Pro-abortion groups team up to promote over-the-counter abortion pills

A small study — published as a 'research letter' by JAMA Internal Medicine and alleging that the abortion pill [mifepristone (200mg)/Mifeprex] is safe for over-the-counter (OTC) use — was funded by an abortion pill investor and authored by researchers associated with groups working to expand abortion.

The research letter, "Accuracy of Self-Selection for Medication Abortion Using a Prototype Drug Facts Label," is receiving a great deal of abortion-friendly media attention for such a small sample size — 168 — who "completed study activities."

Key Takeaways:

• The much-touted JAMA "research letter/study" from 13 authors entrenched in the abortion industry had an extremely small sample size, yet is being used as a way to claim that women could safely use an over-the-counter abortion pill regimen.

• The research letter/study was funded by the pro-abortion Society of Family Planning as well as the Packard Foundation, one of the abortion pill's original financial investors.

• All of the research letter's authors work are associated with pro-abortion groups.

• In reality, despite the small sample size, about 9% of the participants incorrectly assumed — after reading the qualifying parameters for the abortion pill — that they were qualified to take it.

• An over-the-counter abortion pill regimen would expect women to determine gestational age and diagnoses their own ectopic pregnancy accurately.

• ER doctors have noted that women are presenting to emergency departments with ectopic pregnancies after taking the drug because there is currently a "no-test" protocol on the regimen and women can obtain it through the mail thanks to the FDA's relatively recent erosion of safety protocols.

The Details:

Small sample size and 'relatively little of substance'

"For all the authors listed here (thirteen in total, many of the abortion industry’s most well known and celebrated researchers and advocates) and all the data tables and numbers, there is actually relatively little of substance in the report," claimed National Right to Life Director of Education and Research Randall K. O’Bannon.

Unlike the previous survey of 6,950 women, this study chose to use percentages — possibly in an attempt to mask the extremely small study size. Authors claimed 93% (equating to 147 women out of 158) expressed interest in OTC abortion pill use.

Just 144 of the 168 "really met the criteria," O'Bannon explained, adding (emphasis added):

Fourteen women read the materials and thought they qualified but objectively didn’t. Their pregnancy was too advanced, had some condition that made them ineligible, or failed to note some medication they were taking that would compromise the abortion pill’s effectiveness.

Even among these patients who had probably already researched their options before visiting the clinic, nearly 9% made an erroneous assessment of their eligibility for abortion pills after reading the package insert.

This 9% error rate is huge, given the increased failure and complication rates that come with later gestations and the enormous risk posed by the rupture of undetected ectopic pregnancies (whose cramping and bleeding mimic chemical abortion’s process).

1st Trimester Abortion | The Abortion Pill | What Is Abortion?

O'Bannon added:

There were no details on how a woman is to assess her gestational age beyond counting the weeks since a woman’s last menstrual period and no special advice on how to determine if she currently has an ectopic pregnancy, which the pills do not treat.

The popular "no-test" protocol for the abortion pill is what is described here, failing to assess gestational age or ectopic pregnancy before dispensing the drug regimen. As O'Bannon noted, this is very risky for women. He added:

Not a whole lot else was examined in this particular study. We do not know how many of these women actually went on to receive abortion pills or how they fared if they did; whether their abortions were “successful”; or whether they suffered serious complications. Perhaps this information will be released in a follow up study.

Diagnosing Complications

The authors claimed, "We examined abortion patients’ accuracy of self-selection to use MA [medication abortion/the abortion pill] using only a prototype OTC package and drug facts label (DFL)."

According to the research letter, some of the women who "self-selected their eligibility for [medication abortion] MA after a brief, in-person interaction with a prototype OTC package and DFL "were deemed ineligible" because of "gestational duration of more than 70 days" with "other medical contraindications" including "possible ectopic pregnancy."

💊 In a real-world situation obtaining the abortion pill OTC...

• How would a woman accurately determine "gestational duration" (unless she has a very regular cycle which she diligently tracks)?

• How would she diagnose a "possible ectopic pregnancy" (when its symptoms mimic those of the abortion pill itself)?

More problems

Grossman told KUOW:

If they were interested and eligible to participate in the study, they looked at a box that is kind of like a prototype packaging for what an over-the-counter medication abortion package might look like.

• The document links to mimi-pills.com ("MiMi" for the two drugs: mifepristone and misoprostol) and not FDA safety data or the drug's label, which contains a black box warning for sepsis, among other dangers.

• It claimed "3 in 100 users... will need an in-clinic procedure..." contradicting the manufacturer's website:

About 2 to 7 out of 100 women taking Mifeprex will need a surgical procedure because the pregnancy did not completely pass from the uterus or to stop bleeding.

• The prototype packaging also failed to advise participants that the FDA's REMS safety system requires prescribers of the drug (not end users) to handle complications or failures or refer to someone who can.

• Instead, study participants were advised to diagnose their own complications and contact a healthcare provider if needed.

The MiMipills.com pamphlet says nothing about the embryo or fetus, merely referring to "the pregnancy," a deceptive marketing tactic used by the abortion industry.

It advises women to "monitor their symptoms," fails to emphasize risks of sepsis or hemorrhage (claiming only that bleeding and fever are "rare"), claims any age can use these pills, and suggests that RH factor testing and ultrasounds (to determine gestational age even possible ectopics) are generally unnecessary.

While the women were warned not to take abortion pills if they "have ever had" or "currently have" an ectopic pregnancy, they failed to explain how women would diagnose their own current ectopic pregnancies.

ER doctors have warned that women are presenting to emergency departments with ectopic pregnancies after taking the drug.

The pro-abortion authors concluded:

These findings broaden a small body of research demonstrating that people seeking clinician-supported abortion are largely accurate in self-reporting their MA eligibility, including their gestational duration.

"Due to the nature of the ethical approval obtained for this study, data will not be made public," the study's supplemental document claimed.

Behind the Curtain:

The money behind the study

The "study" was funded by the Society of Family Planning Research Fund.

The Society of Family Planning (SFP) was founded with a “generous contribution” from the Packard Foundation and receives millions from the Buffett Foundation. Both Foundations are financial investors in the abortion pill.

Funding for the study was also "supported" by the pro-abortion David and Lucile Packard Foundation, with zero conflicts of interest noted, despite the Packard Foundation's $14.2 million in Danco (the abortion pill's manufacturer) early on.

Researchers and groups behind the study

Ibis Reproductive Health (IBIS)

• Ibis was founded by Charlotte Ellertson, who spent years at the Population Council, which brought the abortion pill into the U.S. and set up the manufacturer, Danco Laboratories. Ibis was for years funded directly by Danco. After Live Action News exposed this financial conflict of interest, the funding connections were suddenly scrubbed from Ibis’s website. 

• Ibis is currently funded by the aforementioned abortion pill investor, the Packard Foundation.

• Study author Kelly Blanchard is current president of IBIS.

Advancing New Standards in Reproductive Health (ANSIRH)

• ANSIRH, led by Daniel Grossman, is a pro-abortion research organization out of UCSF, and is also funded by Packard.

• ANSIRH publishes the TEACH Early Abortion Training Curriculum, which promotes prescribing the abortion pill past the FDA-approved gestational limit.

Study authors Daniel Grossman, Lauren J. Ralph, C. Finley Baba, Katherine Ehrenreich, Natalie Morris, and M. Antonia Biggs are associated with ANSIRH.

Daniel Grossman is the director of UCSF’s Advancing New Standards in Reproductive Health (ANSIRH). Grossman's conflict disclosure in the study only stated that he "receiv[ed] personal fees from the Planned Parenthood Federation of America for serving as an expert witness in cases challenging abortion restrictions." And yet:

• Grossman is a Clinical Professor at the Warren Buffett funded University of California, San Francisco, San Francisco (UCSF).

• He is a vocal proponent of expanding abortion and an abortionist with multiple conflicts of interest surrounding abortion pill studies.

• He served as VP of Research for Ibis and previously served as a senior advisor while Ibis was funded by Danco.

• Grossman has served as a consultant to Planned Parenthood and the Center for Reproductive Rights, and on the boards of NAF and NARAL Pro-Choice America.

• In 2019, Live Action News exposed Grossman’s ties to NARAL, and shortly thereafter, he announced his retirement from the group’s board.

• Grossman previously served on the board of the Whole Woman’s Health Alliance abortion chain.

We Testify

• Pro-abortion group that promotes abortion "storytellers" in an attempt to "break down stigma, and create a more compassionate culture."

• Claims to "support everyone’s decision to have an abortion at any time and for any reason."

• States that "abortion access is our legacy" to carry forward for "generations to come."

• Study author Emma Hernández is the Senior Communications Manager for We Testify.

International Planned Parenthood Federation (IPPF)

• Study author Nathalie Kapp, MD, is chief medical officer at IPPF.

Red River Women’s Clinic

• An abortion facility in Moorhead, Minnesota

• Study author Tammi Kromenaker is the clinic director.

Physicians for Reproductive Health (PRH)

•  Study author Jamila Perritt, MD, is president of PRH and an abortionist.

University of Washington School of Medicine, Seattle

•  Study author Elizabeth Raymond, MD, is in the Department of Obstetrics and Gynecology, is a past recipient of an award from the Guttmacher Institute for her work as a reproductive health "scholar-activist," and worked for the pro-abortion research group Gynuity.

Resound Research for Reproductive Health, Austin, Texas

•  Study author Kari White disclosed a conflict that she has received grants from the Society of Family Planning.

The Backstory:

The abortion pill mifepristone (200mg) was approved by the FDA in 2000 and was placed under a safety system (REMS) in 2011 after serious adverse events were reported. These safeguards have been eroded multiple times in recent years to expand the gestational limits of the drug, remove in-person dispensing, and allow for mail-order and pharmacy dispensing. These efforts were initiated and funded by the abortion industry.

As far back as 2022, Renee Bracey Sherman, founder and former executive director of the abortion group We Testify and a former NARAL board member, co-authored an op-ed with abortionist Daniel Grossman, calling for the abortion pill to be sold over-the-counter.

In 2019, Grossman and abortion industry insiders M. Antonia Biggs, Lauren Ralph, Sarah Raifman, and Diana G. Foster co-authored the result of a survey they conducted on women’s attitudes about advance provision of abortion pills (obtaining the pills to "have on hand" before a confirmed pregnancy) as well as OTC abortion pills. As Live Action News previously documented, out of 6,950 surveyed, only 9% of the women answered “definitely yes” and 14% answered “probably yes” to wanting OTC access.

Those promoting OTC dispensing of the abortion pill are following the roadmap followed in making the emergency contraceptive Plan B OTC, as explained by abortionist Daniel Grossman:

Before emergency contraception (aka the morning-after pill) became available over the counter, clinicians often gave it to patients in advance [advance provision] to have on hand when they needed it. Given the restrictions on abortion, we should think about this strategy for abortion pills.

Neither the mechanisms of action nor the drugs in Plan B and the abortion pill are the same.

READ: Clearing misconceptions: Three differences between the abortion pill and ‘Plan B’

The Bottom Line:

According to NRL's O'Bannon, the study "still shows that written instructions alone — at least as prepared by the industry’s top experts — are an inadequate tool for patients making eligibility determinations." In other words, over-the-counter abortion pills are an unsafe idea for women as well as preborn children.