Chemical Abortion
Chemical Abortion
The American College of Pediatricians (ACPeds) follows the Hippocratic Oath and affirms that any abortion, including chemical abortion, takes the life of a human being and is therefore unethical. Physicians should not intentionally take any human life. Additionally, ACPeds affirms that chemical abortion endangers women’s health and safety.1
Chemical abortion refers to the use of synthetic chemicals mifepristone (Mifeprex) and misoprostol (Cytotec) to induce an abortion. Chemical abortions, with or without medical supervision, entail increased risks of complications, including hemorrhage and incomplete abortions that may require surgical intervention. Additionally, women are being encouraged to order chemicals to carry out their own abortion, without in-person supervision by health care professionals. There are increased risks for those women who use telemedicine or the internet to obtain chemical abortions, especially when used without physician supervision (self-managed). The risks may include an undiagnosed ectopic pregnancy, Rh isoimmunization, and undiagnosed infection. Intimate partner violence and human trafficking are also less likely to be suspected in the absence of an in-person medical evaluation.
Pregnant women with regrets after starting chemical abortions need to be informed about the potential for abortion pill reversal, which reportedly has been successful in saving thousands of babies.2
ACPeds opposes chemical abortions. However, as long as chemical abortions are legal, ACPeds strongly encourages health care professionals, policy makers, and women of all ages and their families to understand the serious risks associated with chemical abortions, especially when self-managed. Laws and regulations can offer partial mitigating protection to women and their children by requiring in-person visits first before dispensing pills. These visits should include ultrasonic screening for ectopic pregnancy, accurate dating for gestational age, and screening for sexually transmitted infections as well as for coercion, intimate partner violence, human trafficking, and sexual abuse. For informed consent women need accurately written information on potential risks and side-effects, on resources available for parenting and adoption in their state, on signs and symptoms of a potentially serious complication, on how to access emergency evaluation and care, and on how to access progesterone to counteract or reverse the effects of the abortion pill. Laws and regulations should require a follow-up visit with the dispensing physician to rule out serious complications and should require that the dispensing physician arrange any needed follow-up that the physician cannot personally provide. Full and accurate reporting of all complications should be required for monitoring. In addition, the Comstock Act forbidding sending abortifacients through the US mail should be vigorously enforced.
Approved by the ACPeds Board of Directors (May 2025)
Approved by ACPeds Members (June 2025)
Corresponding ACPeds Referenced Paper:
Chemical Abortions: With and Without Medical Supervision (Jan. 2023)
Additional Report:
Other Pertinent ACPeds Referenced Papers:
Emergency Contraception – Not the Best for Adolescents (May 2025)
Cohabitation: Effects of Cohabitation on the Men and Women Involved – Part 1 of 2 (March 2015)
Induced Abortion: Risks That May Impact Adolescents, Young Adults, and Their Children (Aug. 2016
