More than Half of All U.S. Abortions Now from Abortion Pills

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

The trends have been pointing this way for years, but today the Guttmacher Institute confirmed that chemical, or “medication” abortions, now account for more than half of the abortions performed annually in the United States.

In an online analysis of preliminary data from Guttmacher’s most recent survey of abortion “providers,” the research institute reported that 54% of the abortions it recorded for 2020 were facilitated by chemical abortifacients like mifepristone and misoprostol. These two drugs are typically used together to abort unborn children in the early to mid first trimester.

Mifepristone blocks the activity of the pregnancy hormone progesterone, thereby shutting down the child’s life support system. As the protective, nutritive cocoon around the baby begins to break down over the next few days, the child is starved or suffocated to death. Misoprostol, the second drug, a prostaglandin, stimulates powerful uterine contractions to expel the emaciated corpse.

Though some “providers” have prescribed these past the recommended limits, they are only supposed to be used by women no more than ten weeks pregnant (measured from a woman’s last menstrual period, or LMP). By this point the child, eight weeks old him or herself, would have a heartbeat, hands, feet, face, and even brain waves.

The “effectiveness” of the abortion pill decreases with gestational age, while complication rates increase, which is why the government protocol does not authorize use of the drugs after ten weeks LMP.

How many abortions this 54% actually represents is not explained by Guttmacher.  Guttmacher says these are “preliminary findings from ongoing data collection” for 2020 to be filled out with “final estimates” to be released “in late 2022.”  The percentage could change as data from more “providers” comes in, but Guttmacher does not expect the proportion for chemical abortion to fall below 50%.

The trajectory of chemical abortion from the time the U.S. Food and Drug Administration (FDA) first approved the sale of mifepristone in September of 2000 to the present has been a slow and steady climb, though accelerating in recent years as the FDA has relaxed standards on distribution and prescription.

Except for a slow down around 2005 when several well publicized deaths of mifepristone patients temporarily took the wind out of the abortion pill promoters’ sails (deaths and injuries which were not adequately addressed and which have continued into the present day), Guttmacher shows chemical abortions hitting 24% by 2011, and then 39% by 2017. The steepest increase was from that point to 54% by 2020.

The latest acceleration was surely facilitated by FDA modification of regulations in March of 2016. With that move, the FDA broadened the prescriber pool to included any “certified healthcare provider,” adjusted doses (lowering costs to prescribers), extended the cut off from seven weeks to ten weeks LMP, and dropped required in person follow-up visits.

Thanks to abortion industry pressure and a sympathetic administration, FDA regulations requiring that mifepristone only be delivered to patients in person were suspended during the pandemic and were eventually dropped entirely. This officially opened the door to the prescription of abortion pills by telemedicine and delivery by overnight mail without any direct physical exam.

This latest move will surely increase the prescription and use of mifepristone, as it will likely also increase the incidence of deaths, complications, and incomplete abortions.

Women coming to the clinic would often have the opportunity for a physical exam and often  an ultrasound, which could confirm gestational age. This could assure both the woman and prescriber that she was not past the gestational deadline where effectiveness dropped off and complications increased.  

Ultrasound and a physical examination could also help ensure that the baby was not implanted outside the uterus in what could be a potentially deadly ectopic pregnancy, which mifepristone and misoprostol do not treat. Worse, women experiencing the pain and bleeding associated with a rupturing ectopic pregnancy can easily mistake these for the standard side effects of a chemical abortion, delaying desperately needed help until too late.

Without these exams and ultrasounds, a lot more women with these conditions who are past these deadlines are likely to be given these pills and to encounter the problems medical research has confirmed accompany attempts to chemically abort at later gestations. 

Whether they will be able to get adequate medical help in time, whether doctors in the emergency rooms will even realize what they are dealing with is an open question. Some groups, in direct contradiction to FDA advice, have counseled women that they do not need to inform emergency personnel that they have attempted a chemical abortion-that they can simply claim to be having a miscarriage.

Be on the watch for a sudden surge in miscarriages; for an unexplained increase in the number of hemorrhaging women showing up in the ER; and for a jump in the number of women dying from the rupture of  previously undetected tubal pregnancies.

When the abortion industry first developed mifepristone, it was with the hope that the chemical abortion would someday replace the surgical abortion. Those had grown increasingly unpopular with women because of the impersonal, mechanical cutting, scraping, bleeding.  

But the more women actually experience these abortions, the more they find out how bloody and painful and dangerous they are. The more women endure these harrowing ordeals, the more they encounter the tiny bodies of their children swirling in the shower drains, the more they’ll realize, once again, that the abortion industry has sold them a bill of goods.

In time, the reality of chemical abortion will become apparent and unavoidable. Women will come to realize that chemical abortion is still abortion, that abortion still involves the death of a child and the physical, social, and psychological wounding of the mother.