New search estimates that there could be 56,700 additional maternal deaths in low- and middle-income countries due to disruption of healthcare due to COVID-19. In response to this tragic projection, abortion activist groups are pursuing expanded “medical abortion”, the termination of pregnancy usually by means of a combination of two drugs and often via “telemedicine”.
Euphemistically called “self-administered abortion”, the practice is marketed as the solution to the so-called skyrocketing number of unwanted pregnancies – a unconfirmed phenomenon the United Nations claims to have reached 7 million worldwide. Yet it is impossible to accurately predict the indirect toll of the virus, and speculation should in no way legitimize unexplored medical trends.
From a medical point of view, medical abortion is extremely dangerous. This practice will greatly exacerbate already high maternal mortality rates in low-resource countries and is a violation of the basic human rights of all women.
Regardless of where they are born, all women deserve excellent health care. Not only do drug-induced abortions fail to improve women’s health, they also pose significant risks to women in settings with inadequate infrastructure – a divide often accentuated in developing countries and manifesting itself according to racial and socio-economic criteria.
The World Health Organization is leading the charge on medical abortion as part of its COVID-19 advice, calling for limited interaction with providers and increased reliance on “self-management”. The WHO’s neglect to recommend highly dangerous interventions without immediate access to medical care is extremely relevant, especially since the United States withdraws from the organization and examines the prospect of self-managed medical abortion on home soil.
Far from what many “experts” claim, medical abortion is far from being an antidote to “unsafe abortion”. For example, a recent the report details how the Canadian organization The women on the Web provided Sudanese women with abortion pills by mail, in response to women asking to have abortions by traditional midwives since abortion is illegal. The organization, undeterred by Sudanese law, says the drugs carry “a very low risk of complications and resemble an early miscarriage.”
The complication rate of medical abortions is four times higher than that of surgical abortions, a devastating statistic that increases as a woman progresses through her pregnancy. At the best of times, medical abortions pose potentially catastrophic risks, which are sure to be compounded in situations of extreme poverty, such as in Sudan and throughout the developing world, where Women on Web is active and the practice takes place, unregulated and illegal.
Even in situations where medication is administered correctly, bleeding is unfortunately a common complication. Women can also suffer from fatal sepsis or ectopic pregnancy which, if not detected by ultrasound – a luxury in developing countries – can lead to rupture and death. Even if support is offered through “telemedicine,” how likely are these women to have easy access to internet and internet access devices?
A question that also arises is whether the woman, if she needs urgent medical attention, can go to the hospital and, once there, receive adequate care. For example, only 50 percent of the inhabitants of Burkina Faso live less than two hours from a hospital, an often impassable distance because women who have suffered obstetric haemorrhage do not have much time. Moreover, most of these facilities lack adequate surgical and blood transfusion capacity and low-income countries frequently suffer from severe blood shortages, which already contribute significantly to maternal mortality.
While medical abortion is considered “safe” during the first 10 weeks of pregnancy, women may be unable to accurately determine their pregnancy timeline, or may even be motivated to be dishonest if it means they may get an abortion. If administered too late, the result can be disastrous.
Additionally, in developing countries, an incomplete medical abortion regimen is often used (including only misoprostol) as opposed to the US Food and Drug Administration-approved dual regimen (mifepristone and misoprostol). The fact that this unique drug protocol is banned in the United States due to high rates of incomplete abortion, but is “acceptable” in Africa, is a gross inequity in the standard of care.
While FDA data on the dangers of medical abortion reveal thousands of adverse events and dozens of deaths, the majority of complications go unreported. As a result of lobbying efforts by numerous pharmaceutical companies, under current guidelines, the only adverse event that Homework to be reported is death.
Internationally, there are no data regarding the number of women seriously injured or killed due to medical abortion. It is safe to extrapolate, however, that the numbers can multiply exponentially in countries where poverty and lack of resources make it extremely difficult for women to receive the appropriate care they need.
Some may argue that women have the right to pursue medical abortion as long as they can give informed consent. But offering medical abortion as the only alternative to “unsafe abortion” does not constitute informed consent, especially when the real risks are hidden from women. They need real options and great health care.
Giving a woman pills and then leaving her to suffer alone not only from an abortion, but also from the probable complications, is a form of reproductive violence that no medical professional should sanction – much like “unsafe abortion “that he’s supposed to fight.
The international community should commit resources to interventions that have been proven to save lives. Evidence shows that basic improvements in emergency departments can reduce mortality by nearly half. At a time when our world is united in suffering from the COVID-19 pandemic, we must remember that women are in urgent need of better health care and better resources.
Women need real options to address rising maternal mortality through life-saving interventions, not self-administered death.
Dr. Christina Francis is a board-certified obstetrician-gynecologist and board chair of the American Association of Pro-life OB/GYNs. Elyssa Koren is Director of United Nations Advocacy for Alliance Defending Freedom International in New York, where she oversees ADF International’s United Nations headquarters and Geneva legal teams. Follow her on Twitter at Elyssa_ADFIntl.