The Abortion Pill Safety Crisis No One Wants to Talk About
Chemical abortion now accounts for nearly two-thirds of all abortions in the United States, 63%, according to the Guttmacher Institute. That’s a dramatic shift in how abortions are performed, and it’s happening at the same moment that serious questions are emerging about whether women are being adequately protected from the risks involved.
Here’s what the data actually shows.
The FDA Label Doesn’t Tell the Whole Story
The FDA’s current label for mifepristone, the first drug in the standard two-drug chemical abortion regimen, states that fewer than 0.5% of women experience serious adverse reactions. Abortion advocates have leaned heavily on this figure, often pairing it with the claim that the pill is “safer than Tylenol.”
Both claims deserve scrutiny.
A peer-reviewed article from the Charlotte Lozier Institute found that there is no scientifically appropriate study actually comparing abortion drugs to Tylenol. The drugs are used for entirely different purposes, making any such comparison methodologically impossible.
More striking is a large-scale study from the Ethics and Public Policy Center, the largest study of its kind, found that serious adverse events from mifepristone occur approximately 22 times more frequently than the FDA currently recognizes. The same study found that more than one in ten women (10.93%) experience sepsis, infection, hemorrhaging, or other serious or life-threatening adverse events within 45 days of taking the drug.
The failure rate compounds the concern: chemical abortion fails roughly 8% of the time in the first trimester and as high as 38.5% in the second trimester, frequently requiring surgical intervention.
What Happens Without In-Person Medical Oversight
When mifepristone was approved by the FDA, in-person evaluations were required before the drug could be prescribed - a protocol designed to screen for ectopic pregnancies, accurately date a pregnancy, and assess contraindications. In 2021, the Biden administration eliminated these requirements, opening the door to abortion pills by mail.
The consequences have been documented.
Physicians recently raised alarms about a pattern of life-threatening, sepsis-like infections occurring after mifepristone use - infections that are especially difficult to identify and treat quickly precisely because so many women are now taking the drug at home, without follow-up care. One board-certified OB-GYN went undercover online to test the system: posing as a pregnant teenager with serious pre-existing medical conditions, she was still able to order abortion drugs through the mail without any medical screening.
A nationwide survey found that seven in ten Americans support reinstating the requirement for an in-person medical evaluation before and after taking abortion pills.
A Pattern of Coercion — and Violence
Perhaps the most troubling dimension of this story is what happens when these drugs enter homes without oversight.
Peer-reviewed research suggests that nearly 70% of women with a history of abortion describe their abortions as inconsistent with their own values and preferences, with one in four characterizing their experience as unwanted or coerced. The mail-order system makes coercion easier to carry out and harder to detect. The case record speaks for itself.
Jona Affholder (Victim, Toledo, OH): A medical resident used his estranged wife’s identity to fraudulently order abortion pills online, then forced crushed pills into his sleeping pregnant girlfriend’s mouth. His medical license was suspended.
Jagmeet Sandhu (Perpetrator, Bakersfield, CA): Broke into his sleeping pregnant girlfriend’s home, held her at gunpoint, and forced her to swallow abortion drugs — killing their 12-week unborn child. He received just one year in jail for involuntary manslaughter.
Mason Herring (Perpetrator, Houston, TX): An attorney secretly spiked his wife Catherine’s drinks with abortion drugs seven times. She was hospitalized. Their daughter survived but was born 10 weeks premature with lasting developmental delays. The case directly inspired Louisiana legislation, signed into law in 2024, making mifepristone and misoprostol classified as controlled dangerous substances, the first state to do so.
Justin Banta (Perpetrator, Parker County, TX): Spiked his girlfriend’s coffee with abortion pills bought online, the same day she returned from a sonogram, showing a healthy 6-week pregnancy. She miscarried the next day after severe bleeding.
The “Vitamins” Case (Watertown, MA): Robert Kawada, 43-year-old man told his ex-girlfriend the abortion pills were iron supplements, then physically checked her mouth to confirm they dissolved.
Manishkumar Patel (Appleton, WI) & Scott Bollig (WaKeeney, KS): Patel received 22 years for spiking his girlfriend’s smoothie with crushed abortion drugs. Bollig received nearly 10 years for grinding an abortion pill into his girlfriend’s pancakes was charged with conspiracy to commit murder.
David Coots (Gig Harbor, WA): A former nurse practitioner secretly inserted abortion drugs directly into his patient and mistress’s body during what she believed was a medical visit. She suffered intense pain and hemorrhaging; ER doctors recovered drug residue inside her.
The Shield Law Case (TX/NY): A Texas mother ordered abortion pills online from a New York physician, without her teenage daughter’s knowledge, then forced her daughter, who wanted the pregnancy, to take them. The girl was hospitalized. The New York doctor faced zero legal accountability under state shield laws.
Normal, IL: Emerson Evans was charged with homicide after drugging his girlfriend with mifepristone at seven weeks, triggering severe hemorrhage. He told police he bought the pill for $50 from “a girl on campus.”
These are not isolated incidents. They represent a documented, growing pattern — enabled in part by a system that allows potent drugs to be ordered online, shipped to any address, and dispensed with no in-person oversight and no meaningful ability to verify who is actually taking them, or why. More cases are documented here.
The Question Worth Asking
If a drug were found to cause serious adverse events at rates 22 times higher than the FDA acknowledges, with a failure rate approaching 40% at certain gestational ages, and with a documented pattern of being weaponized against the very patients it’s prescribed for — what would we expect regulators to do?
That’s a question worth sitting with, regardless of where you stand on the underlying policy debate. Protecting women from harm is not a partisan position.
This article draws on FDA labeling data, peer-reviewed research from the Charlotte Lozier Institute and the Ethics and Public Policy Center, and court records from publicly reported cases.