Abortion proponents push misoprostol-only abortions in wake of uncertainty

As the status of mifepristone — commonly referred to as the abortion pill — remains uncertain, abortion proponents are again pushing for alternative methods, including the use of misoprostol alone ("misoprostol-only") for chemical abortions.

Key Takeaways:

• The Fifth Circuit Court of Appeals ruled in favor of Louisiana, banning mail-order abortions; but that decision was temporarily blocked by the Supreme Court.

• Planned Parenthood and other abortion businesses have said they will commit misoprostol-only abortions if mifepristone is not available.

• Misoprostol has not been approved by the Food and Drug Administration (FDA) for use alone in abortions, and has a higher failure rate than the combination of mifepristone and misoprostol (the abortion pill regimen).

The Details:

This week, the U.S. Supreme Court issued a temporary stay on a ruling from the Fifth Circuit Court of Appeals that sided with the State of Louisiana in its lawsuit against the FDA's 2023 changes to the abortion pill safety protocol (known as REMS). The FDA's decision allowed mifepristone to be sent through the mail and dispensed in retail pharmacies. The Fifth Circuit, in its ruling, found that:

• "FDA’s justifications for remotely dispensing mifepristone were based on flawed or nonexistent data." 

• "The new regulation had resulted in numerous illegal abortions in Louisiana and in Louisiana paying thousands in Medicaid bills for women harmed by mifepristone."

Briefly, the abortion pill was halted from being sent through the mail, until the Supreme Court issued the stay at the request of abortion pill manufacturer Danco Laboratories (on behalf of additional defendants, including the FDA and the generic pill maker GenBioPro).

Alliance Defending Freedom, which represents the State of Louisiana and co-Plaintiff Rosalie Markezich (a victim of coerced abortion), explained, "This is NOT a reversal of Friday's decision. Rather, it's the run-of-the-mill pause that the Justices typically use to consider the issues raised in an emergency application."

The stay will expire on May 11. In the meantime, the abortion industry and its proponents have already begun to prepare in the event that mifepristone returns to an in-person dispensing protocol. One of those options is to swerve toward misoprostol-only abortions instead, as that drug is not under a REMS safety protocol of its own.

Commentary:

“We closely monitored this court case, and we identified a way to keep telehealth medication abortion access intact for our patients,” Planned Parenthood of Northern New England President and CEO Nicole Clegg said in a statement.

Jacquelyn Marrero, a spokesperson for Planned Parenthood of Greater New York, likewise told the New York Times, “In the wake of yesterday’s harmful decision by the Fifth Circuit, Planned Parenthood Direct is mailing misoprostol-only prescription kits."

The Massachusetts Medication Abortion Access Project likewise told the New York Times its plan is to dispense misoprostol-only abortions.

Dr. Kristyn Brandi, an OB/GYN, abortionist, spokesperson for the pro-abortion American College of Obstetricians and Gynecologists, and member of Physicians for Reproductive Health, promoted the misoprostol-only regimen in an interview with NPR this week, claiming it is "incredibly safe and effective."

In the same article, Dr. Jamie Phifer, the medical director of Abortion on Demand, an online abortion business, said, "[W]e're ready. We can make the switch [to misoprostol-only protocols] within hours."

Why It Matters:

Abortion businesses around the world already commit misoprostol-only abortions, with advocates frequently pointing to this regimen as safe and effective. This has also long been the abortion industry's back-up plan, even though it is known to have higher failure rates. Misoprostol is attractive to abortionists because it has fewer safety protocols surrounding its usage.

As Live Action researcher Carole Novielli previously explained:

Misoprostol (Cytotec) was FDA-approved to lower the risk of stomach ulcers caused by nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) in certain people, according to GoodRx.

Misoprostol is not subject to the REMS safety system, which is why bad actors in the abortion industry could be pivoting toward the unapproved one-drug versus the approved two-drug regimen. Technically, using misoprostol in the abortion pill regimen is considered off-label use.

Misoprostol-only abortions, according to the pro-abortion MYA Network, fail "about 10-15%" of the time. Potential complications of a failed chemical abortion include infection, hemorrhage, and sepsis, which can be fatal. According to OB/GYN Ingrid Skop, there is the possibility of a born-alive infant, as well as birth defects in abortion survivors. Skop said that a 2010 study revealed that when misoprostol was used alone...

• There was a 23.8% failure rate, requiring surgery

• "The fetus continued to survive in 16.6% of the pregnancies."

• There was a risk of "birth defects such as Moebius Syndrome, associated with craniofacial and limb abnormalities."

She added:

In contrast, there were 3.5% failures and 1.5% continuing pregnancies in the mifepristone and misoprostol group. Likewise, a 2013 study demonstrated 38.8% failures when misoprostol was used vaginally and 29.9% when used sublingually (under the tongue). Similarly, a randomized trial in 2000 documented that 35% of women using unmoistened vaginal misoprostol had failures requiring surgery.  

In addition, "a worldwide systematic review of more than 12,000 misoprostol abortions found that 22% (nearly one in four) required surgical completion because misoprostol failed to completely empty the uterus of the remains of the child."

The Bottom Line:

The abortion industry is choosing to put women at risk by pivoting to misoprostol-only abortions, putting the deaths of children — and possibly even a risk that they are born alive and premature.

While the pro-life movement is being blamed for these actions, it is abortionists that are promising to break laws and encouraging women to take drugs off-label, even if it could potentially harm them.