Uncommon safety concerns surface in relation to medication-induced abortion, stress healthcare professionals.
"Experiencing about a medical professional making crucial decisions for their own wellbeing and their family's welfare ending tragically in the United States, I believe 'regretful incident' falls short as a descriptor," commented Dr. Ghazaleh Moayedi, a gynecologist and founder of Pegasus Health Equity Center situated in Dallas.
As stated in the report, Thurman obtained abortion medication from a clinic in North Carolina following the ban on abortions after six weeks in her home state of Georgia. She subsequently went to the hospital with a severe infection, her body failing to expel all the fetal tissue following the intake of the medication.
Dr. Moayedi told CNN, "There was no reason for delaying her medical attention by even a moment." Thurman should have been promptly taken in for a uterine aspiration, a medical procedure that removes the contents of the uterus, which is performed for both abortion and miscarriage treatments.
However, Thurman did not undergo the surgical procedure to expel the fetal tissue for 20 hours. It is unclear from her records as to why physicians waited so long. The procedure, according to the report, had been criminalized by the state's abortion law just weeks prior to the incident, following the U.S. Supreme Court's decision to overrule Roe v. Wade that summer.
As reported by ProPublica, Miller never visited a hospital despite experiencing significant pain for days after taking the abortion medication pills. A report from the Clayton County medical examiner suggested that Miller did not seek medical help due to the current abortion-related legislations in the state.
Miller had retained fetal tissue, the report stated, and should have undergone a dilation and curettage (D&C) procedure to avoid infection. Her autopsy report showed that she passed away due to a mixture of medications, including painkillers fentanyl and acetaminophen; her medical examiner's report mentioned that she did not have a history of drug misuse.
Georgia's Department of Public Health refuses to disclose reports from its maternal mortality review committee. ProPublica noted that those reports classified Thurman and Miller's deaths as "avoidable" and in Miller's case, attributed her passing to the state's abortion law.
The reports have reignited the political debate regarding abortion access. Vice President Kamala Harris stated, "This is exactly what we anticipated when Roe was annulled." Harris is expected to visit Georgia on Friday to deliver further remarks on reproductive rights.
Abortion rights detractors accused Thurman's doctors of not providing immediate care and criticized medication abortion itself.
However, researchers studying medication abortion and physicians prescribing it advised CNN that the treatment is safe and offered advice for managing rare complications.
How does medication abortion function?
Medication abortion has been endorsed by the US Food and Drug Administration since 2000 and can terminate a pregnancy within the first ten weeks of gestation.
The most common way people in America access abortion currently consists of two drugs, mifepristone and misoprostol. Mifepristone blocks the hormone progesterone, which is essential for pregnancy, and is ingested first. Misoprostol follows a day or two later, causing the uterus to contract, resulting in cramps and bleeding, leading to the expulsion of the pregnancy tissue.
Moayedi explained that the procedure was "physiologically similar" to a miscarriage.
What is the frequency of complications?
Serious complications arise less than 0.5% of the time with medication abortion, according to Dr. Daniel Grossman, director of the Advancing New Standards in Reproductive Health (ANSIRH) program at the University of California, San Francisco. Potential complications might include hospitalization, blood transfusions, and surgery.
Retaining pregnancy tissue requiring vacuum aspiration occurs for 3% to 5% of people undergoing medication abortion, Grossman noted, but it is not classified as a severe complication and can typically be handled in an outpatient setting; Moayedi confirmed that retained pregnancy tissue rarely leads to infections.
Deaths following medication abortion are extremely uncommon, Grossman affirmed.; there were 32 reported among individuals using mifepristone between 2000 and 2022, a period during which around 5.9 million women utilized the medication. Grossman's team reviewed the possible causes reported to the FDA, finding that nearly half likely had no connection to the abortion.
"I have treated countless people undergoing medication abortion," said Moayedi, whose clinic offers support before and after abortions in Texas, where abortions are prohibited with limited exceptions. "I can count on one hand – fewer than one hand – the number who experienced infections afterward. This is remarkably rare."
Symptoms indicating potential complications include a high fever, intense stomach pain, and excessive bleeding that saturates over two menstrual pads each hour for a span of two hours, according to Moayedi. Additionally, Grossman mentioned that weakness, nausea, vomiting, or diarrhea persisting past a day following the last pill intake could be indicators of an infection.
Grossman recommends individuals with concerning symptoms to attempt reaching out to the clinic or service that provided the medications or contact the Miscarriage and Abortion Hotline at 1-833-246-2632; this hotline, operating for free, is staffed by professionals ready to address queries and provide support.
However, Grossman warns, "Should a patient encounter one of the aforementioned symptoms yet unable to converse with a clinician over the phone, they must seek emergency care at a nearby hospital."
Regarding individuals in states with abortion bans, medical professionals assured CNN that patients have the legal right to receive treatment for complications, even in restricted regions. There should be no reluctance to access emergency care at a hospital.
Moayedi emphasizes the responsibility falls on both patients and hospital systems, with facilities being expected to comprehend local regulations and hold preparedness plans enabling physicians to administer necessary treatment without apprehension.
Grossman also highlights that the same issues that arise with medication-induced abortions can occur during miscarriages and the treatment remains identical.
His team has reportedly heard about prolonged care delays for patients experiencing complications in states with abortion bans. Grossman expressed worry over the accounts of patients' care being postponed, despite the laws not applying to these cases. "I would never encourage a patient to lie, but I am deeply concerned about these incidents where patients' care is being delayed in abortion ban states when they present with complications after an abortion," he said.
He advises clinicians to refrain from inquiring about patients' use of medications to terminate pregnancies to avoid legislative risks for patients and instead focus on providing necessary treatment based on visible symptoms.
CNN’s Jeffrey Kopp and Sandee LaMotte contributed to this report.
After hearing about the tragic consequences of delayed medical attention in abortion cases, Dr. Moayedi emphasized the importance of prompt medical care, stating, "There should never be a delay in providing necessary medical attention, especially when it comes to reproductive health."
In light of the reported cases of avoidable deaths due to complications following medication abortions, Dr. Grossman underscored the need for clear communication between patients and medical professionals, advising, "Patients should never hesitate to seek emergency care if they experience symptoms indicating potential complications."
