Abortion Pill

Woman’s death in India a reminder of ectopic pregnancy dangers with ‘no-test, self-managed’ abortion pill

India, rape

The U.S. Food and Drug Administration has now loosened safety requirements for the abortion pill known as the REMS (Risk Evaluation and Mitigation Strategies), enabling women to obtain the regimen without first consulting a doctor and by mail. In addition, abortion industry spokespersons are pushing for the drug to be made available over-the-counter.

But there are reasons why those abortion pill safety requirements were enacted in the first place, and the now-approved “no-test” abortion pill protocol puts women at great risk.

A chilling, gruesome reminder of exactly that is described in a 2019 case report out of India. It details the researchers’ encounter with a woman who died after taking the abortion pill regimen while unwittingly experiencing an ectopic pregnancy. Although women are technically required to see a doctor and obtain a proper prescription for the abortion pill regimen in India, black market sales abound. Many women skip visiting a physician and obtain the regimen directly from pharmacies and other illicit outlets.

This 26-year-old unmarried client was one such woman. According to the report:

[She] had tested herself positive with a commercially available urine pregnancy test kit and then bought and used mifepristone and misoprostol from a pharmacy without consulting a doctor. She then developed acute abdominal pain and bleeding per vagina and died from haemorrhagic shock [due to a ruptured ectopic pregnancy].

Hospital doctors were unable to revive her in the emergency room. Her autopsy revealed 900 ml of blood and 250 g of blood clots in her abdominal cavity. Early diagnosis with a visit to a provider could have saved the woman’s life. Even an ultrasound beforehand — something no longer required in the United States due to the FDA’s loosening of REMS — could have identified an extrauterine pregnancy in time to prevent this tragic death.

READ: As U.S. FDA loosens abortion pill regulations, India warns of self-managed abortion dangers

Ectopic pregnancy occurs when the blastocyst implants outside of the uterus, most commonly in the fallopian tubes. The most common risk factors are history of pelvic inflammatory disease and the use of oral contraceptives. Other risk factors include age, history of infertility, smoking, history of ectopic pregnancy, and previous IUD use.

Ectopic pregnancy is the most common cause of maternal death in India and the leading cause of first-trimester maternal death in the United States. Between 6 to 16% of pregnant women who go to the emergency room in the first trimester for bleeding and/or pain have an ectopic pregnancy. And yet now, thanks to the Biden-Harris FDA, women are being made to feel that obtaining the abortion pill with no in-person exam, no ultrasound to confirm an intrauterine pregnancy or gestational age, and no blood test to detect Rh factor (which can negatively impact future pregnancies) has little risk.

According to the case report, the risk of ectopic pregnancy is significant, and a “no-test” protocol is extremely dangerous:

In a study, 16 (0.8%) patients were diagnosed to have ectopic pregnancy based on vaginal ultrasound findings. Most (14/16, 87%) of the patients were in second gravida or above… History of intake of MA (mifepristone followed by misoprostol) was present in seven (43.75%) cases. All of the women were tested for pregnancy at home with commercially available kits. Five out of seven patients took the abortifacients (mifepristone followed by misoprostol) directly from a retail outlet without any prescription. Two patients did visit private doctors who prescribed them the MA. None of these patients was advised to have any pelvic USG to confirm intrauterine pregnancy before taking MA. While 4 out of 16 patients were treated medically (methotrexate), 12 cases underwent surgery. Out of 12 cases operated, eight (66.6%) had ruptured ectopic pregnancy, three tubal abortions and one chronic ectopic.6

Despite the risks, U.S. abortion proponents have been vigorously pushing for over-the-counter abortion pill distribution. And even as the U.S. loosens safety protocols, Indian officials have been warning of the dangers of so-called “self-managed” abortions — and little wonder. Research shows that the abortion pill is four times more dangerous for the mother than surgical abortion. One in 50 pregnancies are ectopic and require medical intervention. Research also shows that nearly 15% of women seeking the abortion pill, which is only approved for use up to the 10th week of pregnancy, underestimate the gestational age of their preborn children.

Furthermore, it has been found that one in 20 chemical abortions are incomplete, putting the woman at an increased risk of infection, sepsis, and even maternal death.

All of these factors make a so-called “self-managed,” “no-test” chemical abortion a very risky proposition even as abortion industry mouthpieces continue to push for a reduction in safety regulations and evasion of adverse event reporting. 

Chemical abortions constitute an ever-increasing percentage of total abortions, and related hospital visits are also sharply on the rise. Under current conditions, we could see an ongoing increase in abortion pill-related maternal deaths and injuries — as the abortion industry continues to abdicate any responsibility whatsoever for the actual well-being of its abortion clients.

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