristone use and whether the FDA’s recent loosening of regulations on the drug has led to an increase in these visits. However, experts argue that ER visits are not an accurate measure of the drug’s safety.
“I think ER visits are definitely the wrong measure when looking at safety. It’s important to recognize that the vast majority of people that go to the emergency room are going just for reassurance rather than a true safety concern.”
According to Michael Belmonte, an ob-gyn and fellow at the American College of Obstetricians and Gynecologists, the more important measure is serious adverse events, which are extremely rare with medication abortion. These events include hospital admission, blood transfusion, infection, and death. A 2013 peer-reviewed study found that, among 233,805 medication abortions provided in 2009 and 2010, significant adverse events or outcomes were reported in less than 1 percent of cases.
Understanding the Abortion Pill Regimen
It’s important to note that the abortion pill regimen, which consists of mifepristone and misoprostol, is designed to cause bleeding and cramping. While these effects may be concerning to some patients, they are a sign that the medication is working as intended.
Ushma Upadhyay, a public health social scientist at the UC San Francisco who studies medication abortion, explains that many patients who visit an emergency department after a medication abortion are simply seeking reassurance or confirmation that the medication has worked, rather than experiencing a serious complication.
Distance Traveled and ER Visits
Research published by Upadhyay in 2017 suggests that greater distance traveled to obtain a medication abortion may influence ER visits. This is likely because patients who live far from an abortion clinic or reproductive health clinic may not have easy access to a provider who can answer their questions or concerns.
The Risks of Pregnancy vs. Medication Abortion
Jack Resnick, immediate past president of the American Medical Association, emphasized in a recent statement that the risk of complications from medication abortion is extremely low, and the risk of death is nearly nonexistent. In contrast, the risk of death during or after childbirth is approximately 14 times higher than the risk of death from abortion-related complications.
The Question of Standing
Ultimately, the Supreme Court case may hinge on the legal concept of “standing” – whether the plaintiffs are the appropriate party to bring this case to the court. The Alliance for Hippocratic Medicine argues that physicians could be harmed by treating patients who suffer adverse health effects after taking mifepristone. Much of the justices’ questioning focused on whether this group had proven such harm. If the justices find that the plaintiffs lack standing, the case would be dismissed. A ruling is expected by the end of June.
1 Comment
Fear and misinformation often drive people to the ER, making a tough situation even tougher.