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Fr Flader: US Supreme Court decision on abortion pill

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US abortion pill decision - The Catholic Weekly

I understand many women hurt by abortion are angry about a recent US Supreme Court decision that allows the sale of a drug that causes an abortion. Can you tell me more about it?  

On 13 June 2024, the US Supreme Court ruled that abortion drugs can remain on the market. The background is that in 2000 the Food and Drug Administration (FDA), which approves pharmaceutical products for sale to the public, allowed the sale of the abortion drug Mifepristone (RU486), usually used in conjunction with Misoprostol (Cytotec) to end a pregnancy by medical means.

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The case before the court was brought by emergency room doctors, who have to deal with the traumatic effects of adverse reactions to the drugs.

The case alleged that the FDA was arbitrary and capricious in approving the drugs without the need for minimal safeguards, as well as in removing the reporting of almost all adverse events, in not requiring a physician to prescribe the drug, and in allowing it to be mailed out directly to the user.

An amicus brief, signed by 2743 women who had suffered severe adverse reactions, was tendered as part of the case.

The Supreme Court, in a unanimous decision, rejected the case on the technical grounds that the doctors did not have standing to bring it before the court. Obviously, this opens the way for a subsequent case to be brought by those who do have standing.

The safeguards are important, and they are common practice virtually everywhere the drugs are used. In France, for example, medical abortions using these drugs must be performed at government-operated hospitals and clinics, typically with or adjacent to emergency room facilities.

Women are screened for numerous medical conditions that rule out use of the two drugs. An ultrasound is used to determine the gestational age and to rule out tubal pregnancy.

After women are given the drugs, they are monitored on site for approximately four hours, with their blood pressure taken every half hour, so that allergic reactions, cardiopulmonary “events,” haemorrhaging and the like can be treated promptly before they become life-threatening.

The doctor must also ensure that electrocardiogram equipment and resuscitative cardiopulmonary equipment are at hand.

It is interesting to note that Searle, the pharmaceutical company which manufactures Misoprostol under the brand name Cytotec, has consistently opposed the use of that drug for labour induction and abortion.

A 23 August 2000 letter from Searle, posted on the FDA’s website, reiterates its opposition to these off-patent uses and lists “serious adverse events” that have been reported: “maternal and foetal death; uterine hyperstimulation, rupture or perforation requiring uterine surgical repair, hysterectomy or salpingo-oophorectomy; amniotic fluid embolism; severe vaginal bleeding, retained placenta, shock, foetal bradycardia and pelvic pain.”

Searle’s Cytotec patent expired in July 2000 so the drug is now off-patent.

In the US, without a prescription from a doctor, the woman can have the drugs mailed to her directly, so that she can use them at home to bring about the abortion.

There are no safeguards in the event of adverse reactions, which have been numerous and severe. Use of the drugs at home is especially popular in states where abortion is now prohibited or greatly restricted as a result of the Supreme Court’s 2022 decision overturning Roe versus Wade.

It is estimated that medical abortions account for nearly two-thirds of all abortions in the US.

The amicus brief, relating some of the hundreds of thousands of adverse reactions, makes for horrifying reading.

Without going into the detail related in the brief, the reactions experienced at home included heavy bleeding and passing clots the size of lemons for as much as eight weeks, the woman fearing that she was going to die, fainting, intense cramping, pain greater than any experienced before—even in childbirth—vomiting, nausea, the woman flushing the aborted baby down the toilet with all the trauma involved, and the feeling of guilt, shame and regret.

One woman described it as the most traumatic experience of her life.

Let us pray that another case will be brought so that the Supreme Court can give a decision that redresses these issues.

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