The Real Reason Some Abortion Pill Patients Go to the Emergency Room

Today, the U.S. Supreme Court heard oral arguments in a major case that could lead to Restrict medical abortion nationwide.

A central issue in the case is the safety of the drug mifepristone, the first in a two-pill regimen of pills used for abortions that blocks hormones needed for pregnancy and has been in use since 2000 Approved by the U.S. Food and Drug Administration.

The FDA approval is being challenged by the Hippocratic Medical Alliance, a coalition of anti-abortion doctors and activists, which is calling for the drug to be removed from the market.The organization claims mifepristone is dangerous to patients, citing Study in 2021 Higher rates of emergency room visits were found after medical abortion. However, The study was retracted in February An independent review identified issues with the way the authors analyzed and presented the data.

One of the main questions raised by the justices during Tuesday’s arguments was about emergency room visits following the use of mifepristone and whether the FDA’s loosening of regulations on the drug in recent years has led to an increase in those visits.

“I think emergency room visits are absolutely the wrong thing to do from a safety standpoint,” said Michael Belmonte, MD, an obstetrician-gynecologist and fellow at the American College of Obstetricians and Gynecologists. “It’s important to realize that the vast majority of people who go to the emergency room are suffering from an emergency. The room was set up for reassurance rather than a real safety issue.”

The more important metric, Belmont said, is serious adverse events, which are extremely rare in medical abortion. Use it every day,” he said.

Major adverse events included hospital admission, transfusion, infection, and death. A 2013 peer review research The study found that of the 233,805 medical abortions provided in 2009 and 2010, these major adverse events or outcomes were reported in 1,530, or less than 1%.

“A lot of women might go [to the ER] Because they are experiencing heavy bleeding, which is similar to a miscarriage, they may just need to know if they have complications,” U.S. Deputy Attorney General Elizabeth Prelogar, defending the FDA, said during oral arguments Tuesday.

Belmont said it’s important to note that abortion pill regimens can cause bleeding and cramping. While these effects may be unsettling for some patients, this is the function of the drug and a sign that it is working. “Mifepristone actually just prepares the uterus to empty. So, essentially, mifepristone alone won’t cause any bleeding, cramping or other side effects,” he said. Misoprostol, the second drug used in medical abortion, is responsible for the bleeding and cramping.

Ushma Upadhyay, a public health social scientist at the University of California, San Francisco, who studies medical abortion, said many patients who go to the emergency room after a medical abortion are shocked by bleeding caused by the drug, but that doesn’t mean they are experiencing a medical abortion. “When people have medical abortions, they go through it alone and don’t have a provider with them to ask questions,” she said. “People go to the emergency room to find out if the bleeding they’re experiencing is normal and to evaluate whether the medication is working. . “

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