What the Science Says About Mifepristone Abortion Drug

The Supreme Court has decided to keep the abortion pill mifepristone on the market—at least temporarily—after a Texas judge suspended its FDA approval earlier in April.

Mifepristone is the most common way to terminate a pregnancy through medication in the U.S. It is often taken with the drug misoprostol to induce an abortion, and can be taken during the first 10 weeks of pregnancy.

Challenges to the abortion pill—which has been FDA-approved for over 22 years—have been made over safety concerns.

On April 7, U.S. District Judge Matthew Kacsmaryk ruled in favor of a lawsuit filed by the anti-abortion organization Alliance for Hippocratic Medicine against the U.S. Food and Drug Administration (FDA). The lawsuit argued that the FDA never had the authority to approve mifepristone and that the approval should be rescinded.

In a separate ruling on the same day, U.S. District Judge Thomas Rice in Washington state, appointed by former President Barack Obama, issued a rival ruling, ordering the FDA to keep the abortion pill available in 17 states and the District of Columbia.

The Supreme Court's decision on Friday pauses Kacsmaryk's attempt to revoke federal approval of mifepristone, at least temporarily preserving nationwide access to the drug while legal arguments continue.

In science, however, there is no evidence to back up the safety concerns that have been raised. In fact, the abortion pill is considered safer than many medications, such as Tylenol.

"It's going to be life and death for women in America [if it is banned]," Sam Rowlands, a visiting professor at the Centre of Postgraduate Medical Research and Education and Department of Medical Science and Public Health at Bournemouth University in England, told Newsweek.

Rowlands, who co-authored the book Decriminalising Abortion in the UK: What Would It Mean?, said that U.K.-based data shows that with mifepristone and the other drugs available, abortion is 32 times safer than having a baby.

"So if you start intervening and stopping people having abortions, you're automatically subjecting them to a 32 times risk. So when these people say Mifepristone is unsafe, it's a complete lie. It's more risky to have an injection of penicillin than to have an early abortion with mifepristone," said Rowlands, who also conducted one of the first clinical trials of emergency contraception.

Mifepristone—which blocks the hormone progesterone that is needed for a pregnancy to continue—is deemed safe by the American Medical Association, the U.S. Department of Health and Human Services, the American College of Obstetricians and Gynecologists, the World Health Organization and more.

Over 780 medical reviews have looked into the drug, and evidence shows that major adverse events are "exceedingly rare," and only occur in around 0.3% of cases, the AMA reports.

The death rate surrounding medical abortions is also nearly zero. A 2022 study published in The New England Journal of Medicine, using data from Ontario, Canada, found that after mifepristone became available as a prescription, complications involving abortion remained stable, when compared to the period when the pill was unavailable.

Severe adverse events involving abortion occurred at a rate of 0.03 percent before the drug became available and 0.04 percent afterwards. Abortion complications before the drug became available were recorded at a rate of 0.74 percent, versus 0.69 percent afterwards.

Some 5.6 million women in the U.S. have taken mifepristone, as of June 2022, and there were 28 reports of deaths among women who took the drug between September 2000, when it was approved, and the end of June 2022, according to the FDA.

A 2013 study published in the National Library of Medicine, reviewing 87 different trials of the pill, found that using mifepristone with misoprostol was "highly effective and safe."

Likewise, a 2015 study published in Obstetrics & Gynecology found that medication-induced abortions—such as those using mifeprostine—had less "major complications" associated with them than procedural abortions.

Many have also argued that the abortion pill is safer than Viagra. Newsweek previously reported that this argument appears to be sound, as a review published in December on the adverse effects of Viagra found that over 2,000 deaths were associated with medication.

"There are over 100 studies that have been done in different countries around the world and they all show ... the safety [of mifepristone]," Rowlands said.

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