Fact Sheet: What the Guttmacher Institute’s Report on Chemical Abortion Doesn’t Say

Charlotte Lozier Institute  

To view this fact sheet as a PDF please see: Fact Sheet: What the Guttmacher Institute’s Report on Chemical Abortion Doesn’t Say


The Guttmacher Institute has released preliminary 2020 abortion estimates indicating that chemical abortions have continued their rapid increase in the U.S. to now make up over half of all abortions. Guttmacher heralds this as progress; however, the report neglects to address critical data issues that undermine claims that chemical abortion is safe and beneficial.


The problems with U.S. abortion reporting


The Guttmacher Institute describes chemical abortion as a “game changer” for abortion access, but due to poor abortion data in the U.S., it is unknown how many abortions actually take place and how many women are harmed.

  • Abortion reporting is voluntary on the part of the states, and three states that Guttmacher estimates account for approximately a fifth of all abortions fail to report any abortion data at all (California, Maryland, New Hampshire).
  • In the absence of a comprehensive abortion reporting system, researchers and policymakers are forced to rely on estimates from the abortion industry via Guttmacher, but even these estimates are incomplete and delayed. Reliance on industry data would be considered unacceptable for any other public health issue, such as opioids.
  • Guttmacher acknowledges that statistics do not include “self-managed” abortions, such as those induced using pills illegally mailed by international groups like Aid Access.
  • This lackluster reporting makes it impossible to accurately measure maternal morbidity and mortality from abortion.
  • The CDC and FDA should not accept that an estimated one-fifth of abortion-related and complication-related data is unavailable for policymaking when it is available to an industry-backed entity like Guttmacher Institute.


Lack of support for safety claims


Guttmacher cites three studies to back up its assertions that chemical abortion is safe, but these studies are insufficient to support such broad claims.

  • National Academy of Sciences (2018) – This heavily criticized report, backed by abortion industry funders, cherry picked studies to determine that abortion is “safe”. It neglected key independent studies on abortion safety, including studies showing the risks of chemical abortion compared to surgical abortion and the increasing risks associated with chemical abortion as pregnancy advances.
  • Chong et al. (2021) – Far from proving that chemical abortion is safe, this report indicates the rate of chemical abortion-related emergency room visits exceeds FDA guidelines. Despite the fact that women were overseen by established abortion centers that screened them to see if an ultrasound was needed, 6% of abortions resulted in visits to an emergency room or urgent care. Even FDA has admitted that “The reported outcomes in Chong … are similar to outcomes described in approved labeling except that … the combined ED/urgent care center encounters (6 percent) exceeded the ED visits in approved labeling (2.9-4.6 percent).”
  • Upadhyay et al. (2021) – Even though this study had a short follow-up period, 5% of the women were identified as needing medical care due to incomplete abortions. The FDA said that “determining outcomes at 3 days is insufficient to determine outcome rates or safety findings because a 3-day follow-up period is too short…. This study used a model with numerous deviations from standard provision of medical abortion in the United States, such as no synchronous interaction with the prescriber during informed consent or prior to prescribing medication and no confirmation of self-reported medical, surgical, and menstrual history. These deviations, limited follow-up information, and small sample size limit the usefulness of this study.”


What the data actually shows


Independent, peer-reviewed studies from the United States and Europe show that chemical abortion carries serious risks. The spread of this abortion method means that women and unborn children will be placed in even greater danger.

  • The rate of abortion-related emergency room visits after chemical abortions increased over 500% between 2002 and 2015.
  • By 2015 (latest available data), there were five abortion-related emergency room visits for every 100 chemical abortions. Every indication is this trend is increasing.
  • Data from the United Kingdom shows a significant increase in ambulance calls and emergency room visits related to chemical abortion after abortion-by-mail became available.
  • FDA data shows that chemical abortion has resulted in over 20 deaths and thousands of severe complications.
  • But comparing FDA complication data to complication data independently published by the abortion industry shows that FDA data is seriously flawed, with a significant number of complications unreported. The true number of complications is even higher.




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