NRL News

Relentless push for mail order RU-486 altogether ignores women’s safety

by | Dec 29, 2017

By Randall K. O’Bannon, Ph.D. and Dave Andrusko

A forthcoming study in the journal Contraception, already promoted and publicized by pro-abortion media outlets, is a classic illustration of the extent to which the abortion industry is pushing chemical abortifacients without even a semblance of scientific rigor. While “Exploring the feasibility of obtaining mifepristone and misoprostol from the internet” has the trappings of a serious study, in fact, it lacks data, controls, or concern for the women who would be taking the two drugs at home without a prescription and without medical supervision of any kind.

The authors, a virtual rogues gallery of pro-abortion partisans, bury the absence of precautions in a landfill of exaggerated benefits.

The objective seems modest enough: “We aimed to document the experience of buying abortion pills from online vendors that do not require a prescription and to evaluate the active ingredient content of the pills received.” But in English that means researchers from Gynuity Health Projects were studying what the results might be if women could purchase mifepristone and misoprostol by mail order to use at home. So they sought RU-486 from 20 websites to see if they worked—that is, were they effective at killing the unborn child.

The authors say that while certain of the pills may have been “substandard” and the ordering process “suboptimal,” this method is nonetheless “feasible” for women who want to chemically abort but for some reason either can’t or don’t want to go to the clinic. As we shall see, this is simply not proven. Note as well the way the ordering process is constructed, a third party—not the woman—could buy the abortifacients, even in bulk.

NRL News Today has written many stories about boyfriends who have slipped chemical abortifacients into their girlfriend’s drink, causing her to lose her baby. Online purchases without a prescription would only aggravate the problem.

The Contraception study also reveals how the abortion establishment not only defends but promotes the online sales of these drugs, and how this fits in with their long-term plans for expanding the use of the abortion pill in the United States.

Chemical abortion protocols

The standard chemical abortion today is far different that what was recommended in 2000 when it was approved by the FDA for use in the United States. It now involves taking a single pill of mifepristone (RU-486) to shut down the supply of essential nutrients to the baby, then a second set of prostaglandin pills (misoprostol) taken a day or so later, to stimulate powerful uterine contractions to expel the tiny corpse. Some women, following the advice of groups like those involved in this study, have tried using the cheaper, easier to find, misoprostol alone to abort, though this is less effective than the mifepristone-misoprostol combination.

What the study found

Researchers in four states–TX, WA, CA, and NY–acted as “mystery shoppers” (their own words) looking for abortion pills on the internet that sellers said they would ship to the U.S. Over a four month period from December 2016 to March 2017, they identified and ordered 22 products from 18 different websites.

Multiple problems were found with the shipments. None of the suppliers required a prescription or any relevant medical information, in spite of the fact that certain physical conditions render use of the drugs ineffective or dangerous to women. Pills were shipped without any instructions on use, even though the pills are supposed to be taken in certain amounts and in a certain order.

Some of the drug packets came with small pinprick punctures that may have partially “degraded” or spoiled the contraction-inducing misoprostol used in tandem with mifepristone. Nothing on the packaging indicated they contained pharmaceutical products, much less chemical abortifacients, which required any special handling.

The Contraception study mentions three groups by name who have actively promoted on-line sales of abortion pills who say they will not ship to the U.S. Those include Women on Waves, Women Help Women, and safe2choose. (We have written about two of these before here and here). Though they take orders for abortion pills on their websites, these groups say that they only make “information” available to women in the U.S.

This is the background against which this latest marketing study has been done. While we perhaps do find out something about how easy (or not) it is to obtain abortifacients online in the U.S., we certainly learn more about the intentions of abortion activists in this country.

How deep is the penetration of the American market?

It is deeply troubling that unscrupulous entrepreneurs would try to turn a few quick bucks by selling knockoff abortion pills from a couple of rogue Indian labs, but not surprising. The internet is being used to sell drugs, legitimate or otherwise.

Foreign companies began to develop generic copies of the new French abortion pill once they figured out the formula and saw there was a market. By 2014, mifepristone was being sold under more than sixty different names from manufacturers in at least a dozen countries (

Although it is clear that online sellers exist, most of the drug companies have publicly shied away from the American market. Why?

It may be that the U.S. has had its own version (made in China) available for sale since 2000. Or it could be that an import restriction and an official warning from the FDA has frightened a few off. (A few of the suppliers in this study expressed concern to their “customers” that they were being “investigated.”)

Research with an agenda

To understand the point and purpose of the study one only needs to go as far as the author list. Despite claims that the “Authors report no conflicts of interest,” two come from “Plan C,” a group whose online home page opens with the question “Did you know there is a safe, private option for an at-home abortion?”

The other three are associated with Gynuity, a “research and technical assistance” organization specifically devoted to bringing products like chemical abortions to the world.

One of the authors, Beverly Winikoff, is not only Gynuity’s president, but prior to that, she was part of the Population Council where as Director for Reproductive Health and a Senior Medical Associate she was instrumental in bringing RU-486, the “abortion pill,” to the U.S.

The abortion pill was developed in the 1980s because surgical abortion had become increasingly unpopular among women. Clinics were closing, the ranks of abortionists were thinning, and the number of abortions were dropping.

Chemical abortion offered the industry the chance at a new non-surgical alternative that did not require trained surgeons or expensive fully equipped surgical centers.

The abortion pill was approved in the United States in September of 2000. The dosage was specific–three pills of mifepristone, two pills of misoprostol); its use was limited to pregnant women 49 days or fewer past their last menstrual period; the pills were under the supervision of a physician; and the protocol required three separate office visits.

From the very beginning, promoters of the abortion pill chafed at any conditions or limits on distributing or prescribing the pills. The distributor agreed to whatever limits they had to in order to obtain FDA approval, but once it had approval in hand, the industry (through the National Abortion Federation) put forward its own protocol.

They altered doses, reducing mifepristone from three pills to one, boosting the misoprostol from two pills to four. They also eliminated the return visit for administration of the prostaglandin. This gave women the opportunity to take the pills at home. Moreover, they extended the cutoff from 49 days LMP to 10 weeks LMP.

The Obama FDA eventually accepted all of these changes in 2016.

Even that was too much for some, especially the requirement that the abortionist had to meet the woman and deliver the pills in person. This led to the web-cam abortion, where a woman’s screening and counseling takes place over a computer monitor and an abortionist in another city remotely triggers a drawer releasing the drugs there at some storefront location.

Groups like Gynuity and Plan C find even this too burdensome. They have sought instead to have the pills sold over the counter at the local pharmacies or to have these drugs sold over the internet and delivered by mail.

This is the context for this latest “study.”

Gynuity’s broader objectives

It is no coincidence that Gynuity, over the last year or so, has been involved in a separate study of its own (perhaps more correctly identified as a campaign) studying the “feasibility” of abortion by mail in Washington, Oregon, Hawaii, and New York. Women in that study find Gynuity on the internet, do an online consult, make arrangements with a local doctor for certain needed tests, and then have Gynuity ship them the drugs via overnight mail.

This is, of course, quite similar to the process Gynuity and Plan C are examining in the Contraception study, albeit with a few additional, and very minimal, safeguards. That makes this touted “scientific study” very close to just basic marketing research or even competitor surveillance.

This helps to explain why the authors walk a fine line. They raise issues with the product and practices of some of the random online abortion pill retailers, but stop short of condemning the concept. While they admit there were problems with some of the batches that they received and how these orders were handled, they want people to know that the idea is “feasible” and that there was “no evidence” that the pills sold online were “dangerous or ineffective.”

They don’t want to do anything to impede the market they’re hoping will be there if their study convinces the FDA to explicitly authorize this online mail order method.

In other words, they admit that it’s all a bit messy with a couple of opportunistic marketers of Indian generics, but want to emphasize no one has gotten hurt (yet, as far as we know). They wish to leave the impression that all these “minor” problems can be solved once the government authorizes online sales and allows “responsible” groups such as Gynuity, Plan C, Women on Web, Women Help Women and safe2choose with ties to reputable manufacturers, to operate.

They also want to try to make the case that the market and demand for such a product already exist, that women have already shown that they are going to do this anyway, and that the government might as officially authorize responsible groups like theirs.

Something else we learn: promoters of these pills aren’t worried about chemical abortion’s side effects and failures that have put hundreds of women in the hospital and are responsible more than a dozen deaths in the U.S. alone. All of this took place when the drugs were being dispensed under more rigorous conditions.

Their minimal concerns about degraded drugs, drugs that took more than two weeks to be delivered, and drugs that were ordered and failed to arrive, are not reassuring.

They simply want these drugs out there, preferably through programs like theirs, so that it is easier for more women to have abortions, without the industry having to find and train more abortionists or build more expensive clinics.

Editors note. Dr. O’Bannon is NRL Director of Education & Research.

Dave Andrusko is the editor of National Right to Life News Today.

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