Fact-checking Florida Attorney General James Uthmeier on abortion pill hospitalizations

Florida Attorney General James Uthmeier is suing Planned Parenthood for what he called deceptive marketing practices involving abortion pills.

In a Nov. 6 video on X, Uthmeier said Planned Parenthood "falsely marketed to women" that abortion pills are safer than over-the-counter medications.

"Evidence suggests that 1 in 25 women who consume these dangerous pills are hospitalized," Uthmeier said. "And we’ve seen dozens of reported deaths. This is wrong, and we’re going to hold them accountable."

Although Uthmeier used the word "hospitalized" to describe the outcome, text that appeared on screen in the video as he spoke said 1 in 25 women "end up in the ER," a figure that combines results from two studies Uthmeier cited. Emergency department visits are not the same as hospitalizations, which involve patients being formally admitted. 

When contacted for evidence, Uthmeier’s spokesperson pointed PolitiFact to a table in the U.S. Food and Drug Administration’s label for mifepristone, the first of two pills taken in early pregnancy for medication abortion. One line in the table said two U.S. studies with 1,043 women found a 2.9% to 4.6% frequency rate for ER visits. The higher end of the range roughly correlates to 1 in 25 women.

Besides conflating hospitalizations and ER visits, Uthmeier cited studies with small sample sizes; multiple larger studies found lower rates of both ER visits and hospitalizations following medication abortion. Researchers told PolitiFact emergency department visits are not a reliable indicator of drug safety and are not proof that patients experienced serious adverse events or were admitted to the hospital.

"In large studies of medication abortion, hospitalization is very rare, generally occurring in <0.5% of patients," Dr. Daniel Grossman, a professor of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco, wrote in an email to PolitiFact. Grossman said ER visits are more common because patients who do not live near their provider might have to go to an emergency department for anything that requires in-person consultation, including to confirm an abortion was successful. 

The FDA label that Uthmeier cited also showed hospitalization rates of 0.04% to 0.06% among 14,339 women evaluated in three studies, or about 86 women on the higher end of the range.

The FDA label does not include the research methodology or details about the cases. The FDA didn’t answer our questions about the studies.

Danco Laboratories, which manufactures and distributes mifepristone under the brand name Mifeprex, provided the studies to PolitiFact. The two reports showed 41 women out of 1,043 visited the ER after taking abortion pills. Eight of the 41 were hospitalized and, of those, three were admitted for unrelated reasons, including pancreatitis and hip pain. That means five out of 1,043 women evaluated were hospitalized for reasons related to abortion pills.

"The actual percentage of related serious adverse events that required hospital admission in these two studies was 0.5%," said Ushma Upadhyay, a professor and public health scientist at the University of California, San Francisco.

What is medication abortion and how safe is it?

Medication abortion is approved in the U.S. up to the 10th week of pregnancy and involves two medicines — mifepristone and misoprostol — that are typically taken 24 hours apart. Studies have found that around 95% to 98% of patients who take the medicines as prescribed will end their pregnancies without  complication.

The FDA has repeatedly reaffirmed mifepristone’s safety since the drug was first approved in 2000. (Misoprostol has been on the market longer and has different uses, including preventing stomach ulcers.)

Medication abortions are common, accounting for 63% of all abortions in the U.S. in 2023, according to the Guttmacher Institute, a research organization that supports reproductive rights. More than 5 million women in the U.S. have used abortion pills to terminate pregnancies.

Over 100 studies spanning decades have found medication abortion to be safe and effective. 

"We've been using mifepristone in the U.S. for over two decades and we aren't seeing legitimate studies that are documenting any medical fallout or medical complications from this drug," said Rachel Jones, Guttmacher Institute principal research scientist.

Medication abortion and ER visits, hospitalizations

Research shows abortion pills are not associated with a high percentage of emergency room visits or hospitalizations.

The studies Uthmeier pointed to did not prove that medication abortion is dangerous, experts said

One of the studies, published in 2012, acknowledged that major adverse events attributable to medication abortion, such as hospitalizations, emergency department visits and blood transfusions, are "rare." 

The vast majority of mifepristone research is in line with this.   

A 2013 study that examined 233,805 medication abortions by Planned Parenthood in 2009 and 2010 found an emergency department treatment rate of 0.1%, and said significant adverse events requiring hospital admission occurred in 0.16% of cases.

A 2015 study on emergency room visits and complications after 55,000 abortions — 11,000 of which were medication abortions — found that serious adverse events occurred in 0.3% of all cases.

Emergency department visits alone are not indicative of adverse events, Upadhyay, the 2015 study’s lead author, told PolitiFact.

A 2018 study found around 51% of abortion-related ER visits involved observational care only. "This really shows that people go to the emergency department to have their questions answered. They aren’t getting any treatment. They are being observed and released," Upadhyay said.

U.S. Health and Human Services Secretary Robert F. Kennedy Jr. and FDA Commissioner Dr. Marty Makary have promised to launch another mifepristone safety review. The top health officials have referenced studies that experts say have several problems.

For example, one April report by the Ethics and Public Policy Center, a conservative nonprofit that opposes abortion, found a substantially higher rate of serious side effects from the drug compared with other studies.

The report wasn’t peer-reviewed or published in a medical journal. It didn’t disclose its data source and contained multiple methodological issues, 263 reproductive health researchers wrote in a letter to the FDA. Uthmeier cites the report in Florida’s lawsuit against Planned Parenthood.

Our ruling

Uthmeier said, "Evidence suggests that 1 in 25 women who consume (abortion) pills are hospitalized."

Uthmeier conflated hospitalizations with emergency department visits. Roughly 1 in 25 women visited the ER in the two studies Uthmeier cited, but only five out of 1,043 — or 1 in 200 — were hospitalized related to the abortion pill.

ER visits, which can often involve only observational care followed by release, are not a reliable indicator of drug safety, researchers said, and do not mean patients experienced a serious adverse event or were admitted to the hospital.

Several other studies found lower rates of ER treatment and hospitalizations following medication abortion.

Uthmeier’s statement contains an element of truth but ignores critical facts that would give a different impression. We rate it Mostly False.  

PolitiFact Researcher Caryn Baird contributed to this report.