A federal judge in Texas held a hearing Wednesday morning on a lawsuit seeking a nationwide ban on the use of mifepristone, the first drug used in medical abortion procedures.
Data analyzed by CNN shows that mifepristone is even safer than some common low-risk prescription drugs, including penicillin and Viagra. Since mifepristone was approved in 2000, five deaths per million people in the United States have been attributed to mifepristone use. US Food and Drug Administration As of last summer. That’s a 0.0005% mortality rate.
By contrast, penicillin — a common antibiotic used to treat bacterial infections such as pneumonia — caused four times the risk of death compared to mifepristone, according to a study of life-threatening allergic reactions. Taking Viagra (used to treat erectile dysfunction) had a nearly 10-fold higher risk of death, according to a study cited in a friend-of-the-court briefing filed by the FDA.
“[Mifepristone] It’s been used by more than 5 million people who are able to conceive for more than 20 years,” said Ushma Upadhyay, an associate professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at UCSF. “It’s been very safe. ”
The lawsuit, filed against the FDA by a coalition of national medical societies that oppose abortion under the aegis of the Hippocratic League of Medicine and several physicians, is seeking multiple court actions, chief among them an injunction ordering the FDA to “withdraw rice fepristone and misoprostol as FDA-approved chemical abortion drugs, and withdraw defendants’ action to deregulate these chemical abortion drugs.”
“Plaintiffs now ask this court to do what the FDA has and is legally required to do: to protect women and girls by prohibiting, setting aside, and revoking FDA’s actions to approve chemical abortion drugs, and to remove important safeguards for those who experience the dangers .medication regimen,” they wrote in their original complaint.
If the lawsuit is successful, 40 million women of childbearing age across the country would lose access to medical abortion care, it said. Data from abortion rights advocacy group NARAL Pro-Choice America. And that doesn’t include the 24.5 million women of childbearing age who live in states that ban abortion.
“It goes against decades of scientific and clinical evidence,” said Dana Johnson, a doctoral candidate in public policy and demography at the University of Texas at Austin who studies abortion access and care. “The fact that this lawsuit could undercut what we know to be an extremely safe, extremely effective, and one of the most accessible methods of obtaining abortion right now, I think that’s absolutely terrifying.”
Medication abortion has become the most common abortion method, accounting for more than half of all abortions in the U.S. in 2020, according to Guttmacher Institute.
Abigail Aiken, an associate professor at the University of Texas at Austin who leads the medical abortion research group, said the growing popularity of medical abortion is largely due to its accessibility.
“It reduces costs and barriers that people might not want to go to the clinic,” she said.
It is also a safer option than a procedure abortion or childbirth. According to one study, the incidence of major complications of medical abortion, such as bleeding or infection, is about 1 in 100. Study in 2015 Hosted by Upadhyay. That means 35 out of more than 11,000 cases had any major complications.
possibility of Serious Complications from Procedural Abortion Abortions performed at or after the second trimester had a slightly higher rate than medical abortions at 0.41 percent, according to the same study.and childbirth The risk is by far the highest at 1.3%.
Aiken told CNN that if mifepristone use is cut off, abortion clinics and telemedicine facilities may switch to misoprostol-only abortions. Although misoprostol is used around the world for abortions, they are less effective, have a higher risk of serious complications and are often more painful than a combination of mifepristone and misoprostol, she said .
in the latest The US Self-Administered Misoprostol Medical Abortion Study, Johnson found that misoprostol-only abortions were a safe option, though not as safe as taking both pills together. Published in February, the study analyzed data from 2020 from Aid Access, an online telemedicine provider of medical abortion. Nearly 90% of the 568 users reported having completed abortions, and 2% had serious complications when using misoprostol alone.
Together, mifepristone and misoprostol are still considered the gold standard, Aiken told CNN. People who used the combination of the two pills were less likely to have serious complications than those who used the misoprostol-only regimen.
“It’s clear that mifepristone and misoprostol are very safe medications that people can take at home without the help of a medical professional,” Aiken said.
Johnson told CNN that because misoprostol is used to treat a variety of conditions, including stomach ulcers, it is readily available in pharmacies and is unlikely to be taken off the market anytime soon.
However, a less effective method means more people may have an unsuccessful miscarriage.
“It may not work for some people and prolong their miscarriage,” Upadhyay said. “And then when they come back to the clinic, they’re in the later stages of pregnancy seeking an abortion.”
Before the ruling, 19 states had restricted telemedicine abortion care, limiting access to medical abortion.As of late January, nearly half of U.S. adults were unsure if medical abortion is currently legal in their state, according to a survey Survey conducted by the Kaiser Family Foundation. Experts say the confusion will only intensify.
“People aren’t sure whether mifepristone or misoprostol are actually available. I think it’s confusing,” Aiken said. “When people shop around for options or are unsure of their options, they may end up putting off [care]”