Vice President is expected to about abortion Friday in Georgia, where two women鈥檚 deaths have been tied to a state law that mostly bans the procedure .
Amber Thurman died after waiting 20 hours for a hospital to treat complications that occurred after she took abortion pills. earlier this week, the case is the first publicly reported instance of a woman dying from delayed care tied to a state abortion law.
The news organization also reported on the , a woman with lupus, diabetes and hypertension who took abortion pills she ordered online. An autopsy found fetal tissue that hadn鈥檛 been expelled and a lethal combination of painkillers, ProPublica reported. The state鈥檚 maternal mortality review committee did not believe abortion medication caused her death.
Still, the fact both women used the pills 鈥� mifepristone and misoprostol 鈥� may raise questions about whether they are safe. Here are some facts.
What safety limits have been imposed?
The U.S. Food and Drug Administration approved mifepristone in 2000 as a safe and effective way to . The drug, which blocks the hormone progesterone, also primes the uterus to respond to the contraction-causing effect of another drug typically used along with it, misoprostol. The pills are used in abortions nationally.
There are rare occasions when mifepristone can cause excessive bleeding that requires emergency care.
Because of that, the FDA initially imposed strict safety limits on who could prescribe and distribute it 鈥� only specially certified physicians and only as part of three mandatory in-person appointments with the patient getting the drug. The doctors also had to be capable of performing emergency surgery to stop excess bleeding and an abortion procedure if the drug didn鈥檛 end the pregnancy.
Over the years, the FDA reaffirmed mifepristone鈥檚 safety and repeatedly eased restrictions, culminating in a 2021 decision doing away with any in-person requirements and allowing the pill to be sent through the mail.
In 2022, a coalition of anti-abortion groups filed a federal lawsuit against the FDA challenging the agency鈥檚 long-standing approval of mifepristone. in June that the abortion opponents lacked the legal right to sue and preserved access to the medication.
How often are there serious problems?
Abortion opponents say the more lax restrictions resulted in many more 鈥渆mergency complications.鈥� But that argument lumps together women experiencing a range of issues with mifepristone 鈥� from the drug not working to people who may simply have questions or concerns but don鈥檛 require medical care.
OB-GYNs say a tiny fraction of patients suffer 鈥渕ajor鈥� or 鈥渟erious鈥� adverse events after taking mifepristone.
A legal brief by a group of medical organizations including the American College of Obstetricians and Gynecologists says: 鈥淲hen used in medication abortion, major adverse events 鈥� significant infection, excessive blood loss, or hospitalization 鈥� occur in less than 0.32% of patients, according to a highly regarded study with more than 50,000 patients.鈥�
The definition that scientists generally use for serious adverse events includes blood transfusions, major surgery, hospital admissions and death, said Ushma Upadhyay, one of the authors of that .
The prescribing information included in the packaging for mifepristone tablets lists slightly different statistics for what it calls 鈥渟erious adverse reactions.鈥� It cites ranges for how frequently various complications occur: 0.03% to 0.5% for transfusion; 0.2% for sepsis and 0.04% to 0.6% for hospitalization related to medication abortions. The ranges reflect findings across various relevant studies, experts said.
Why do patients go to the emergency room?
Mifepristone鈥檚 labeling also lists a complication that most medical groups don鈥檛 consider a serious or major adverse event: ER visits, which ranged from 2.9% to 4.6%. The current FDA label lists going to the ER as an option if patients experience prolonged heavy bleeding, severe abdominal pain or a sustained fever.
But ER visits don鈥檛 always reflect big problems, doctors told The Associated Press.
Some people may go there after a medication abortion because they want to be checked out or have questions but don鈥檛 have a doctor, said Upadhyay, a professor at the University of California, San Francisco. Others, she said, 鈥渄on鈥檛 want to go to their primary care provider about their abortion鈥� because of stigma.
A in 2018 found that slightly more than half of patients who visited the ER because of abortions received only observational care. Some, Upadhyay said, 鈥渄on鈥檛 receive any treatment.鈥�
How effective is the medication?
Mifepristone results in a completed abortion 97.4% of the time, according to U.S. studies cited in the FDA label.
But in 2.6% of cases, a surgical intervention is needed. And 0.7% of the time, the pregnancy continues.
That鈥檚 compared to a procedural abortion in a clinic, where the chance of the procedure failing to end a pregnancy 鈥渋s extremely, extremely low,鈥� probably less than 0.1%, said Dr. Pratima Gupta, a board member for the college of OB-GYNs.
鈥淎ny time a procedural abortion is done, the clinicians ensure that it was a complete abortion鈥� by examining the tissue that is removed or performing an ultrasound during or after the procedure, she said.
Gupta, who has done abortion procedures for more than 20 years, said there are 鈥渧ery few complications from abortion 鈥� any kind of abortion, medication or procedural abortion.鈥� A suggests that鈥檚 just as true for medication abortions that happen in a clinic, a doctor鈥檚 office or at home with the help of telehealth.
How does mifepristone鈥檚 safety and effectiveness compare to other drugs?
The FDA makes drug approval decisions on a case-by-case basis, weighing effectiveness, safety and other factors.
No drug is 100% effective, and many common medications don鈥檛 work for a significant portion of patients.
Antidepressants typically help between 40% and 60% of people with depression. New antibiotics approved by the FDA often resolve about 70% of infections.
Since 2000, roughly 6 million patients have taken mifepristone, according to the FDA. A 2021 review of agency records looking for deaths that were likely related to the drug identified 13, or .00027% of patients.
Medical organizations supporting mifepristone鈥檚 availability say the drug鈥檚 safety 鈥� given the rate of deaths 鈥� compares to 鈥渋buprofen, which more than 30 million Americans take in any given day.鈥�
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute鈥檚 Science and Educational Media Group. The AP is solely responsible for all content.
Laura Ungar And Matthew Perrone, The Associated Press
