Today, the abortion pill will kill considerably more children than surgical abortion in the United States. Accessible online and through the mail, there are virtually no barriers to procuring the drug, which was created for the singular purpose of killing the child in the womb. And not surprisingly, the drug is incredibly dangerous to the women who ingest it.
But we cannot allow Washington to discuss the maternal safety data and not the child fatality data that go along with it. We cannot end abortion without talking about its primary victim. A landmark study by the Ethics and Public Policy Center, the largest of its kind ever conducted, analyzed insurance claims from 865,727 mifepristone abortions between 2017 and 2023. What researchers found should concern every physician, regulator, and policymaker in America: More than 1 in 10 women who take the chemical abortion drug suffer a serious adverse event within 45 days. Sepsis. Hemorrhage. Life-threatening infection. The real-world serious adverse event rate is at least 22 times higher than what appears on the drug label — the same label the Food and Drug Administration and the drug’s manufacturer, Danco Laboratories, have used to market mifepristone as “safe and effective.”
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It is not.
Despite the dangers, the FDA tore down the minimal safety requirements that once stood between the abortion drug industry, a pregnant woman, and her child. Once requiring in-person dispensing, abortion drugs are now delivered to the doorstep of anyone who orders them, including abusive men. All of this deserves serious, sustained attention. The FDA should reinstate robust patient safety protocols immediately. Manufacturers should be required to report serious adverse events fully and honestly, and Congress should demand accountability.
But I want to be clear about something, because the policy world has a way of letting us talk about women’s health as a proxy for the deeper question.
The biggest problem with chemical abortion drugs is not the failure rate. It is not the hemorrhage rate. It’s not the environmental impact. It is not even the dishonesty of regulators and pharmaceutical companies that buried evidence of harm. All of those things matter.
The real problem is that these drugs kill a developing human being.
That is their purpose. That is what they do. Mifepristone blocks progesterone, the hormone that sustains a pregnancy, and misoprostol expels the child whose life has been ended. Some drugs that are used off-label for abortion have good and legitimate uses. Misoprostol, for instance, saves lives in obstetric emergencies and, unlike mifepristone, was never designed with the intent of causing harm. But it is evil to use any drug, chemical, herb, or device to kill an innocent child. The “product” these drugs deliver when they’re marketed for abortion is a dead baby. Every safety study, every policy debate, every FDA hearing is conducted in deliberate silence about that central fact.
When we build an entire regulatory and medical framework around a drug whose purpose is to end a human life, and we refuse to name that purpose plainly, we distort everything downstream. We evaluate “effectiveness” by how reliably the child dies. We measure “safety” by the harm to the mother while treating the child’s death as a neutral outcome, even a successful one. We grant pharmaceutical companies the cultural immunity that comes from serving a politically protected cause, and women pay for it in sepsis and hemorrhage and trips to emergency rooms that their doctors were never told about.
The EPPC study is valuable precisely because it strips away one layer of that distortion. It shows that the drug doesn’t even serve women well on its own terms, that the “safe and effective” promise is a marketing claim, not a medical reality. That matters. Women deserve the truth about what they are taking and what it may do to their bodies.
But the fuller truth is this: No drug should be FDA-approved, manufactured, distributed, or prescribed for the purpose of ending a child’s life. Not in the mail. Not in a clinic. Not with a physician present and a crash cart nearby. The method of delivery is not the moral crux. The act itself is.
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Policy debates require precision, and I understand why advocates focus on the medical harms that are documentable and legally actionable. But precision without candor produces bad policy. We can pursue FDA reform, reinstate dispensing requirements, mandate adverse event reporting, and challenge telemedicine loopholes — and we should do all of those things. But we should do them as part of an honest reckoning, not as a substitute for one.
The chemical abortion drug debate is, at its foundation, a debate about who counts as a human being. Until we are willing to have that debate plainly, every reform we win will be incomplete.
Clare Ath is the senior policy analyst at Human Coalition, one of the largest pro-life organizations in the nation, which operates a network of telecare and brick-and-mortar women’s care clinics across the country.
