Heritage study suggests ER visits from abortion pills rose after FDA lifted in-person requirement

Allowing abortion pills to be dispensed without an in-person medical visit made obtaining them more convenient, but a newly released study indicates that the downside has been an increase in medical complications.

A report by the conservative Heritage Foundation found that the number of visits to emergency rooms in three states — Arkansas, New Jersey and South Carolina — for abortion-pill complications as well as miscarriages rose after the in-person safeguard was lifted in 2020.

The study examined miscarriage-related visits because pro-choice groups have emphasized that symptoms from taking the abortion pill look the same as those from a miscarriage, meaning that some women may be reporting abortions as miscarriages.

“Based on the data available, there is significant evidence that the ER visitation rate due to complications from induced abortion increased after the FDA stopped enforcing the in-person dispensing requirement for mifepristone,” said Jonathan Abbamonte, Heritage senior research associate, who wrote the report released Monday.

His findings jibe with those of the pro-life Charlotte Lozier Institute, which has released several abortion-pill studies, including a 2021 paper that found taking abortion pills was more likely to result in a visit to the ER than undergoing a surgical abortion, based on Medicaid data.

The Heritage study used publicly available ER data from the three states in the years before and after a federal court suspended the in-person rule in 2020. The FDA ultimately made the change permanent.

“The model predicts that there were on average 2.6 more ER visits from abortion complications for every 1,000 induced abortions after the FDA’s policy change,” said the report. “This represents an approximately 45 percent increase in the ER visitation rate on average, and between a 7.1 percent and 83.7 percent increase at the 95% confidence level.”

The data also showed an increase in ER visits for reported miscarriages in New Jersey and South Carolina.

The study warned that prescribing pills online or via telehealth makes it impossible to screen for certain risks, including ectopic pregnancies.

“Some contraindications of mifepristone are potentially life-threatening such as ectopic pregnancy which can only be effectively screened for with an ultrasound,” said the Heritage study. “Mifepristone cannot be used to treat ectopic pregnancy.”

Abortion-rights advocates cheered the FDA’s decision to make the abortion pill more accessible, while pro-life groups have accused the FDA of bowing to political pressure at the expense of women’s health.

Mr. Abbamonte recommended that the FDA bring back its in-person requirement, saying the evidence “points in the direction of a negative impact on maternal health and morbidity.”

“The FDA should follow evidence-based policy on mifepristone and, thus, should immediately reinstate the mandatory in-person dispensing requirement for mifepristone and reverse its decision to allow retail pharmacies to dispense the drug,” he said.

The FDA has approved the two-drug combination of misoprostol and mifepristone to terminate pregnancies up to 10 weeks’ gestation.