Study: Com­pli­ca­tions up after Ohio’s abor­tion law

Risks surged after doc­tors forced to use FDA pro­to­col

Baltimore Sun - - NATION - By Deborah Net­burn

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.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.