Politics drove the retractions of needed studies on abortion safety

When it comes to abortion, what Americans don’t know can hurt them. The abortion industry relies on the public’s lack of knowledge about abortion to make misleading claims — for instance, that abortion drugs are “safer than Tylenol.”

Most peer-reviewed articles examining abortion complications have been published by abortion-advocacy researchers. Journalists who report on those studies often ignore or are unaware of known deficiencies in U.S. abortion data collection, notably the many women lost to follow-up with unknown abortion outcomes and the failure of many women to report a preceding abortion when a complication occurs later.  

To fill these major gaps in research, I, along with other Charlotte Lozier Institute researchers, published high-quality studies examining Medicaid data in the 17 states where the program paid for elective abortions at the time. These extensive records of more than 423,000 abortions examined over 17 years were not plagued by loss-to-follow-up problems, because Medicaid payments already link the abortions to any care for subsequent complications.  

Unfortunately, that research has come under attack after Sage Publications made the decision to retract those studies. With those attacks, groups within the abortion lobby, including the Guttmacher Institute, have continued to repeat numerous falsehoods rather than genuinely engage on the merits of the research.  

The Guttmacher researchers correctly reported that by 2015, the last year of the primary study at issue, for every thousand abortions, there were more than 350 ER visits for “any cause” in the month following the abortion. This is an interesting statistic, demonstrating in part the Medicaid population’s overreliance on the emergency room setting for less urgent medical needs.

But this was not the point of the study, as these researchers would have realized if they truly sought to understand our research or read the study in its entirety. Our goal was to look at emergency room visits specifically related to abortion and compare surgical and abortion drug complications.  

Their complaint amounts to the claim that they would not have written the paper the same way. But this does not constitute grounds for the paper’s retraction. The Guttmacher researchers have not identified a single error, fabrication or even a misleading statement justifying such an extreme approach with our paper. Indeed, the only thing that is erroneous and misleading is their mischaracterization of our research on abortion-related emergency room visits. 

The more concerning finding from our study was that by 2015, approximately 5.2 percent of women receiving abortion drugs and 2.2 percent of those receiving surgical abortions ended up in the emergency room within a month for reasons directly related to the abortion itself. Given that nearly half a million abortions were performed with mifepristone in 2020, this suggests that many thousands of American women required emergency room care for abortion complications that year.

Additionally, 61 percent of abortion-related ER visits following mifepristone and 39 percent following surgery were miscoded as having been caused by miscarriage. Women whose drug-induced abortions were miscoded required 78 percent more hospital admissions on average before finally receiving the treatment they needed (usually surgery) further demonstrating the extent of U.S. data deficiencies and patient abandonment by the abortion industry.   

The Guttmacher researchers have also claimed that the retraction was justified because we had not disclosed conflicts of interest. That is incorrect. We disclosed everything that Sage asked us to disclose. And although not required by Sage, we also posted our pro-life institutional affiliations on the very first page of our article.

The Guttmacher researchers certainly do not hold pro-abortion rights organizations — including themselves — to the same standard to which they are now claiming to hold us. For example, there are no disclosures whatsoever in this Sage study by the Guttmacher Institute.  

They also pointed out that one of the peer-reviewers for three of our papers was affiliated with CLI as an associate scholar. The Guttmacher researchers implied they would never agree to performing such a review of an associate’s article. Yet the Guttmacher researchers failed to acknowledge that Sage has a double-blind peer-review process whereby the authors and reviewers do not know the identity of one another. Indeed, the identity of this person who reviewed our study remains unknown to us to this day. If there was a conflict in assigning this reviewer to our paper, the fault lies with Sage, not with us.  

Finally, the Guttmacher researchers stated that “if [mifepristone] was as dangerous as anti-abortion groups are claiming, emergency departments would be filled with patients suffering from complications. That is simply not the case.”

I would humbly remind these critics that this is indeed the case, as physicians outside of academia’s ivory tower are well aware. As a board-certified OB-GYN practicing in Texas for more than 30 years, I can affirm these women do exist. I have cared for many of them, and their frequent emergency room care does indeed burden limited medical resources and increase systemic costs.

Why do we not hear their stories? One reason is that women who have had abortions are often ashamed of their actions. This makes them less likely to lodge a complaint against an abortionist or file a medical malpractice lawsuit.

I, along with the rest of the Lozier scholars, am more than happy to engage with those who disagree with or question our research, because we are confident in the findings. Unfortunately, instead of these discussions taking place in the scientific research community, where it belongs, we are forced to rebut dishonest claims in the editorial sections of media outlets.  

I can only hope people see through the dishonesty, read the research themselves and come to their own conclusions.  

Dr. Ingrid Skop is vice president and director of medical affairs for the Charlotte Lozier Institute.