Are Abortion Pills Safe? Here's the Evidence.
The Times reviewed 101 studies of medication abortion and found that they are safe for terminating a pregnancy.
Over 100 scientific studies have been conducted across continents and decades to examine the safety and effectiveness of the abortion pills commonly used in America, mifepristone & misoprostol. All studies conclude that the pills can be used to safely terminate a pregnancy.
Each of the small icons represents a study on medication abortion.
The icons are rearranged and grouped according to the number of participants in each study. The majority of the studies had a small sample of less than 1,000 patients, while five of them had more than 10,000.
The New York Times, in consultation with medical researchers and covering more than 124,000 first-trimester abortions, reviewed 101 studies.
The icons are grouped by region. The majority of studies were conducted in North America, South America, Asia and Europe.
Sample sizes varied from as few as 19 patients to as large as a total of 20,000.
The icons are grouped by decade. The majority of the events took place between 2000 and 2010, followed by the 2000s.
The study took place in 26 different countries across continents.
It lasted for more than 30 Years.
In a vast majority of studies, it was reported that over 99 percent of patients taking the pill did not experience any serious complications. Some of these uncommon complications include hospitalizations, blood transfusions, or major surgery.
Abortion pills: safety and effectiveness
Patients who do not suffer serious complications
A histogram indicating that the majority of studies reviewed in The Times Review found that patients did not have serious complications.
50 studies
40
In 86 out of 101 studies, there were almost no patients.
There were serious complications.
30
20
10
Safety is less than safe
Safer
0
20
40
60
80
100%
10 studies
20
30
40
50
100%
Safe and Secure
In 86 out of 101 studies, there were almost no patients.
There were serious complications.
80
Safer
60
40
Safety is less than safe
20
0
Abortion providers claim that pills are safer than common drugs like Tylenol or Viagra. Drug safety experts don't usually compare drugs this way. Instead, they assess the safety of each medication in comparison to other options.
If a pregnant woman is considering medication abortion as an alternative, she can choose childbirth or procedural abort.
Serious Complication Rates
Abortion by procedure
Patients with 0.16% of the total number of patients
Medication Abortion
0.31%
Childbirth
1.4%
Sources: Ushma UPadhyay (University of California San Francisco, 2015 study); Centers for Disease Control and Prevention, 2014 study
Dr. Caleb Alexander is a professor of medicine and epidemiology at the Johns Hopkins Bloomberg School of Public Health and co-director of Center for Drug Safety and Effectiveness.
Anti-abortion groups have asked the federal judge in the United States to block the use of these drugs to end pregnancies despite the fact that there is a long scientific record that shows their safety. They claim they are dangerous.
A ruling in favor of the plaintiffs, if upheld by the higher courts, could change the abortion landscape across the nation, where over half of all abortions are performed with medication. The drugs are usually used during the first 12 weeks.
The anti-abortion group's complaint states that 'the use of these two chemicals abortion drugs causes significant harms and injuries to pregnant women and young girls'.
The plaintiffs use a few studies to prove this harm. None of these contradict the research presented in the Times review. The cited studies instead point out common and expected patient experiences, such a bleeding and pain or experiences which are not clear measures of serious complications such as visits the emergency room following taking the pills.
Most patients experience pain and bleeding during an abortion medication, as the pills are essentially what triggers a miscarriage.
Abortion pills: Side effects and complications
Mild
Most cases resolve without medical intervention.
Nausea
Diarrhea
Vomitting
Headache
Dizziness
Fever, heat or chills
Moderate
Medical intervention is usually requested by the patient or necessary.
After incomplete abortion, you need to take certain steps.
Uterine infection requiring antibiotics
Emergency Room Visit
Serious
Can cause serious health problems without medical attention.
Hospitalization for serious complications
Blood transfusion
Infection requiring hospitalization
Death
It's not pleasant. It's natural for people to worry about whether the bleeding is normal or if pregnancy tissue has been lost, said Ushma UPadhyay a professor of reproductive science at the University of California in San Francisco.
Some patients will visit the emergency room if they are concerned about bleeding or side effects. However, Dr. Upadhyay’s research has shown that the majority of patients do not experience serious complications.
While the pills are effective in about 95 percent of cases, 3 to 5 percent require an additional procedure for removal of remaining tissue or termination of pregnancy. The providers say that these situations are not dangerous.
Dr. Adam R. Jacobs is the medical director for complex family planning at Mount Sinai Hospital, New York. Still very safe with low risks of complications.
The plaintiffs in the lawsuit filed against the U.S. Food and Drug Administration, which seeks to ban the use of these pills, cited five studies as evidence that they cause harm. Three of them were conducted by researchers from Finland and two others from the Charlotte Lozier Institute (an arm of Susan B. Anthony Pro-Life America).
Citation in F.D.A. A lawsuit
A diagram compares the research papers cited in the F.D.A. The plaintiffs of a lawsuit against medication abortion cite papers from the F.D.A.
The conclusion of medication
Abortion is safe
Do not Measure
Safety is paramount
Citation by the
Plaintiffs
Citation
F.D.A.
The conclusion of medication
Abortion is safe
Safety is not measured
Citation
F.D.A.
Citation by the
Plaintiffs
Note: Studies which did not measure safety were those that did report serious complications.
One of the studies cited in court by plaintiffs only reports serious complications associated with the use of abortion pills within the typical 12-week period used in the United States. Two other studies looked at safety later in pregnancy.
This study examined records of more than 40,000 medication-induced abortions performed in Finland during the early 2000s. The study reported that 20% of patients visited a clinic, mostly for bleeding but also for procedures to complete the abortion and evacuate the uterus.
Plaintiffs and anti-abortion organizations claim that the 20 percent figure in this study indicates a high level of risk for complications following the use of the pills. The study notes that bleeding can be expected, complications are rare, and medication abortions are safe.
Eight scientific studies on medical abortion.
The Times Review published 101 studies, which all found that medication abortions were safe and effective.
In an interview, Dr. OskariHeikinheimo said that groups against abortion are misinterpreting data. He is the author of the Finland Study and professor of Obstetrics and Gynecology at University of Helsinki.
Dr. Heikinheimo stated that the correct way to do science is to examine all of the evidence. If you only pick the results you like, that is pure nonsense.
In response to the lawsuit, Dr. Donna Harrison said that other researchers call moderate what she considers serious complications.
She said, 'I agree that you cannot pick and choose what results you want.' You have to consider what this means for the women.
The risk of death is one of the most important indicators of medication safety. Researchers reported that among the 101 studies and the 124,000 medication-induced abortions included in the Times review of the Times, one death was caused by an infection associated with the abortion and another death occurred from a cause unrelated to the abortion.
U.S. Food and Drug Administration reports that since 2000, when the FDA approved the regimen, approximately 5.6 millions women in the United States have taken the pills. 28 of them, or 0.0005 per cent, died. Some of these deaths could have been due to other causes, according to the agency.
Methodology
The New York Times examined 147 research articles published that evaluated the safety and efficacy of mifepristone during the first three months of pregnancy. These papers were used in five systematic reviews on medication abortion and were published between 1991 and 2023. The Times included research studies that were used by the F.D.A. In its medical reviews, the Times included research studies used by the F.D.A.
In many studies, the number of patients who experienced'serious negative events' was reported. These included hospitalizations, major surgeries, or infections that were serious. Usually, adverse events are reported for emergency department or clinic visits that do not include these treatments or follow-up procedures, which may be routine but rare, to complete an abortion. The Times calculated the percentage of patients who did not suffer serious complications by counting serious adverse events.
The Times excluded 46 studies from its analysis. Either because they only reported on common side effects, but did not specify if there were any serious adverse events, or their data was not accurate enough to count. The excluded studies did not conclude that the pills were unsafe.
The Times considered any serious adverse events, such as hospitalizations, major surgery, infections, or deaths, that were reported in studies without specifying the severity of those events. The Times discounted serious complications such as heart disease and dengue fever, which were not related to the medication abortion. The Times removed duplicate counts of patients who faced more than one serious problem. However, this may have led to a slight reduction in the calculated safety rate.
The Times asked for the opinions of several researchers, including experts in drug safety and authors of systematic reviews on abortion safety. The researchers included:
Ushma UPADHYAY, professor at the University of California San Francisco, with Advancing New Standards in Reproductive Health.