Why Some Abortion Patients Go to the ER

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Today the United States Supreme Court heard oral arguments in the next threatened lawsuit restricting the availability of abortion pills throughout the country.

The main issue in this case is the safety of mifepristone, the first of two pills used for abortion. These drugs block important hormones in the body and have been approved by the US Food and Drug Administration since 2000.

That FDA approval is being challenged by a coalition of anti-abortion doctors and activists, the Alliance for Hippocratic Medicine, which is calling for the pill to be taken off the market. The group said that mifepristone is dangerous for patients, citing a 2021 scholarship who found the number of emergency room visits after abortion. However, the study was terminated in February after an independent review found problems with the way the authors analyzed and presented the data.

During Tuesday’s arguments, the main line of questioning from the jury was about ER visits after using mifepristone and whether the FDA’s liberalization of the drug in recent years has led to an increase in these visits.

“I think ER visits are the wrong way to look at safety,” says Michael Belmonte, ob-gyn and fellow at the American College of Obstetricians and Gynecologists. “It’s important to note that most people who go to the emergency room are going for a boost rather than a real concern.”

Belmonte says the most important thing is adverse events, which are extremely rare in medical abortion. “Bad things happen with any drug or procedure and, to be honest, the side effects that happen with these drugs are very rare compared to what we use every day,” he says.

Serious complications include hospital admissions, transfusions, morbidity, and death. In 2013 peer-reviewed research found that, among the 233,805 medical abortions performed in 2009 and 2010, these major events or side effects were reported in 1,530 cases, less than 1 percent.

“Many women can go [to the ER] because they are experiencing a lot of bleeding, which is similar to a miscarriage, and they may need to know if they have a problem or not,” said US Attorney Elizabeth Prelogar, who is defending the FDA, in oral arguments on Tuesday.

Belmonte says it’s worth noting that birth control pills are designed to reduce bleeding and cramping. Although the results may be difficult for some patients, the drug’s activity is a sign that it is working. “Mifepristone only prepares the uterus to move, so, naturally, mifepristone alone does not cause bleeding, pain, or other side effects,” he says. Misoprostol, the second drug used in medical abortions, causes bleeding and cramping.

Ushma Upadhyay, a public health scientist at UC San Francisco who studies abortion, says many patients who go to the emergency department after a medical abortion panic because of the bleeding it causes, but that doesn’t mean they’re having an abortion. a very bad experience. He said: “When people have an abortion with medicine, they abort themselves, and they don’t have a caregiver to ask them questions.” “People are going to the ER to understand if the blood they’re dealing with is healthy and to see if the medication has worked.”

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