NRL News

Mifepristone complications less than one percent?

by | May 19, 2023

That’s not what the data really show

By Randall K. O’Bannon, Ph.D. NRL Director of Education & Research

In the recent hearing at the U.S. Fifth Circuit Court on the U.S. Food and Drug Administration’s approval the abortion pill mifepristone, government lawyer Sarah Harrington claimed that “the rate of serious complications is well less than 1 percent,” a statistic that was picked up and repeated in media accounts all across the country.

This also reflects the abortion industry’s constant refrain about the safety of the pill–the claims and spin of handpicked studies by mifepristone’s biggest promoters, regularly assuring the public that complications are few and far between.

But a closer look at those studies, and at more objective data obtained by researchers who do not have such strong ties to the abortion industry, reveals a much different story.

Top abortion researcher reports higher complication rates

A 2015 study of emergency room visits by University of California, San Francisco researcher Ushma Upadhyay is one of those often cited as proof that the rate of serious complications is “less than 1%.” Indeed, in “Incidence of emergency department visits and complications after abortion,” from the January 2015 issue of Obstetrics & Gynecology, Upadhyay officially found that “The major complication rate was 0.23%,” less than a quarter of one percent.

But this depends on several questionable moves to finesse the data. 

First, Upadhyay specifically limits what can be counted as a “serious” or “major” complication.

“Major complications were defined as serious unexpected adverse events requiring hospital admission, surgery, or blood transfusion,” the article asserts. “Minor complications were all other expected adverse events.”

While this sounds reasonable, consider the things included in Upadhyay’s “minor complications”: hemorrhage, infection, incomplete or “failed” abortion requiring “uterine aspiration” (i.e., surgical abortion). Even things like “uterine perforation” were classified as “minor.”

Second, with this knowledge, consider that when Upadhyay added in and counted both major and “minor” complications, the complication rate for chemical abortions was 5.19% – considerably higher than the “less than one percent” advertised.

Finally, calling these complications “minor” diminishes the significance of the fact that these incidents were sufficiently serious to prompt more than one out of every twenty abortion pill patients to visit their local emergency room. 

And this was among only those who somehow revealed their chemical abortion attempt when many abortionists were telling them they didn’t have to.

Other more objective studies confirm high complication rates

That isn’t the only published study to reveal high numbers of complications.

A Canadian study appeared earlier this year in the online edition of the Annals of Internal Medicine (January 3, 2023) by Ning Liu and Joel G. Ray, two researchers from the University of Toronto. They found even higher complication rates among patients picking up mifepristone prescriptions from pharmacies, similar to the protocol recently authorized here.

Among the 39,856 patients in that study, emergency room visits were reported by 10.3% — at least one out of every ten patients.

Experience with chemical or “medication abortion” in Britain tracks with the higher numbers reported in these studies.  Kevin Duffy is a former executive from international family planning giant Marie Stopes. He found that 5.9% of chemical abortion patients who were treated during the United Kingdom’s “Pills by Post” program (where mifepristone was mailed to women’s homes during COVID), experienced complications connected to incomplete abortions or “retained products of conception.”

There is more. Three percent of women there required surgery to deal with incomplete abortions and 2.3% of these patients were treated in Britain’s National Trust hospitals for hemorrhage (Percuity, 10/27/21)

This was while the British government was officially only identifying just one single complication among 23,061 chemical abortion patients between April and June of 2020. (The New Statesman, 12/15/20.)

This is consistent with information recently being reported in the newspapers about increased calls to ambulances during this time.  These calls jumped during the “Pills by Post” program, increasing by more than 50% in some areas, up at least 25% in others. (“Home abortion pills spark major review demand as emergency call outs double in some areas,” Daily Express [London], April 25, 2023. This can be found at, accessed 5/10/23.)

FDA label shows higher rates of “adverse reactions”

Though Harrington was repeating this “less than one percent” myth to the judges in last Wednesday’s court session, the lawyer for the litigants, Alliance for Hippocratic Medicine, was pointing to the FDA’s own admission of a much higher figure on its official label for the abortion drug.

On page 8 of the FDA Mifeprex label (“Mifeprex” is the trade name of the mifepristone pill sold by Danco in the U.S.)., under the “ADVERSE REACTIONS”  subhead, there is a chart titled “Table 2: Serious Adverse Reactions Reported in Women Following Administration of Mifepristone (oral) and Misoprostol (buccal) in U.S. and Non-U.S. Clinical Studies.”  In that table, the FDA shows that the studies it relied upon found that 2.9-4.6% of women visited the emergency room.

Again, these are only going to be among those women who revealed their attempted chemical abortions to ER staff or researchers.  Women today are often advised that they don’t have to make that information known to hospital staff, that they can simply tell them they are experiencing a miscarriage and that doctors won’t be able to tell the difference.

Industry spin versus a much more dangerous reality

The point here is simply that the “less than one percent” complications rate is abortion industry spin, not scientific reality. The real numbers tell us that these abortion pills send a considerable number of women to the emergency room with complications that they (and many of the rest of us) consider quite serious.

And if the current administration gets its way and these start being sold at pharmacies and shipped to women’s homes by overnight mail, the situation is only going to get worse.

Categories: Abortion Pill