Yesterday, a federal judge ruled that, during the COVID-19 pandemic, women do not need to abide by a policy requiring that they go to a medical facility in order to obtain chemical-abortion drugs. The ruling by a U.S. district judge in Maryland, Theodore D. Chuang, stated that the “in-person requirements” were a “substantial obstacle” to women seeking abortions. As a result, the ruling allows health-care providers to mail or otherwise deliver abortion pills directly to women.
During the recent pandemic, supporters of legal abortion have been aggressive in their efforts to expand access to chemical abortions. In March, a coalition of 21 state attorneys general wrote to the commissioner of the FDA requesting that it loosen its safety regulations for chemical abortions. In June, more than 100 members of Congress made a similar request of the FDA.
Unfortunately, this decision by Judge Chuang likely will have adverse effects on women’s health. There is a body of research suggesting that chemical abortions pose significantly greater health risks to women than surgical abortions do. One of the best studies on this subject was published in 2015 after obtaining comprehensive and reliable data from Medicaid billing records in California. It found that chemical abortions result in a complication rate four times higher than the complication rate for first-trimester surgical abortions. The risk of a major complication with a chemical abortion was nearly twice as high as the risk of a major complication with a first-trimester surgical abortion. It seems likely that, if a higher number of chemical abortions are conducted without medical supervision, the risks of a complication will only increase.
Some supporters of loosening restrictions on chemical abortion cite a study published in Obstetrics and Gynecology surveying chemical abortions provided via tele-medicine im Iowa and purporting to show that those procedures were safe. However, that study had a number of shortcomings. For instance, it used data from a survey of Iowa hospitals, with only a 35 percent response rate. It also failed to hold constant the gestational age of the unborn child and other factors that could increase the health risks involved with obtaining an abortion. Finally, the authors of the study admitted that some respondents might not have reviewed medical records and instead relied on their recall of events, making it possible that some adverse events were excluded. As a result of those shortcomings, this study should not be taken as a definitive data point regarding the safety of tele-med abortions.
There is evidence that the incidence of abortion has increased during the pandemic. According to a CBS News article from April, some abortion facilities have reported an increase in the number of women seeking abortions. Meanwhile, ABC News reported that many “abortion funds,” which use private donations to subsidize abortions, had seen an increase in requests for help funding abortions. Data from Florida this spring show that the number of abortions in the state has increased by nearly 7 percent since a similar point in time last year. It is unfortunate that judges and policymakers are prioritizing access to medically risky chemical abortions instead of finding creative ways to support pregnant women in need.