Patients who undergo a medication abortion during the first trimester of pregnancy are at a significantly higher risk of experiencing severe pain and heavy bleeding than if they had surgical abortions, according to a new study published in the American Journal of Obstetrics and Gynecology.
Researchers from the University of Pennsylvania surveyed over 500 abortion patients, more than two-thirds of whom chose to take medication abortion, also often called a self-managed abortion, compared to a surgical procedure.
Choosing a medication abortion puts the patient at five times the risk of experiencing severe pain, according to the researchers’ statistical modeling. Medication abortions also put patients at more than nine times as likely risk of developing severe bleeding complications than surgical abortions.
The researchers also found that a current diagnosis of depression doubled the patient’s risk for severe pain and heavy bleeding.
Medication abortions make up approximately two-thirds of all abortions in the United States, but access to the medication has been highly politicized since the Supreme Court overturned Roe v. Wade federal abortion protections in June 2022.
The first pill in the medication abortion regimen, mifepristone, works by blocking progesterone receptors that are necessary for the fetus to continue development. The second medication, misoprostol, is taken within 48 hours of mifepristone and induces contractions to expel the pregnancy tissue.
The Food and Drug Administration’s warning label for mifepristone indicates that between 2.9% and 4.6% of medication abortion patients will experience significant complications, including sustained severe bleeding or life-threatening infections.
Of the patients in the AJOG study, a quarter of both medication and surgical abortion patients reported severe pain, and over 30% reported experiencing more pain than they anticipated prior to the abortion.
Researchers also found that more than a third of patients were unprepared for the amount of bleeding they experienced as a result of their abortions.
“While most patients were prepared for the pain and bleeding experienced after abortion, the patient experience may be improved by anticipatory guidance that incorporates risk factors for severe pain and heavy bleeding,” wrote the authors, who are researchers at the University of Pennsylvania.
The authors of the study did not respond to the Washington Examiner’s request for comment.
Similar findings were published in December as part of a study from the British National Health Service, which reported that nearly half of abortion patients in the United Kingdom experienced more pain during their medication abortion than they were told to expect from their healthcare providers.
In that study, more than 9 in 10 patients ranked their pain as at least a four out of the maximum 10 on the standard pain scale. About 40% ranked their pain as between eight and 10 on the pain scale, indicating severe pain.
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Since the overturning of Roe, the number of brick-and-mortar abortion clinics across the country has declined by 5%, according to the abortion-rights think tank the Guttmacher Institute. This accounts for a net loss of 42 clinics, mostly from facility closures in the 14 states that have completely banned abortion.
But between 2020 and 2023, abortions increased by 11% to a national total of nearly 1.4 million in 2023, which is in part due to abortion medications prescribed to patients via telehealth appointments.