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Yahoo
3 days ago
- General
- Yahoo
Abortion opponents are coming for mifepristone using what medical experts call ‘junk science'
Packages of Mifepristone tablets are displayed at a family planning clinic on April 13, 2023, in Rockville, Maryland. (Photo illustration by) Using flawed studies and scientific journal publications, abortion opponents are building a body of research meant to question the safety of the abortion pill mifepristone, a key target for the movement. The effort comes as federal officials have expressed a willingness to revisit the drug's approval — and potentially impose new restrictions on a medication used in the vast majority of abortions. This report was originally published by The 19th. The Illuminator is a founding member of the 19th News Network. Mainstream medical researchers have criticized the studies, highlighting flaws in their methodology and — in the case of one paper published by the conservative think tank Ethics and Public Policy Center (EPPC) — lack of transparency about the data used to suggest mifepristone is unsafe. The vast body of research shows that the drugs used in medication abortion, mifepristone and misoprostol, are safe and effective in terminating a pregnancy. 'There's a proliferation of anti-abortion propaganda right now. I think it is a coordinated attack on mifepristone,' said Ushma Upadhyay, an associate professor at the University of California, San Francisco who studies medication abortion. Released in April, the EPPC paper suggests that mifepristone results in serious adverse events for 1 in 10 patients — substantially higher than the widely accepted figure of .3 percent complication rate most research has attributed to the pill. The paper appears to count what other researchers say are non-threatening events, such as requiring follow-up care to complete the abortion, or visiting an emergency room within 45 days of an abortion — even if the patient did not end up requiring emergency care — as serious adverse effects. That paper also did not go through peer review, a standard process for scientific research in which other scholars review a study's findings and methodology before it can be published. Another paper, a commentary piece published this week in the journal BioTech, challenges the commonly cited statistic that mifepristone has a lower complication rate than acetaminophen, or Tylenol, tracing the history of the comparison and arguing that it is mathematically flawed. The paper's author, Cameron Loutitt, is a biomedical engineer by training and director of life sciences at the Charlotte Lozier Institute, a research arm of the anti-abortion group SBA Pro-Life America. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX 'My hope is that this paper sparks action in my peers in the research and medical community to more critically evaluate these unfounded claims regarding abortion drug safety,' Loutitt said in a statement. Days later, a group of researchers from the institute published another study, this one arguing that emergency rooms are likely to identify medication abortions as miscarriages, which they say increases the risk of needing hospital care. A miscarriage and a medication abortion are medically indistinguishable, and patients will sometimes visit an emergency room to ensure the drugs worked, or if they suspect possible complications. In places where abortion is illegal, patients may also tell health care providers they experienced a miscarriage to minimize their legal risk. Studies like the Lozier Institute paper suggest complications from medication abortions are being undercounted. That study was rejected by another journal on April 12 before being published this week, noted Upadhyay, who had served as a peer reviewer in that rejection process. A similar paper written by many of the same researchers behind the Lozier Institute's was retracted a year ago by the journal that published it, along with two others suggesting mifepristone was unsafe. 'They keep trying to publish the same junk science,' Upadhyay said. James Studnicki, the Charlotte Lozier Institute's director of data analytics, who led the second of its new anti-abortion papers and the study retracted last year, did not respond to a request for comment. But a spokesperson for the institute said the organization is challenging last year's retraction through an arbitration process. This March, Studnicki said in a statement that the retraction placed 'politics over publication ethics.' These studies and papers all fall outside the scientific consensus. More than 100 studies over decades of research have found that mifepristone — and the medication abortion regimen as a whole — has a low complication rate and is very safe to use for abortions. Papers like these aren't new, and their scientific accuracy has long been questioned. But the bevy of new reports and analyses comes at a moment when abortion opponents may have more influence in shaping public policy. Mifepristone restrictions are a top priority for the anti-abortion movement. About two-thirds of all abortions in the United States are now done using medication. Even in states with abortion bans, pregnant people have increasingly turned to abortion medication, which they receive from health providers in states with laws protecting abortion. Nationwide, about 1 in 5 abortions are now performed using telehealth; almost half of those are for people in states with bans or restrictions. Mifepristone is currently approved for use through 10 weeks of pregnancy. Health and Human Services Secretary Robert F. Kennedy Jr. testified before a Senate committee that he has directed the Food and Drug Administration to review the approval of mifepristone, citing the EPPC paper specifically. Jim O'Neill, who is nominated for a deputy secretary role, has also said he is in favor of a 'safety review' of the drug — a move that could result in new restrictions on how it is prescribed. Meanwhile, physicians and researchers are highlighting the rigor of the FDA approval process. 'FDA approval of mifepristone must reflect the rigorous clinical evidence that has proven unequivocally that it is safe and effective for use in medication,' 13 reproductive medical organizations, including the American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine, said in a statement after Kennedy indicated the drug may undergo a new FDA review. 'Mifepristone has been used for decades for abortion and miscarriage management by millions of patients, and complications are exceedingly rare, minor, and most often easily treatable.' The International Institute for Reproductive Loss, an anti-abortion nonprofit, has explicitly prioritized the publication of research that supports restrictions on medication abortion. Presenting at an anti-abortion conference last September, that organization's science director, Priscilla Coleman, highlighted strategies that she said could help result in the retraction of studies showing mifepristone's safety, such as finding 'agenda-driven, poorly developed and conducted studies published in peer-reviewed journals' and writing to journal editors. Coleman did not respond to a request for comment. Though no scientific consensus has changed, anti-abortion lawmakers have rallied around the suggestion that complications are common. In a private Zoom meeting reported on by Politico, abortion opponents cited the EPPC paper as a potential tool to justify further restrictions on mifepristone — even while acknowledging that the report is 'not a study in the traditional sense' and 'not conclusive proof of anything.' Sen. Josh Hawley, a Republican from Missouri, cited the EPPC paper in a letter to FDA Commissioner Marty Makary, who had only a day before the report's publication indicated openness to reviewing mifepristone's approval if new evidence emerged. 'The time to act is now. It is time to revisit and restore the FDA's longstanding safety measures governing mifepristone,' Hawley wrote. His office did not reply to a request for further comment. 'They're producing this terrible 'science' because they don't have any real science that backs them up. And all they've gotten from the administration is, 'Yeah, we'll study it,'' said David Cohen, a law professor at Drexel University who has advised state legislatures on crafting abortion-protetctive laws. Through the courts and Trump administration, abortion opponents have pushed to reverse a 2021 FDA decision allowing mifepristone to be distributed via telehealth. In addition to calling for the in-person requirement to be reinstated, abortion opponents are asking for restrictions such as the dispensation of the drug to require three in-person visits, and for mifepristone to only be approved for use only in the first seven weeks of pregnancy. Many have also argued the drug should be taken off the market entirely. The Trump administration said on the campaign trail that it would leave abortion policy up to the states. So far, there has been little indication from the federal government that such changes are imminent. 'Pills are kind of just spreading, as we predicted, without almost any restriction and so far the anti-abortion movement hasn't figured out what to do,' Cohen said. SUPPORT: YOU MAKE OUR WORK POSSIBLE This story was originally reported by Shefali Luthra of The 19th. Meet Shefali and read more of her reporting on gender, politics and policy.
Yahoo
4 days ago
- General
- Yahoo
Abortion opponents are coming for mifepristone using what medical experts call 'junk science'
Using flawed studies and scientific journal publications, abortion opponents are building a body of research meant to question the safety of the abortion pill mifepristone, a key target for the movement. The effort comes as federal officials have expressed a willingness to revisit the drug's approval — and potentially impose new restrictions on a medication used in the vast majority of abortions. Mainstream medical researchers have criticized the studies, highlighting flaws in their methodology and — in the case of one paper published by the conservative think tank Ethics and Public Policy Center (EPPC) — lack of transparency about the data used to suggest mifepristone is unsafe. The vast body of research shows that the drugs used in medication abortion, mifepristone and misoprostol, are safe and effective in terminating a pregnancy. 'There's a proliferation of anti-abortion propaganda right now. I think it is a coordinated attack on mifepristone,' said Ushma Upadhyay, an associate professor at the University of California, San Francisco who studies medication abortion. Released in April, the EPPC paper suggests that mifepristone results in serious adverse events for 1 in 10 patients — substantially higher than the widely accepted figure of .3 percent complication rate most research has attributed to the pill. The paper appears to count what other researchers say are non-threatening events, such as requiring follow-up care to complete the abortion, or visiting an emergency room within 45 days of an abortion — even if the patient did not end up requiring emergency care — as serious adverse effects. That paper also did not go through peer review, a standard process for scientific research in which other scholars review a study's findings and methodology before it can be published. Another paper, a commentary piece published this week in the journal BioTech, challenges the commonly cited statistic that mifepristone has a lower complication rate than acetaminophen, or Tylenol, tracing the history of the comparison and arguing that it is mathematically flawed. The paper's author, Cameron Loutitt, is a biomedical engineer by training and director of life sciences at the Charlotte Lozier Institute, a research arm of the anti-abortion group SBA Pro-Life America. 'My hope is that this paper sparks action in my peers in the research and medical community to more critically evaluate these unfounded claims regarding abortion drug safety,' Loutitt said in a statement. Days later, a group of researchers from the institute published another study, this one arguing that emergency rooms are likely to identify medication abortions as miscarriages, which they say increases the risk of needing hospital care. A miscarriage and a medication abortion are medically indistinguishable, and patients will sometimes visit an emergency room to ensure the drugs worked, or if they suspect possible complications. In places where abortion is illegal, patients may also tell health care providers they experienced a miscarriage to minimize their legal risk. Studies like the Lozier Institute paper suggest complications from medication abortions are being undercounted. That study was rejected by another journal on April 12 before being published this week, noted Upadhyay, who had served as a peer reviewer in that rejection process. A similar paper written by many of the same researchers behind the Lozier Institute's was retracted a year ago by the journal that published it, along with two others suggesting mifepristone was unsafe. 'They keep trying to publish the same junk science,' Upadhyay said. James Studnicki, the Charlotte Lozier Institute's director of data analytics, who led the second of its new anti-abortion papers and the study retracted last year, did not respond to a request for comment. But a spokesperson for the institute said the organization is challenging last year's retraction through an arbitration process. This March, Studnicki said in a statement that the retraction placed 'politics over publication ethics.' These studies and papers all fall outside the scientific consensus. More than 100 studies over decades of research have found that mifepristone — and the medication abortion regimen as a whole — has a low complication rate and is very safe to use for abortions. Papers like these aren't new, and their scientific accuracy has long been questioned. But the bevy of new reports and analyses comes at a moment when abortion opponents may have more influence in shaping public policy. Mifepristone restrictions are a top priority for the anti-abortion movement. About two-thirds of all abortions in the United States are now done using medication. Even in states with abortion bans, pregnant people have increasingly turned to abortion medication, which they receive from health providers in states with laws protecting abortion. Nationwide, about 1 in 5 abortions are now performed using telehealth; almost half of those are for people in states with bans or restrictions. Mifepristone is currently approved for use through 10 weeks of pregnancy. Health and Human Services Secretary Robert F. Kennedy Jr. testified before a Senate committee that he has directed the Food and Drug Administration to review the approval of mifepristone, citing the EPPC paper specifically. Jim O'Neill, who is nominated for a deputy secretary role, has also said he is in favor of a 'safety review' of the drug — a move that could result in new restrictions on how it is prescribed. Meanwhile, physicians and researchers are highlighting the rigor of the FDA approval process. 'FDA approval of mifepristone must reflect the rigorous clinical evidence that has proven unequivocally that it is safe and effective for use in medication,' 13 reproductive medical organizations, including the American College of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine, said in a statement after Kennedy indicated the drug may undergo a new FDA review. 'Mifepristone has been used for decades for abortion and miscarriage management by millions of patients, and complications are exceedingly rare, minor, and most often easily treatable.' The International Institute for Reproductive Loss, an anti-abortion nonprofit, has explicitly prioritized the publication of research that supports restrictions on medication abortion. Presenting at an anti-abortion conference last September, that organization's science director, Priscilla Coleman, highlighted strategies that she said could help result in the retraction of studies showing mifepristone's safety, such as finding 'agenda-driven, poorly developed and conducted studies published in peer-reviewed journals' and writing to journal editors. Coleman did not respond to a request for comment. Though no scientific consensus has changed, anti-abortion lawmakers have rallied around the suggestion that complications are common. In a private Zoom meeting reported on by Politico, abortion opponents cited the EPPC paper as a potential tool to justify further restrictions on mifepristone — even while acknowledging that the report is 'not a study in the traditional sense' and 'not conclusive proof of anything.' Sen. Josh Hawley, a Republican from Missouri, cited the EPPC paper in a letter to FDA Commissioner Marty Makary, who had only a day before the report's publication indicated openness to reviewing mifepristone's approval if new evidence emerged. 'The time to act is now. It is time to revisit and restore the FDA's longstanding safety measures governing mifepristone,' Hawley wrote. His office did not reply to a request for further comment. 'They're producing this terrible 'science' because they don't have any real science that backs them up. And all they've gotten from the administration is, 'Yeah, we'll study it,'' said David Cohen, a law professor at Drexel University who has advised state legislatures on crafting abortion-protetctive laws. Through the courts and Trump administration, abortion opponents have pushed to reverse a 2021 FDA decision allowing mifepristone to be distributed via telehealth. In addition to calling for the in-person requirement to be reinstated, abortion opponents are asking for restrictions such as the dispensation of the drug to require three in-person visits, and for mifepristone to only be approved for use only in the first seven weeks of pregnancy. Many have also argued the drug should be taken off the market entirely. The Trump administration said on the campaign trail that it would leave abortion policy up to the states. So far, there has been little indication from the federal government that such changes are imminent. 'Pills are kind of just spreading, as we predicted, without almost any restriction and so far the anti-abortion movement hasn't figured out what to do,' Cohen said. The post Abortion opponents are coming for mifepristone using what medical experts call 'junk science' appeared first on The 19th. News that represents you, in your inbox every weekday. Subscribe to our free, daily newsletter.
Yahoo
13-02-2025
- Health
- Yahoo
Republican states claim zero abortions. A red state doctor calls that 'ludicrous'
This is a . In Arkansas, state health officials announced a stunning statistic for 2023: The total number of abortions in the state, where some 1.5 million women live, was zero. In South Dakota, too, official records show zero abortions that year. And in Idaho, home to abortion battles that have recently made their way to the U.S. Supreme Court, the official number of recorded abortions was just five. In nearly a dozen states with total or near-total abortion bans, government officials claimed that zero or very few abortions occurred in 2023, the first full year after the Supreme Court eliminated federal abortion rights. MORE: Fighting for their lives: Women and the impact of abortion restrictions in post-Roe America Those statistics, the most recent available and published in government records, have been celebrated by anti-abortion activists. Medical professionals say such accounts are not only untrue but fundamentally dishonest. "To say there are no abortions going on in South Dakota is ludicrous," said Amy Kelley, an OB-GYN in Sioux Falls, South Dakota, citing female patients who have come to her hospital after taking abortion pills or to have medical procedures meant to prevent death or end nonviable pregnancies. "I can think of five off the top of my head that I dealt with," she said, "and I have 15 partners." For some data scientists, these statistics also suggest a troubling trend: the potential politicization of vital statistics. "It's so clinically dishonest," said Ushma Upadhyay, a public health scientist at the University of California-San Francisco, who co-chairs WeCount, an academic research effort that has kept a tally of the number of abortions nationwide since April 2022. The zeroing out is statistically unlikely, Upadhyay said, and also runs counter to the reality that pregnancy "comes with many risks and in many cases emergency abortion care will be needed." "We know they are sometimes necessary to save the pregnant person's life," she said, "so I do hope there are abortions occurring in South Dakota." State officials reported a sharp decline in the official number of abortions after the Supreme Court overruled Roe v. Wade in June 2022. Arkansas reported zero abortions in 2023, compared with 1,621 in 2022. Texas reported 60 in 2023, after reporting 50,783 abortions in the state in 2021. Idaho reported five in 2023 compared with 1,553 in 2021. South Dakota, which had severely restricted abortions years ahead of the Dobbs ruling, reported zero in 2023 compared with 192 abortions in 2021. Anti-abortion politicians and activists have cited these statistics to bolster their claims that their decades-long crusade to end abortion is a success. "Undoubtedly, many Arkansas pregnant mothers were spared from the lifelong regrets and physical complications abortion can cause and babies are alive today in Arkansas," Rose Mimms, executive director of Arkansas Right to Life, said in a press statement. "That's a win-win for them and our state." A spokesperson for the Arkansas Department of Health, Ashley Whitlow, said in an email that the department "is not able to track abortions that take place out of the state or outside of a healthcare facility." State officials, she said, collect data from "in-state providers and facilities for the Induced Abortion data reports as required by Arkansas law." WeCount's tallies of observed telehealth abortions do not appear in the official state numbers. For instance, from April to June 2024, it counted an average of 240 telehealth abortions a month in Arkansas. Groups that oppose abortion rights acknowledge that state surveillance reports do not tell the full story of abortion care occurring in their states. Mimms, of Arkansas Right to Life, said she would not expect abortions to be reported in the state, since the procedure is illegal except to prevent a patient's death. "Women are still seeking out abortions in Arkansas, whether it's illegally or going out of state for illegal abortion," Mimms told KFF Health News. "We're not naive." MORE: Abortion ballot initiatives could have helped Harris win, instead Trump overperformed The South Dakota Department of Health "compiles information it receives from health care organizations around the state and reports it accordingly," Tia Kafka, its marketing and outreach director, said in an email responding to questions about the statistics. Kafka declined to comment on specific questions about abortions being performed in the state or characterizations that South Dakota's report is flawed. Kim Floren, who serves as director of the Justice Empowerment Network, which provides funds and practical support to help South Dakota patients receive abortion care, expressed disbelief in the state's official figures. "In 2023, we served over 500 patients," she said. "Most of them were from South Dakota." "For better or worse, government data is the official record," said Ishan Mehta, director for media and democracy at Common Cause, the nonpartisan public interest group. "You are not just reporting data. You are feeding into an ecosystem that is going to have much larger ramifications." When there is a mismatch in the data reported by state governments and credible researchers, including WeCount and the Guttmacher Institute, a reproductive health research group that supports abortion rights, state researchers need to dig deeper, Mehta said. "This is going to create a historical record for archivists and researchers and people who are going to look at the decades-long trend and try to understand how big public policy changes affected maternal health care," Mehta said. And now, the recordkeepers "don't seem to be fully thinking through the ramifications of their actions." Abortion rights supporters agree that there has been a steep drop in the number of abortions in every state that enacted laws criminalizing abortion. In states with total bans, 63 clinics have stopped providing abortions. And doctors and medical providers face criminal charges for providing or assisting in abortion care in at least a dozen states. Practitioners find themselves working in a culture of confusion and fear, which could contribute to a hesitancy to report abortions -- despite some state efforts to make clear when abortion is allowed. For instance, South Dakota Department of Health Secretary Melissa Magstadt released a video to clarify when an abortion is legal under the state's strict ban. The procedure is legal in South Dakota only when a pregnant woman is facing death. Magstadt said doctors should use "reasonable medical judgment" and "document their thought process." Any doctor convicted of performing an unlawful abortion faces up to two years in prison. MORE: A state-by-state breakdown of where abortion stands after ballot initiatives pass In the place of reliable statistics, academic researchers at WeCount use symbols like dashes to indicate they can't accurately capture the reality on the ground. "We try to make an effort to make clear that it's not zero. That's the approach these departments of health should take," said WeCount's Upadhyay, adding that health departments "should acknowledge that abortions are happening in their states but they can't count them because they have created a culture of fear, a fear of lawsuits, having licenses revoked." "Maybe that's what they should say," she said, "instead of putting a zero in their reports." For decades, dozens of states have required abortion providers to collect detailed demographic information on the women who have abortions, including race, age, city, and county -- and, in some cases, marital status and the reason for ending the pregnancy. Researchers who compile data on abortion say there can be sound public health reasons for monitoring the statistics surrounding medical care, namely to evaluate the impact of policy changes. That has become particularly important in the wake of the Supreme Court's 2022 Dobbs decision, which ended the federal right to an abortion and opened the door to laws in Republican-led states restricting and sometimes outlawing abortion care. Isaac Maddow-Zimet, a Guttmacher data scientist, said data collection has been used by abortion opponents to overburden clinics with paperwork and force patients to answer intrusive questions. "It's part of a pretty long history of those tools being used to stigmatize abortion," he said. In South Dakota, clinic staff members were required to report the weight of the contents of the uterus, including the woman's blood, a requirement that had no medical purpose and had the effect of exaggerating the weight of pregnancy tissue, said Floren, who worked at a clinic that provided abortion care before the state's ban. "If it was a procedural abortion, you had to weigh everything that came out and write that down on the report," Floren said. The Centers for Disease Control and Prevention does not mandate abortion reporting, and some Democratic-led states, including California, do not require clinics or health care providers to collect data. Each year, the CDC requests abortion data from the central health agencies for every state, the District of Columbia, and New York City, and these states and jurisdictions voluntarily report aggregated data for inclusion in the CDC's annual "Abortion Surveillance" report. In states that mandate public abortion tracking, hospitals, clinics, and physicians report the number of abortions to state health departments in what are typically called "induced termination of pregnancy" reports, or ITOPs. Before Dobbs, such reports recorded procedural and medication abortions. But following the elimination of federal abortion rights, clinics shuttered in states with criminal abortion bans. More patients began accessing abortion medication through online organizations, including Aid Access, that do not fall under mandatory state reporting laws. At least six states have enacted what are called "shield laws" to protect providers who send pills to patients in states with abortion bans. That includes New York, where Linda Prine, a family physician employed by Aid Access, prescribes and sends abortion pills to patients across the country. MORE: What could abortion access look like under Trump? Asked about states reporting zero or very few abortions in 2023, Prine said she was certain those statistics were wrong. Texas, for example, reported 50,783 abortions in the state in 2021. Now the state reports on average five a month. WeCount reported an average of 2,800 telehealth abortions a month in Texas from April to June 2024. "In 2023, Aid Access absolutely mailed pills to all three states in question — South Dakota, Arkansas, and Texas," Prine said. Texas Attorney General Ken Paxton filed a lawsuit in January against a New York-based physician, Maggie Carpenter, co-founder of the Abortion Coalition for Telemedicine, for prescribing abortion pills to a Texas patient in violation of Texas' near-total abortion ban. It's the first legal challenge to New York's shield law and threatens to derail access to medication abortion. Still, some state officials in states with abortion bans have sought to choke off the supply of medication that induces abortion. In May, Arkansas Attorney General Tim Griffin wrote cease and desist letters to Aid Access in the Netherlands and Choices Women's Medical Center in New York City, stating that "abortion pills may not legally be shipped to Arkansas" and accusing the medical organizations of potentially "false, deceptive, and unconscionable trade practices" that carry up to $10,000 per violation. Good-government groups like Common Cause say that the dangers of officials relying on misleading statistics are myriad, including a disintegration of public trust as well as ill-informed legislation. These concerns have been heightened by misinformation surrounding health care, including an entrenched and vocal anti-vaccine movement and the objections of some conservative politicians to mandates related to COVID-19, including masks, physical distancing, and school and business closures. "If the state is not going to put in a little more than the bare minimum to just find out if their data is accurate or not," Mehta said, "we are in a very dangerous place." Republican states claim zero abortions. A red state doctor calls that 'ludicrous' originally appeared on
