What’s Magical About Abortion Pills?

An abortion advocacy group, Reproaction, has a national campaign called “Abortion Pills are Magic.” As you browse their website, you find they label their stance on abortion as “progressive.” They unapologetically push for easier access to abortion and an absolute right to abortion. They represent the extreme of the pro-choice end of the spectrum. 

Magical Unicorns

Estimated reading time: 11 minutes

Their vision statement says (emphasis added)

Reproaction’s vision is to uphold abortion rights and advance reproductive justice as a matter of human dignity. We introduce a new culture of accountability, and empower and inspire the reproductive rights movement and the broader progressive community to openly and enthusiastically stand up for abortion rights.

Their closely-related mission statement also specifically addresses abortion:

Reproaction’s mission is to increase access to abortion and advance reproductive justice.

 

The Campaign

They have several national campaigns: “Stop Prosecuting Abortion,” calling out “Big Pro-Life,” “Protect Roe,” and others. However, the national campaign I have seen come across my social media the most is “Abortion Pills are Magic.” They post this phrase often to their Twitter, Facebook, and Instagram accounts and have a special graphic just for this campaign. On their website, the campaign details are sparse:

“Don’t want to be pregnant?

No problem.

Abortion pills work.

When used correctly, abortion pills are 95 [percent] effective using the standard protocol, and serious complications occur in less than 0.4 [percent] of patients who use it, according to the Guttmacher Institute. That makes abortion statistically safer than a tonsillectomy, giving birth, and even crossing the street!

Sign our petition now to say you believe in the power of abortion pills, and you think it’s time for politicians to get over themselves and make it easier for people to obtain the safe, effective, and magic abortion pills they want.”

It makes sense that a group so devoted to expanding legal abortion access would organize national campaigns to urge lawmakers to do just that. And perhaps unsurprisingly, they provide no details for any of the claims made in their campaign. They seem afraid to put everything out there while trying to convince people that abortion is a positive good.

I want to take a closer look at Reproaction’s claims to see what they’re hiding and help pro-life people be able to formulate a response to them. As outlandish as their claims are, Reproaction is serious about their abortion advocacy.

 

Claim #1: Abortion Pills Fix Unwanted PregnancyMagical abortion pills image

Don’t want to be pregnant?

No problem.

Abortion pills work

As obvious as this should be to anybody, abortion pills are a form of abortion. And because Reproaction won’t tell you how abortion pills work, just that they do, I’ll go ahead an let you in on what they want to be a secret: they suffocate the embryo, cut it off from its source of nutrition, and expel it from a hospitable environment into a lethal environment. You can read more about it here.

Since abortion kills a human organism (science, not philosophy) and pro-life people believe all human organisms are persons (philosophy, not science), pro-life people believe abortion is a grave moral wrong. But even if abortion were not morally wrong (if it did not kill a person), abortion does kill a human organism. The number of people I have come across personally who do not understand human development and biology or how abortion procedures work is astounding. To completely gloss over the fact that abortion kills by framing it as a “fix” to unwanted pregnancy is euphemistic. What’s more, it contributes to continued ignorance of basic facts about pregnancy and abortion, which people should be aware of whether they are considering the “procedure” or arguing for a viewpoint. Many prominent pro-choice activists admit that abortion kills human organisms, and even human persons, but this hasn’t filtered down to the average pro-choice person.

It’s not like this “fix” is risk-free, either. In fact, to imply medical abortion is a quick and easy fix to the problem of unwanted pregnancy is a problem itself. Medical abortion is not as easy or “safe” as advocates like to claim (see Claim 2, below).

Additionally, the decision to get an abortion is not usually as easy as this campaign makes it sound. In reality, most women getting an abortion don’t want an abortion; they want a way out of a difficult situation and abortion seems like the best (or only) option. Reducing the complex and varied reasons women seek abortion in the first place down to “don’t want to be pregnant?” ignores the root causes of abortion-seeking for a vast majority of women and does nothing to help address these causes. Abortion advocates and pro-life advocates alike would do well to not make women considering or seeking abortion feel ignored, overlooked, alienated, or boxed into a stereotype. 

Another aspect to this claim is that the tone makes pregnancy seem like an unfortunate surprise outcome of sexual activity. But anyone engaging in consensual sexual activity must, by definition, be giving informed consent, which means understanding that pregnancy is a reasonably foreseeable outcome of sexual activity and no birth control or contraceptive method prevents pregnancy 100 percent of the time. To treat pregnancy as a surprise outcome to sexual activity is actually condescending and infantilizing to women and men alike. Who are they talking to—adult women, or seven-year-olds asking mom and dad where babies come from? If you’re supporting easy access to abortion, maybe don’t also act like people engaged in sexual activity are doing so ignorant of the basic biological fact that sex can cause pregnancy. 

 

Claim #2: Abortion Pills Are Totally Safe

When used correctly, abortion pills are 95 [percent] effective using the standard protocol, and serious complications occur in less than 0.4 [percent] of patients who use it, according to the Guttmacher institute. That makes abortion statistically safer than a tonsillectomy, giving birth, and even crossing the street!

What is the standard protocol? What are “serious complications”? What exactly from Guttmacher are they referencing? Reproaction just makes assertions without evidence or sources and apparently expects this to be convincing enough to get people on board.

Reproaction doesn’t define any terms or give specific citations, so we’re going to have to make some assumptions. It appears they are referencing Guttmacher’s overview of medical abortion in Evidence You Can Use: Medication Abortion, from November 2019. Let’s also assume the “used correctly” and “standard protocol” terms mean FDA-approved protocols based on drug trials before approval of the medication and later trials after approval. According to the FDA, the current approved protocol for administering and prescribing Mifeprex (mifepristone) is:

Day One: MIFEPREX Administration
One 200 mg tablet of MIFEPREX is taken in a single oral dose.
Day Two or Three: Misoprostol Administration (minimum 24-hour interval between MIFEPREX and misoprostol)

Four 200 mcg tablets (total dose 800 mcg) of misoprostol are taken by the buccal route.

The “95 percent effective” stat seems to be factual. Reproaction doesn’t tell us what it means for the pills to be effective. However, if we’ve assumed the correct Guttmacher source, Guttmacher cites a review from Doctors Chen and Creinin which defines an effective abortion as “complete expulsion of the pregnancy without need for surgical intervention.”

According to the FDA, complete abortion—the embryo or fetus died, everything is expelled from the uterus, no surgery or second round of medication is needed—occurs over 97 percent of the time overall based on the U.S. drug trials (a little lower for non-U.S. trials). The numbers from the Chen and Creinin review are pretty much in line with the FDA’s, with some numbers a little higher or lower, likely because the definition each source is using is different.

However, they also claim less than half a percent of women experience “serious complications.” Keep in mind, normal side effects which are reasonably expected from a medical abortion (besides bleeding for up to a month) include:

  • Nausea: 51–75 percent
  • Weakness: 55–58 percent
  • Fever/chills: 48 percent
  • Vomiting: 37–48 percent
  • Headache: 41–44 percent
  • Diarrhea: 18–43 percent
  • Dizziness: 39–41 percent

Again, we have to assume what they mean by “serious” since they do not tell us. The FDA defines “serious adverse reactions” from clinical trials in the U.S. as including:

  • Blood transfusion: 0.03–0.5 percent
  • Sepsis: 0.2 percent
  • Hemorrhaging: not directly reported on in any clinical trial! However, treatment for excessive bleeding using vasoconstrictor drugs was needed for 4.3 percent of women and surgery for about 1 percent of women. Acute blood loss signaled by a decrease in hemoglobin was present in 5.5 percent of the women.
  • ER visits: 2.9–4.6 percent 
  • Hospitalization: 0.04–0.6 percent 
  • Surgical intervention, including for ongoing pregnancy, was needed 2.6 percent of the time (surgical intervention can also be used for excessive bleeding or for incomplete abortions). 

The Chen and Creinin review includes reported on the following severe adverse effects:

  • Blood transfusion: 0.02–0.6 percent 
  • Infection: 0.01–0.9 percent 
  • Emergency department visits: 2.9–3.7 percent
  • Hospitalization: 0.04–1.3 percent
  • Surgical intervention for reasons not including ongoing pregnancy was reported 1.8–8.9 percent of the time. The authors even admit that some of the severe adverse outcomes, like ER visits and hospitalizations, are not well-tracked. And yes, women have died from the medication abortion regimen.

While the U.S. does not require reporting on abortion to a central agency (like the CDC), many smaller European countries do require reporting of all abortions, and patient outcomes can be tracked using all of the medical records linked to any one patient. These types of studies can give a more accurate picture of the effects of abortions pills on women. For example, two record-linkage studies in Finland done by the same authors have shown between 6–10 percent of adult women have an incomplete abortion, 6–13 percent needed surgical evacuation, about 2 percent experience infection, and about 15 percent experience hemmoraghing. Similar studies in Sweden showed 4 percent of women had an incomplete abortion, 1.9 percent had bleeding (heavy bleeding longer than 12 hours, or constant bleeding for >21 days, not the expected bleeding from the medication), and 1.2 percent got an infection—and the number of women experiencing one or more of these complications increased with the number of abortions done per year. 

While some of these serious adverse outcomes are below the cited 0.4 percent, some are above that threshold by many factors, even with the lowest number for the reported range. So how is Guttmacher, and by extension Reproaction, coming to this “less than 0.4 percent” conclusion?

As far an abortion being safer than a tonsillectomy (24 percent chance of delayed hemorraghing), that depends on which which serious complication you compare (there are plenty to choose from). And abortion being safer than childbirth? That idea comes from a single publication where the authors conducted a very poor statistical analysis. Dr. John Ferrer already debunked this claim in his excellent article

 

Claim #3: Abortion Pills Are Powerful and Magical

Sign our petition now to say you believe in the power of abortion pills, and you think it’s time for politicians to get over themselves and make it easier for people to obtain the safe, effective, and magic abortion pills they want.

This claim glosses over why abortion pills are powerful. I agree, they are powerful. Anything which kills a human could be labeled “powerful.” Abortion pills don’t make someone un-pregnant, they terminate the condition of pregnancy by killing the prenatal human. They’re powerful in pretty much the same way they’re safe: a small, weak human dies, but we choose not to care about that person.

Using the terms “magical” and “magic” make abortion seem like a positive good. In reality, many people see abortion as a necessary evil, a last resort, or at least a decision not to be taken lightly. Instead of merely downplaying the negative, possibly very dangerous side effects and complications of medical abortions, Reproaction is actively trying to make medical abortions sound good and empowering.

 

Claim #4: Access Is Only Restricted Because Politicians Can’t Get Over Themselves

This claim makes abortion legislation seem to be made at the mere whim of clueless or malicious male politicians. To Reproaction, there clearly can’t be any reason to oppose freely available abortion pills besides a desire to control women’s bodies and oppose women’s rights. The desire to oppose killing humans would be one good pro-life justification.

But not all politicians in support of abortion regulations are men, or Republican, or conservative, or religious, or old, or even “pro-life.” One does not have to be any of those things to understand at the very least that some amount of regulation is needed. Regulation isn’t just to protect the woman who is seeking an abortion from the side effects of the pills themselves, but also from people seeking abortion for her. Less regulation around access means a greater possibility that someone who is not the pregnant woman can buy the medication online and give it to her without her knowledge or consent. In fact, stories like this have already made their way to the news. Regulation like this should be a point of common ground between pro-choice and pro-life people, but groups like Reproaction want more abortion, not safer abortion. After all, the majority of Americans agree there should be regulations on abortion, not completely free and unfettered access to them.

 

Final Thoughts

Framing abortion as magic is condescending. You’re talking to grown, adult women. Stop acting as if you’re talking to an 8 year old child who loves Disney princesses and still believes just wishing for things can make them come true. Treat us like adults. Tell us the truth.

If abortion really is so good and wonderful and empowering, you should be able to tell us the truth about what abortion is and what it does to a living human being, and be confident that will be enough to convince us that abortion is good, wonderful, and empowering. By glossing over the truth, ignoring it, or outright lying to us in your attempt to make abortion more palatable, you show you don’t actually trust us to believe the same way you do on abortion. You have to outright lie, spin the truth, or dance around it to help us buy into your narrative. I wonder why?

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Petra is a Kansas City native who transplanted to Columbus, OH in 2014 to attend graduate school at Ohio State University. She got her B.S. in chemistry from UMKC and her M.S. in chemistry from OSU, studying DNA polymerases and HIV RNA.

She worked at OSU in the chemistry and biochemistry departments and now works full-time at Heartbeat International, helping connect pregnant and worried women with local life-affirming resources to get the help and support they need.

In her free time, she is a writer, editor, and the Content Director for the Human Defense Initiative, has written for Pregnancy Help News, and gives presentations about the pro-life viewpoint and movement to anyone willing to give her a captive audience. Petra is passionate about the pro-life movement and strives to find ways to use her science background and teaching experience to speak up for the most vulnerable humans among us.

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