AAPLOG Statement

on ACOG Practice Bulletin 225 – Medication Abortion up to 70 Days Gestation

 

In its most recent practice guidelines on medication abortions (conveniently released to coincide with their lawsuit against the FDA), ACOG’s prioritization of unfettered abortion access over sound medical care is more evident than it has ever been.  There are a number of concerning recommendations that place women’s lives at risk and represent substandard care.  

  1. Clinical examination and/or ultrasound are not recommended to determine gestational age, despite the face that complication rates increase significantly after 10 weeks gestation (upper limit of FDA approval for mifepristone). Per ACOG’s Committee Opinion 700 on estimating due date, approximately 50% of women are wrong about their gestational age based on LMP alone and a pregnancy without an ultrasound to confirm gestational age is considered sub optimally dated.

  2. Screening for ectopic pregnancy to be done by asking about risk factors and symptoms only – no clinical exam or ultrasound.

  3. Foregoing Rh screening or administration of Rhogam if it would delay a woman obtaining an abortion, despite the recommendation that it always be given in cases of miscarriage.

  4. Provision of abortions by nonphysician advanced practice providers.

  5. Provision of abortion via telemedicine without an in person visit, which precludes the ability to ensure a woman is not being coerced to have an abortion.

  6. No scheduled in person follow-up – despite the risk of incomplete abortion and mental health complications.

Any physician who provides medical care for pregnant women will immediately recognize that the above recommendations are not consistent with sound medicine and show a lack of concern for the health and well-being of our patients.  Considering the fact that medication abortions carry a 4x higher risk of complications than surgical abortions and that up to 1 in 5 women will experience these complications, physician oversight of medication abortions should be increased, not decreased.  And, as an organization that claims to promote women’s health, ACOG should re-examine why it thinks women seeking abortions are less deserving of excellent care than other women.