Chuck Donovan | The Washington Stand
Time magazine has made newly elected President Donald Trump its 2024 Person of the Year. It’s next to impossible to argue with the choice of a figure who has changed the course of American politics, launched a grassroots movement, endured federal and state prosecutions from his political opponents, and survived two assassination attempts that nearly took his life. In this same year, he has been extraordinarily open to the media, and he was again with editors and writers at Time, who spent more than an hour with the man who will be inaugurated for a second time in just a few weeks.
The interview covered a wide array of domestic and foreign policy themes, and it allowed more insight into Trump’s plans for the most common form of abortion, the two-pill regimen of mifepristone and misoprostol. The latest figures from the U.S. Centers for Disease Control, released on Thanksgiving Day as has become the custom, show that abortion by pill increased 4% from 2021 to 2022 and by 129% over the decade 2013-2022. Numbers from the pro-abortion Guttmacher Institute for 2023 peg the percentage of abortions-by-pill even higher, at more than 63% nationally.
Questioned about his intentions, where both he and Vice President-elect J.D. Vance have promised no limit on “access” to abortion polls, the president-elect left only the slimmest opening for review of the abortion drug. When Time asked, “Will you vow that your FDA will not do anything to limit access to medication abortion or abortion pills?” Trump replied at first, “Well, we’re going to take a look at all of that. That’s why I’m here. We’re going to take a look at all of that.” Pressed by the interviewer for a bottom line on blocking the pill, however, he went on and said:
“Look, I’ve stated it very clearly, and I just stated it again very clearly. I think it would be highly unlikely. I can’t imagine, but we’re looking at everything. But highly unlikely. I guess I could say probably as close to ruling it out as possible, but I don’t want to. I don’t want to do anything now. I want to do it at some point. There will be a time in the future where people are going to know everything about subjects like that, which are very complex subjects for people, because you have other people that … feel strongly both ways, really strongly both ways, and those are the things that are dividing up the country. But you know my stand from a very long, hard thing, and I think it’s highly unlikely that I ever change that. Is it 100% unlikely that I change or that I stay—”
The interviewer then pressed even harder and the president-elect’s last rejoinder regarding whether he would ensure FDA does not “strip access” was emphatic: “That would be my commitment. Yeah, it’s always been my commitment.”
The window for action on abortion drugs clearly seems narrow, but of course, the president is not the only actor in the drama, substantial though his political influence may be. Only intervention by then-President Bill Clinton secured the transfer of patent rights from the French company Roussel-Uclaf in the 1990s, allowing the Clinton Food and Drug Administration (FDA) to ram through an earlier version of the drug regimen known as RU-486 before the end of Clinton’s second term.
What other factors might influence the FDA to abandon incuriosity and take a deeper look at the impact of chemical abortion today? In truth, there are many, beginning with the relaxation of medical standards for its administration to women, the lack of comprehensive data on the drugs’ sequelae under changing conditions of use, and the manner of distribution of the drug that accommodates criminal activity and violations of the family home and parents’ rights.
Throughout his four years in office, President Biden loosened health requirements for prescription of the abortion pill, most importantly exploiting the COVID epidemic to end the FDA’s requirement for a woman to be seen by a certified prescriber in person before obtaining the drugs. In the last days of his administration, Barack Obama had acted similarly and extended the gestational age at which the drug could be lawfully dispensed from 49 days to 70 days (10 weeks) after the first day of the woman’s previous menstrual period (Planned Parenthood has its own 77-day limit, not approved by the FDA). Interest in potentially using these later in pregnancy continues.
Efforts by the American Association of Pro-Life Obstetricians and Gynecologists and other groups to check or reverse these changes continued through the Trump and Biden administrations with little success.
Meanwhile, evidence beginning with overseas studies and followed by fresh examinations of Medicaid claims data continued to show that chemical abortion, including at higher gestational ages, sends disproportionate numbers of women to emergency rooms (ERs) for treatment. A landmark study by the Charlotte Lozier Institute (CLI) in the peer-reviewed journal Health Services Research and Managerial Epidemiology documented these increases in November 2021, sparking a politically motivated decision by the journal publisher to retract the study and two others at the behest of an abortion activist in Georgia. CLI has filed suit over the retractions but at the same time has renewed its research initiative by publishing a new peer-reviewed paper documenting the acuity of the ER visits due to chemical abortion.
The new paper appeared in September 2024 in the International Journal of Epidemiology and Public Health Research. The authors of the paper took on the most salient criticism of the retracted papers, which was not leveled at the original paper’s findings of elevated emergency room visits but at the question of the severity of the medical conditions that led women to the ERs. Apart from its dismissal of women’s evident concerns about their well-being post-medical abortions, the criticism merely pointed to an additional question the Lozier authors deemed worthy of investigation.
The outcome: women’s ER visits post-chemical abortion were more than twice as likely to involve a “severe or critical acuity code” than visits made by women who were not pregnant during a comparable time frame. Moreover, visits after starting a chemical abortion were significantly more likely than for visits by women who had either had a surgical abortion or live birth.
The FDA has more than sufficient grounds — and indeed has a positive public health obligation — to examine the impact of its decisions to move to chemical abortions later in pregnancy, without an initial medical visit with a prescribing doctor, and with no requirement on treating personnel to report any injury to the woman beyond a fatal outcome. Taken in combination, the FDA’s decision, driven by White House ideology under the Obama and Biden presidencies, is a vast experiment on women’s health with no plan to collect data and monitor the impact on a host of potential adverse outcomes. All of this leaves aside the poignant questions about the impact on women’s health of being the agent and the witness to the abortion of her child at home, nor the impact on the child whose mere existence is said to be the cause for intervention with drugs.
The COVID-era justification for dispensing with in-person administration of abortion pills has of course vanished. Physicians have pointed out time and again the critical knowledge this single act by presidential order has suppressed on the risks to which women are subject, including failure to detect a dangerous ectopic pregnancy or address Rh sensitivity that may endanger a woman or a child in a future pregnancy. An FDA decision to reverse the COVID policy by no means amounts to a ban on the drug, as welcome as that would be, but it would improve a margin of safety that until recently was viewed as the standard of care.
Other dimensions of abortion pills are ripe for reconsideration. The ability to order the drugs online, from various types of merchants and websites, has made it possible for them to be obtained by sex traffickers and malevolent boyfriends determined to destroy the baby. Here, as elsewhere, data is sparse but making these drugs a mail-order proposition and not a medically supervised event has led to a number of appalling cases across the nation and around the world, as here, here, and here.
Congress in the meantime need not be supine regarding the most prevalent tool of abortion in the United States. It can urge and or fund a new FDA review of the data regarding the impact of chemical abortion. It can strengthen the nation’s laws with respect to the mailing of abortion pills across state lines. Imagine being a parent and discovering, after the fact, that your minor daughter has been shipped abortion drugs by an online contact in the United States or overseas. She consumes them in your family home and bleeds for nine to 16 days, or worse, and you are in the dark. Imagine that she orders them for her friends or another family member without your knowledge, and she has been told by the mailer not to disclose the drugs she has taken.
Congress can strengthen the recourse families have against such an invasion of the home or abuse of a minor. Finally, Congress or the FDA could ensure that women receive accurate information on abortion pill reversal, a process that is used in other contexts to prevent miscarriage and that has led to the saving of more than 6,000 babies from chemical abortion.
The evidence shows that chemical abortion presents many threats to the well-being of women and girls. The policy of recent Democratic administrations has been to expand it at all costs and to render tracking of its impact on women’s mental and physical health all but impossible. The incoming Trump administration should immediately reverse this incurious posture and begin to address the policy flaws that put both mothers and babies at risk. By all accounts, the Trump team will not do so. But this should only spur pro-life members of Congress and pro-life groups to demand action. What else are we here for?
Chuck Donovan served in the Reagan White House as a senior writer and as Deputy Director of Presidential Correspondence until early 1989. He was executive vice president of Family Research Council, a senior fellow at The Heritage Foundation, and founder/president of Charlotte Lozier Institute from 2011 to 2024. He has written and spoken extensively on issues in life and family policy.
SOURCE: THE WASHINGTON STAND
