Study: Complications up after Ohio’s abortion law

Risks surged after doctors forced to use FDA protocol

Women seeking medical abortions in Ohio experienced a higher rate of complications after the state implemented a law that put new restrictions on doctors who performed the procedure, according to a study published this week.

The law, which took effect in 2011, requires abortion providers to adhere to specific guidelines from the U.S. Food and Drug Administration when giving patients a combination of two drugs, mifepristone and misoprostol. The drugs have been shown to terminate early pregnancies safely and effectively.

The FDA protocol was set in 2000, with specific dosages of mifepristone and misoprostol. Within a few years, however, doctors realized that using a lower dose of mifepristone and a higher dose of misoprostol produced better outcomes for their patients.

The World Health Organization, the American Congress of Obstetricians and Gynecologists and the National Abortion Federation found shortcomings with the FDA’s protocol soon after it was issued, and began recommending changes as early as 2003. Health care providers throughout the U.S. followed their lead and prescribed the drugs according to the latest medical research rather than the dosages on the drug’s label.

The practice of prescribing drugs for use “off label” is both legal and commonplace. By one estimate, 21 percent of all U.S. prescriptions are intended for offlabel use.

Before Ohio’s law went into effect, doctors in the state were able to decide what doses of the drugs were most effective based on the latest research and best practices. Afterward, doctors lost that flexibility and were forced to follow the FDA’s outdated protocol.

To see what effect that had on patients, researchers examined the medical records of 2,783 women who had medication abortions at one of four clinics in Ohio between 2010 and 2014. The researchers found that women were nearly three times more likely to require additional intervention after the law was implemented than they were before.

Before 2011, doctors had to provide some kind of additional care in 4.9 percent of cases. Usually, this meant administering an additional dose of misoprostol or using suction to remove the fetus from the uterus. After the law was enforced, measures like these were required in 14.3 percent of cases, according to the study.