By Tom Perille

Why mandate drug-induced abortion access at Colorado’s colleges and universities?

At a time of unprecedented Colorado state budget challenges, you would think state legislators would be laser focused on creating and funding those programs where there is broad public consensus and demonstrated need. They would avoid measures driven primarily by tribal and ideological considerations that would further compromise the state budget.

You would be wrong.

House Bill 26-1335 passed its first House committee challenge on April 16 and will be soon headed for the Colorado Senate. The bill creates an unfunded mandate for state colleges and universities to establish and fund drug-induced abortion services at their campus health centers.

Though the fiscal note claims there would be no cost to the state, this is ludicrous. In states like California, where this has been adopted, millions of dollars were set aside to establish the program, and there was recognition there would be a substantial long-term financial commitment by the state.

Colorado taxpayers already fund 10% to 30% of public university budgets. When the state imposes new mandates without funding, those costs do not disappear. In the short term, they can be either shifted to students through fees and tuition or absorbed through cuts to other critical educational services. But ultimately, they will be paid by the state in the form of increased funding.

Mandating abortion provision transforms student health centers beyond their traditional scope. Student health centers are designed for primary care, preventative services and limited outpatient management of common diseases. They are not equipped to deal with complex reproductive health services that commonly require follow-up and surgical interventions. During the hearing on HB26-1335, there was no testimony from those institutions directly affected by the measure.

Selecting eligible women for a drug-induced abortion is not as simple as it seems and introduces risk to a campus-based abortion service. Approximately 2% to 4% of patients may be incorrectly classified as eligible for medication abortion using self-assessment methods. To mitigate this risk, campus health centers should have ultrasound capabilities which introduce another layer of clinical expertise and cost that would be required.

Even when executed based on clinical best practices, drug-induced (mifepristone/misoprostol) abortions carry substantial risk. Mifepristone can be anticipated to cause significant adverse effects. According to the FDA package insert, 85% of women can anticipate an adverse reaction. Though serious adverse effects are uncommon, the FDA cites a 0.3% to 0.5% requirement for transfusion, 0.2% incidence of sepsis, 2.6% requirement for surgical intervention, 2.9% to 4.6% utilization of emergency departments and 0.04% to 0.6% need for hospitalization. Higher frequency and higher acuity emergencies are more common after drug-induced abortions than following surgical abortion or live birth. This will affect many women seeking abortion services on Colorado campuses ill-equipped to deal with this level of physical harm.

The introduction of drug-induced abortion services on college campuses will exacerbate an already endemic mental health crisis amongst young adults. Studies of mental health in college student populations demonstrate an alarming incidence of mental health problems. The Colorado Assembly should not be proposing mandates known to exacerbate existing mental health problems and precipitate problems in otherwise mentally healthy students. Recent research suggests a markedly increased incidence of hospitalization for psychiatric disorders (81% higher), substance abuse disorders (157% higher) and suicide attempts (116% higher) in women who had abortions. This adds to a growing body of international literature on the adverse mental health effects of abortion.

The bill does nothing to address the abuse of drug-induced abortion by partners and sexual traffickers. HB26-1335 does not require in-person dispensing which increases the risk coercion on campuses will not be detected and an abortion might be the choice of partners or traffickers and not the woman.

Hemorrhage is the most common and anticipated result of the drug-induced abortion procedure. They will increase the risks of exposure to biohazards in college dormitories. Students and staff will be unprepared for the additional exposure to bloodborne pathogens and medical waste that accompanies drug-induced abortions. This introduces a whole new source of jeopardy to the student body and increases state financial liability.

Mandated abortion services on campus draw college roommates into an emotional/physical drama without their consent. They may be woefully unprepared to deal with the sequelae.

The notion without abortion, women’s educational and professional lives would be irreversibly affected has credibly been debunked by 240 professional women, scholars and feminists. College women can be better served by policies and programs that make academic and logistical accommodations for pregnant women in the academic environment.

Abortion is morally repugnant to a sizable minority of Coloradans and mandating the procedure on campuses is an affront to those sensibilities. The bill does not include conscience objections. It flagrantly violates Hippocratic tenets of medical professionals and the moral principles of approximately 40% of the state’s population.

There is no reason to make our 32 state colleges and universities purveyors of drug-induced abortion when it is widely available off campus. Legislators should reject this bill which comes with both negative budgetary implications at a great personal cost to our students. Instead, let’s focus on those things we can agree on that we know lead to individual and community flourishing.

Tom Perille, M.D., is a member of American Association of Pro-Life OBGYNS of Colorado and Democrats for Life of Colorado.