Studies cited in case over abortion pill are retracted due to flaws and conflicts of interest

A medical journal has retracted two studies claiming to show the harms of the abortion pill mifepristone, citing conflicts of interest by the authors and flaws in their research.

Two of the three studies retracted by medical publisher Sage Perspectives were cited in a pivotal Texas court ruling that has threatened access to the pill. The U.S. Supreme Court will take up the case next month, with a decision expected later this year. The court’s ruling could affect nationwide access to mifepristone, including whether it continues to be available by mail.

Medication abortion accounts for more than half of all abortions in the U.S., and typically involves two drugs: mifepristone and misoprostol.

WHAT DO THE STUDIES SAY?

Both studies cited in the court ruling were published in the journal Health Services Research and Managerial Epidemiology. They were supported by the Charlotte Lozier Institute, part of an advocacy group that seeks to end access to abortion.

A 2021 paper looked at 423,000 abortions and more than 121,000 emergency room visits following medication abortions and abortions done through a medical procedure from 1999 to 2015. Researchers concluded medication abortions are “consistently and progressively associated with more postabortion ER visit morbidity” than the other type.

A 2022 paper concluded failure to identify a prior abortion during an ER visit — either by a doctor or because a patient concealed it — is “a significant risk factor for a subsequent hospital admission.”

HOW ARE THE STUDIES AND MIFEPRISTONE CASE RELATED?

U.S. District Judge Matthew Kacsmaryk cited the studies in a controversial legal ruling that will go before the U.S. Supreme Court next month.

Essentially, Kacsmaryk sided with a conservative medical group, arguing mifepristone’s original approval by U.S. regulators was flawed because it overlooked serious safety issues.

He cited one of the retracted studies in claiming that mifepristone causes “many intense side effects.” The ruling also cited the second retracted paper in explaining why antiabortion physicians had the legal standing to bring their lawsuit — instead of showing they were directly harmed by a product, the judge said medical abortions cause “enormous pressure and stress” to physicians.

The Food and Drug Administration’s original 2000 approval of mifepristone is not in question, but the Supreme Court could roll back recent changes that made the drug easier to obtain, including via mail.