When Abortion Pills Don’t Work
By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research
Abortion pills, even when taken as instructed, don’t always work. The baby is not always killed and the woman’s body flushed out. It’s something that the abortion industry admits in the fine print, but certainly doesn’t like to advertise.
They insist that failure is rare and imply that it isn’t a big problem. When the chemical (or “medical”) abortion fails, the abortion industry just tells a woman to take more pills or get a quick surgical abortion.
But from the very beginning, one suspected this was far more spin than science.
Now, from a surprising source, come first-hand accounts of what that failure is really like and it is very, very ugly. Freelance journalist Rose Stokes tells in graphic detail about her “failed” chemical abortion along with that of a couple of other women, in VICE UK (the British side of VICE online digital news). Stokes shares details about the real physical problems and psychological challenges that accompanied those failures.
Failure is not an unexpected option
Beverly Winikoff, one of the activists/researchers long in the forefront of the push for chemical abortions, likes to tell people that chemical abortion “has been shown to be safe and up to 98% effective for early pregnancy termination” (International Perspectives on Sexual and Reproductive Health, September 2012).
Even if that effectiveness figure were accurate, this would mean over 5,000 failures among the 265,000+ who took the drug in the U.S. in 2014 alone. Slightly more forthcoming observers (e.g., mifepristone distributor Danco) admit that the failure rate may be at least 7%, meaning the yearly failures could involve 12,000 women a year or more. And we know that failure rates increase with gestation age, and that the industry keeps doing later chemical abortions, meaning even those figures may be low.
Abortion pill promoters may try to pass this off as mere statistical noise, but something affecting this many women is clearly a public health concern.
So what is a failed chemical abortion like?
Rose Stokes is unapologetic about her abortion, saying her reasons for doing so “are deeply personal, painful, and nobody’s business but mine.” But she offers details of her own chemical abortion that show that, at least for some women, the experience is dramatically different than advertised.
Given a choice between a surgical and chemical abortion, Stokes asked what the difference was. “Well, one you take a pill and the other is more invasive” she was told. She opted for the chemical one, thinking it would be “simpler.”
Stokes took the first pill (mifepristone) at her first visit. She returned two days later and had the second pill (misoprostol) inserted into her vagina. (It is unclear from the text whether Stokes or the clinician did this  Stokes said this “felt like an act of self-violence” and she walked back to the waiting room and into her mother’s arms “crying with a ferocity I hadn’t experienced since childhood.”
Stokes was told that she could expect her “miscarriage” to begin at any time, and that it should be over in a day. She might have some mild cramping for up to a week, they told her, but she could take some pain pills if it hurt.
She felt some pain about four hours after getting home to her apartment. Stokes says she went into “full labor” within an hour, complete with “contractions, vomiting, bleeding, crying, sh***ng.” This went on for hours, Stokes describing herself as “traumatized.”
The contractions finally began to recede about 12 hours later, allowing Stokes to think the worst was over. But the contractions didn’t entirely disappear, and when they persisted a week later after an unsuccessful attempt to return to work, she went to the doctor for “some stronger meds.” He found that her blood pressure was “dangerously low” and he sent her straight to the hospital.
There, after Stokes lay on the floor of the waiting room of the pregnancy unit for four hours, crying, a scan revealed that her abortion was “incomplete,” that there were still “remaining products” in her womb. (Stokes does not say whether or not this included the baby or just leftover material from the remaining placenta.)
She had surgery three days later and lost another week of work. Stokes says, “The whole ordeal left me physically and emotionally wrung out.”
Before considering the accounts of other women who also experienced chemical abortion failures, note a few things about Stokes’ experience.
She was given the impression it would be relatively quick and simple. It wasn’t. Her experience with the pain and bleeding and contractions were actually quite normal for a standard chemical abortion. It wasn’t until those contractions continued for another week that Stokes began to sense that maybe something wasn’t right.
And though there are multiple studies by abortion pill advocates touting the “satisfaction” of abortion pill users, Stokes describes her experience as psychologically traumatic and physically wrenching from beginning to end.
Stokes says, “I don’t regret for a second my decision to terminate my pregnancy” and she remains convinced that “Abortion is a safe medical procedure.” However, she does say that as long as women are going to have abortions, that they have “access to fair, honest, and detailed information about the various procedures involved” should be ensured “as a matter of public health.”
Not the only one
Stokes relates the stories of others who had failed chemical abortions. “Diana” (a pseudonym) took pills to have a chemical abortion when she was 19. “The procedure went as planned,” Diana went home, and then on a family vacation. The problem was, she was still bleeding.
“It was just awful,” Diana related to Stokes. “I’d have a shower and look down and the floor would be red. I’d bleed through pads at an astonishing rate and couldn’t go swimming.”
On the plane ride home, the bleeding became more intense and she knew something was wrong. “The blood felt like it was gushing out of me and it soaked through my dress and onto the plane seats. It was humiliating and terrifying.”
Upon landing, her family rushed her to the hospital where she was told that the abortion had not been successful and that she would have to have surgery.
Like Stokes, Diana felt “traumatized” and says she ended up dropping out of college. The complications served to amplify her sense of guilt and shame. “I felt like I was being punished for my decision to end the pregnancy.”
Again, you see the depth of the psychological trauma that often accompanies the chemical abortion process, even if a woman still defends the decision.
And here with Diana we also see that bleeding can be a serious issue with these chemical procedures. Whether one successfully aborts or not, if the drugs work at all, women will bleed, and it can be heavy and long lasting. Abortion advocates sometimes like to compare it to a “heavy period,” but those reading of Diana’s experience will find that ludicrous.
The bleeding can reach dangerous levels and is known to be responsible for at least two women’s deaths.
Women react differently to abortion pill
Stokes talked with Yvonne Neubauer, the associate clinical director of Marie Stopes (essentially Britain’s Planned Parenthood). Neubauer admitted that women’s bodies react differently to the drugs, in the same way that every pregnancy is different. This means the advice the abortionist gives the woman is not a guarantee, but at best maybe some sort of average. “We give advice based on the median experience” Neubauer told Stokes.
Neubauer says that “Women’s bodies are complex and extremely variable, and no experience of abortion is the same…. This is why we prioritize support before, during, and after the process, and provide access to a range of resources, including a 24-hour support line.”
With U.S. abortion pill researchers pushing for less and less direct medical supervision, to the point of advocating for webcam abortions and the delivery of abortions pills by mail, Neubauer’s observation is remarkable. The priority of support before, during, and after the process appears to be an acknowledgment of the inherent risk of the chemical abortion procedure and the necessity of close monitoring, which only seems borne out by these women’s experiences.
Even if most do not suffer the complications and failures that Stokes and Diana did, Neubauer seems to be making the case that the only responsible thing to do is to plan for the exception.
The waiting is nerve-wracking
In her third case, Stokes makes the argument that going the chemical abortion route is traumatic even when it doesn’t work at all. Zoe Beaty, another journalist, took the pills, went home and waited for the abortion to begin. Nothing happened.
Afraid of miscarrying on the job, she stayed home from work. The clinic didn’t want to see her again until she had given the pills a full two weeks to work. Stokes said Beaty was “marooned at home.”
Waiting, knowing she was still pregnant, took an “emotional toll” on Beaty, says Stokes. “It just felt like things were getting out of control,” said Beaty. “I’d never heard of abortions not working.” She eventually booked a surgical abortion at 11 weeks.
The waiting built into the process of chemical abortions is at odds with the quick-fix mentality of abortion. Though this window of waiting provides some women with the opportunity to reconsider their decision, for most of the rest it means spending a longer time dealing with the reality of the intentionally deadly process. How this shapes post-abortion trauma in the future will soon become apparent.
But whether it occurs relatively quickly, slowly, or not at all, the chemical abortion process requires that a woman spend time thinking about something she doesn’t want to be thinking about.
And the fact that Beaty had “never heard of abortions not working” shows that the abortion pill’s promoters haven’t been as conscientious about telling the full truth about the drug as they have about making the sales pitch.
Quite different than advertised
Stokes admits that she didn’t pay too much attention to the details after picking what she thought was the “simpler” abortion. But after her experience, she thinks that women need to be given more complete, more honest information about chemical abortion.
Stokes said of the account she wrote, “[T]his is the article that I wanted to read both before the procedure and afterward, so that I could have been fully informed and prepared for what could happen to my body, rather than finding out during the process. I don’t want anyone to be as in the dark as I was.”
If Stokes got the wrong impression about chemical abortions, where did she get it from? We have been telling women about the physical and psychological trauma of these abortions for more than 20 years.
It is the abortion industry and their media pals who have tried to soft peddle and ignore chemical abortion’s problems, to try and sell bloody, painful traumatic process as nothing more than a chemically-induced “miscarriage.”
It’s not a miscarriage, but an abortion which takes the life of a child and puts a woman’s life at risk.
 Although Stokes’ chemical abortion was performed somewhere in Britain, the two drugs (mifepristone and misoprostol) and dosages appear to be the same as those currently used in the U.S. The British protocol (at least in Stokes’ case) involved returning to the clinic for a second visit and having the misoprostol inserted vaginally, as some clinics have done in the U.S. A later third visit was to confirm the abortion.