A report published in a medical journal warns emergency room doctors to be on high alert for women with an undiagnosed ectopic pregnancy that took the abortion pill instead of acknowledging the dangers associated with the Food and Drug Administration loosening restrictions. 

The paper, published on January 19 in the New England Journal of Medicine titled, Discovery of an Ectopic Pregnancy after Attempted Self-Managed Abortion, describes a case involving a 22-year-old patient who had taken the abortion pill showing signs of an ectopic pregnancy. The report was authored by Isabel Beshar, a resident at Stanford Medical school, and several of her colleagues.

“A history of recent medical abortion (including self-managed abortion) without previous confirmation of intrauterine pregnancy, a history of previous ectopic pregnancy or previous tubal surgery, the presence of an intrauterine device, or ultrasound findings of abdominal free fluid should increase concern for ectopic pregnancy,” the report reads. 

According to the paper, “Clinicians should routinely assess beta human chorionic gonadotropin (hCG) in patients of reproductive age presenting with abdominal pain and consider the possibility of ectopic pregnancy.” 

The report seems to be missing or outright ignoring the lack of in-person medical supervision surrounding the abortion pill, the reason why women who undergo chemical abortions face this health risk in the first place.

Reprotection has had concerns about women with an undiagnosed ectopic pregnancy undergoing the chemical abortion pill regimen ever since the FDA lifted the in-person requirements for mifepristone in December 2021. We raised similar fears when the FDA announced on January 3 that it had modified restrictions, allowing certified pharmacies to dispense mifepristone. 

By not requiring women to meet with a provider before taking the pill and making this dangerous drug easier to access, the risk of women with an undiagnosed ectopic pregnancy undergoing the chemical abortion pill regimen increases.

Mifepristone and misoprostol, the two drugs used in a chemical abortion, cannot treat an ectopic pregnancy, a life-threatening condition where a pregnancy implants in an extrauterine location. 

A woman who takes the abortion pill without first ruling out this condition may think the pain and bleeding she’s experiencing are side effects associated with the chemical abortion. She may not even know that she’s bleeding to death until it’s too late. 

While the report advises emergency room doctors to keep an eye out for such patients, it fails to acknowledge that, by the time a woman arrives at the emergency room, her life may already be in danger. The time to be concerned about women experiencing complications from a chemical abortion is before she’s even prescribed the abortion pill. 

In addition, a 2021 peer-reviewed longitudinal study conducted by the Charlotte Lozier Institute found that the rate of emergency room visits after a chemical abortion increased by over 500% from 2002 through 2015. The researchers also noted that by 2015, 60.9% of emergency room visits due to chemical abortion pill complications were miscoded as miscarriages. 

Abortion facilities and abortion pill dispensaries that provide women with these drugs before ruling potential pregnancy complications need to be held accountable. That’s why Reprotection continues to be on the lookout for cases involving gross negligence of women’s safety, ensuring they and their unborn children are no longer harmed by the chemical abortion pill regimen.