Number of chemical abortions growing in U.S., outpacing surgical abortions in many states

By Randall K. O’Bannon, Ph.D. NRL Director of Education & Research

Editor’s note. This appeared in the November digital edition of National Right to Life News. Please share this, and all the other stories, op-eds, analyses, President’s column, and editorials with your pro-life friends and family.

RU486With comprehensive national surveys from Guttmacher and the U.S. Centers for Disease Control (CDC) still in the works, the Reuters News Agency (10/31/16) has accessed preliminary data from Planned Parenthood and state health departments showing what appears to be a significant increase the number of chemical abortions performed in the U.S.

In fact, in some states there are more chemical abortions than surgical ones. Let’s look back at the steady increase.

The U.S. Food and Drug Administration (FDA) gave mifepristone (RU-486) marketing approval in September of 2000. It took a while for it to be accepted, but growth has been slow and steady from that point on.

More recently, in 2011, the Guttmacher Institute reported there were 239,490 chemical abortions performed in the U.S.–22.6% of all abortions.

This number represented an increase of about 40,000 more than there were in Guttmacher’s 2008 abortion survey, when chemical abortions constituted 16.4% of all abortions performed. This, even while overall abortion number had dropped by more than 150,000 from 2008 to 2011.

Clearly, as NRL News has reported on numerous occasions, chemical abortions are a substantial growth area for the industry.

New national figures from Guttmacher for 2014 could come out as early as January 2017. However, as the Reuters story suggests, data from Planned Parenthood and state health departments are already hinting that the growth in chemical abortions could be on the verge of really taking off.

For example, Planned Parenthood, the nation’s largest abortion chain, told Reuters that chemical (or “medication”) abortion represented 35% of the abortions it performed in 2010. Independently, we know that Planned Parenthood performed 329,445 abortions that year. Thirty-five percent would be about 115,000 abortions.

But in 2014, Planned Parenthood says, chemical abortions were 43% of the abortions the group performed. Forty-three percent of the 323,999 its annual reports says it performed that year would be 139,000.

This is no shock, given that Planned Parenthood has been increasing the number of clinics offering chemical abortions over the past several years. In 2016, over half of its clinics–361 out of about 649–were offering chemical abortions.

Figures from state health departments show a similar pattern, Reuters reports. In some states, the news agency points out, chemical abortions now exceed surgical ones. In Michigan, 55% of abortions are chemical. In Iowa, nearly two thirds (64%) are now chemically induced.

The story in Iowa in instructive. There, Reuters recounts, Planned Parenthood is employing telemedicine to perform what we have termed the “web-cam abortion.” Here an abortionist back in the city at a clinic hub video conferences with a woman at a smaller, remote rural office. If satisfied with what he sees in his report and hears in the interview, he clicks a button remotely releasing a drawer containing the abortion drugs there at her location.

She takes the RU-486 pills (mifepristone), initiating the abortion process, and takes prostaglandin pills, misoprostol, home with her where she will expel the dead child. The woman is never physically examined by the doctor and may only be seen by a certified medical assistant who takes her blood pressure and performs an ultrasound. She can go to her local emergency room for any problems she has – if it is not too far away.

Other reasons chemical abortion numbers could increase

Other states like Maine and Alaska are following the Iowa model, but that’s hardly the latest development. Another abortion technology group, Gynuity, headed by some of the same people who helped bring RU-486 to the United States, has set up experiments in New York, Hawaii, Washington and Oregon sending abortion pills by mail.

Another recent development is expected to further spur the growth of chemical abortions in the U.S. Last March, the Food and Drug Administration (FDA) officially changed the two-drug protocol–mifepristone (RU-486) and misoprostol.

At the request of Danco, the U.S. distributor, and in recognition of widespread disregard for its original guidelines, the FDA adjusted the dosage of pills, reduced the number of recommended visits, widened the scope of authorized prescribers, and extended the cutoff date.

The protocol change meant that clinicians could prescribe one of the expensive RU-486 pills (approximately $90) rather than three and double up the dose of the cheaper prostaglandin ($1-2 a pill). The FDA no longer said that women had to return to the clinic to have the doctor administer the misoprostol, saving at least one visit, and said only that these needed to be done under the supervision of a “certified healthcare provider” rather than an actual physician.

The most significant change was saying that these pills could be used up to 70 days after a woman’s last menstrual period (LMP), ten weeks, rather than the 49 days LMP, the original cutoff.

While nothing in these changes specifically addressed safety issues that have led to the deaths of more than a dozen chemical abortion patients, they do have the effect of making the drugs available to a wider customer base, making fewer demands on clinic staff, and generally making the chemical abortion more profitable for clinics.

Reuters notes that there are indications that the protocol change is already having an impact in states such as Ohio, Texas, and North Dakota which had made the original FDA guidelines legally mandatory. Demand for chemical abortions in those states has tripled in the past several months, Reuters says, now accounting for as much as 30% of all abortions in some clinics.

Chemical abortions in Texas had shown a sudden drop off after November of 2013, when the old FDA protocol was made mandatory.  The number dropped by two thirds from the six months prior to the six month period after.

Chemical abortions dropped in Ohio in 2011 with implementation of the old protocol law, to the point that they reflected less than 2% of the abortions performed in that state (Contraception, June 2015).

If Reuters is right, this is all changing, with chemical abortions in these states heading the other direction, going up.

Long term impact?

Whether this will impact the overall long-term downward national trend on abortions nationwide has yet to be seen.

Some of this, of course, is just women switching from surgical abortion to chemical abortions. But from the beginning, the plan of the abortion pill’s promoters was to expand the number of abortionists and to bring abortion into “under-served” communities. There is some evidence, given this recent report that this is now occurring, thanks to a sympathetic administration.

Women intimidated by the thought of surgical abortion may, for a time, be susceptible to the lure of the promise of an “easy, safe, simple” chemical abortion available at a neighborhood clinic. These recent numbers may reflect that.

We can only hope, however, that as we share actual women’s nightmares of their chemical abortion experiences, that as we show people these are still abortions which that take the lives of precious unborn children, and as we continue to make life preserving alternatives available to women who may not see a way out, that more and more women will choose to reject abortion altogether and choose life for both themselves and their unborn children.