Georgia deaths linked to abortion restrictions; experts confirm pill safety

Vice President Kamala Harris is set to address abortion issues on Friday in Georgia, where the deaths of two women have raised concerns linked to a state law prohibiting the procedure after approximately six weeks of pregnancy.

Amber Thurman tragically passed away following a lengthy delay of 20 hours for medical care after experiencing complications from taking abortion pills. This incident, highlighted by ProPublica earlier this week, marks the first publicly acknowledged case where a woman’s death is connected to delayed medical attention post-abortion pill usage.

Alongside Thurman’s case, ProPublica also reported on Candi Miller, a woman with pre-existing health conditions including lupus, diabetes, and hypertension, who also ingested abortion pills procured online. An autopsy revealed that fetal tissue had not been expelled, and a dangerous combination of painkillers was present. Yet, the state’s maternal mortality review committee did not attribute her death to the abortion medication.

The connection of both women with the use of mifepristone and misoprostol—the two medications typically used for abortion—does raise inquiries regarding their safety.

The U.S. Food and Drug Administration (FDA) approved mifepristone in 2000, acknowledging it as a reliable method to terminate early pregnancies. The drug operates by blocking the hormone progesterone, preparing the uterus to respond effectively to misoprostol, a second medication that induces contractions. Mifepristone is utilized in over 60% of abortions conducted nationwide.

Although mifepristone can on rare occasions lead to severe bleeding requiring immediate medical intervention, strict initial safety protocols were established by the FDA to regulate its use. Only certified physicians were allowed to prescribe the medication, a process initially structured around three mandatory in-person appointments, where doctors needed to be able to perform emergency surgeries if necessary.

As time went on, the FDA reaffirmed the safety of mifepristone, gradually lifting restrictions, culminating in a 2021 decision that eliminated in-person requirements and permitted mail delivery of the medication.

Despite a coalition of anti-abortion groups launching a federal lawsuit against the FDA in 2022 to challenge the drug’s approval, the courts ruled in June that these organizations did not possess the legal standing to file the lawsuit, thereby safeguarding access to mifepristone.

While opponents of abortion contend that relaxed restrictions have led to increased emergency situations, this argument conflates several issues, from effective drug administration to patients seeking counsel and reassurance without requiring serious medical treatment.

Obstetricians and gynecologists support that a minuscule percentage of patients experience serious side effects after taking mifepristone. A legal brief issued by several medical organizations, including the American College of Obstetricians and Gynecologists, highlights that significant adverse events occur in less than 0.32% of all cases, as noted in a comprehensive study comprising over 50,000 patients.

Experts define serious adverse events in various forms such as the necessity for blood transfusions, major surgeries, hospital admittance, or fatalities. Notably, certain complications leading to emergency room visits do not always indicate significant problems. A considerable number of patients seek emergency care out of precaution or due to discomfort rather than because they face life-threatening situations.

Emergency visits following medication abortions often reflect patient uncertainties rather than severe complications. Many individuals may prefer not to approach their primary care provider for abortion-related concerns due to stigma, prompting them to go directly to the ER.

Statistically, mifepristone achieves a successful abortion in 97.4% of cases, although surgical intervention is required in 2.6% of instances, with 0.7% of pregnancies continuing despite medication use. Compared to procedural abortions performed in clinics, which have an exceedingly low failure rate of less than 0.1%, both medication and procedural abortions exhibit a similarly low risk of complications.

The FDA evaluates the safety and efficacy of medications on a case-by-case basis. While no drug guarantees 100% effectiveness, many standard medications exhibit lower response rates than mifepristone. For instance, only 40% to 60% of patients with depression benefit from antidepressants. Since mifepristone’s approval, around six million patients have used it, with data revealing only 13 deaths that were likely related to the drug, corresponding to a rate of 0.00027%.

Proponents of mifepristone’s availability claim that its safety record aligns with widely used medications, such as ibuprofen, which is utilized by over 30 million Americans daily.

Source: Associated Press