Controversial Studies on Medication Abortion Retracted Due to Undeclared Conflicts of Interest

Two influential studies that have been used as evidence to support the restriction or withdrawal of medication abortion have recently been retracted by academic publisher Sage. The retractions come after the studies were found to have undisclosed conflicts of interest and unreliable findings.

Investigation into Research Prominent in Abortion Pill Case

Last year, it was reported by States Newsroom that Sage had initiated an investigation into research featured prominently in the Alliance for Hippocratic Medicine v. U.S. Food and Drug Administration case. This case, which is set to be heard by the U.S. Supreme Court next month, focuses on mifepristone, a key component of the two-drug regimen used for pregnancy termination and miscarriage management.

Sage Retracts Studies Funded by Pro-Life Organization

Sage has retracted three studies published in its journal “Health Services Research and Managerial Epidemiology.” These studies were funded and produced by the Charlotte Lozier Institute, the research arm of Susan B. Anthony Pro-Life America, an influential organization working to elect anti-abortion lawmakers at the federal and state levels.

Undeclared Conflicts of Interest and Lack of Scientific Rigor

The decision to retract the studies was made following Committee on Publication Ethics (COPE) guidelines. Expert reviewers found that the studies lacked scientific rigor and had unreliable conclusions. Undeclared conflicts of interest were also discovered, leading to the retraction.

The Retracted Studies

The three retracted studies are as follows:

• “A Longitudinal Cohort Study of Emergency Room Utilization Following Mifepristone Chemical and Surgical Abortions, 1999–2015” (2021)
• “A Post Hoc Exploratory Analysis: Induced Abortion Complications Mistaken for Miscarriage in the Emergency Room are a Risk Factor for Hospitalization” (2022)
• “Doctors Who Perform Abortions: Their Characteristics and Patterns of Holding and Using Hospital Privileges” (2019)

Authors’ Affiliations and Undisclosed Conflicts of Interest

James Studnicki, the vice president and director of data analytics at Charlotte Lozier Institute, was the lead author for each of the retracted studies. At the time of publication, Studnicki served on the editorial board of “Health Services Research and Managerial Epidemiology.” The Sage statement revealed that all authors, except one, had affiliations with pro-life advocacy organizations. These organizations, including the American Association of Pro-Life Obstetricians and Gynecologists (AAPLOG), explicitly support judicial action to restrict access to mifepristone. AAPLOG is also a plaintiff in the Alliance v. FDA lawsuit.

Authors Respond to Retraction

In response to the retraction, James Studnicki and Tessa Longbons, senior research associate, issued a statement calling it a “baseless ideological attack” on their scientific research. They criticized Sage for caving to “outside partisan pressures” and accused the medical community of suppressing research that challenges the pro-abortion narrative.

Concerns Raised by Pharmaceutical Sciences Professor

Pharmaceutical sciences professor Chris Adkins raised concerns about the 2021 “Longitudinal Cohort Study” last year. This study was cited by U.S. District Judge Matthew Kacsmaryk as evidence in the Alliance v. FDA case. Adkins expressed doubts about the study’s conclusions, stating that the data was presented in a way that exaggerated the risks of medication abortion.

Peer Review Findings Support Concerns

Independent post-publication peer reviewers, including epidemiology and public health experts, agreed with Adkins’ concerns. They found fundamental problems with the study design and methodology, unjustified or incorrect factual assumptions, material errors in the data analysis, and misleading presentations of the data in the 2021 and 2022 papers. The 2019 article using a different dataset was also found to have unsupported assumptions, misleading presentations of findings, and a lack of scientific rigor.

Mifepristone’s Safety and Efficacy

Experts have consistently cited the safety and efficacy of mifepristone, with over 5.6 million recorded uses over the past two decades. The FDA has reported 28 deaths but has not identified mifepristone as the cause of these deaths.