Yesterday the Food and Drug Administration announced that they are permanently lifting restrictions on the abortion inducing drug, Mifepristone. Women can receive it by mail following a session via telemedicine. FDA has already granted this permission under its enforcement discretion for the duration the COVID-19 pandemic. As many states put restrictions on abortion in place, the new policy protects this option. This is especially important if the Supreme Court rules that access to the procedure does not remain protected by the Constitution.
Mifepristone (a.k.a. Mifeprex was approved in 2000 by FDA. Current medical abortion protocols include a single dose of mifepristone which reduces progesterone levels and thins the skin. A dose of misoprostol is added to the mix, which can cause uterine contractions. This regimen can be used up to 10 weeks after a woman is born, according to the FDA. The Centers for Disease Control and Prevention reported that 79 per cent of American abortions were completed at nine weeks.
Original FDA regulations required that mifepristone only be given in the presence of a doctor. The FDA approved the TelAbortion Study research project in 2016. It was designed to evaluate the safety and effectiveness of prescribing the drug using “a video evaluation via the internet.” The program grew during the epidemic, eventually reaching 17 states and all of the District of Columbia. According to a TelAbortion report published last March, covering nearly 1,400 packages of pills mailed from May 2016 through September 2000, “this direct-to-patient telemedicine service was safe, effective, and acceptable, and supports the claim that there is no medical reason for mifepristone to be dispensed in clinics as required by the Food and Drug Administration.”
Maryland federal court judge blocked the enforcement of FDA’s requirement for women to visit medical facilities in order to receive mifepristone. The judge stated that it was likely that the FDA’s mandate placed an “undue burden” upon abortion access due the widespread pandemic. The U.S. Court of Appeals, 4th Circuit refused to grant a stay against the preliminary injunction. In January the Supreme Court reinstated FDA’s requirement pending the outcome of its appeal.
After the Biden administration had reevaluated mifepristone policies, three months later the FDA stated that they would not enforce them “during a COVID-19 Public Health Emergency” (public health crisis). In an April 12 letter to the American College of Obstetricians and Gynecologists, the lead plaintiff in the case that challenged the FDA rule, Acting FDA Administrator Janet Woodcock said the evidence at that point did “not appear to show increases in serious safety concerns…occurring with medical abortion as a result of modifying the in-person dispensing requirement during the COVID-19 pandemic.”
Yesterday, the FDA stated that it has “determined the data support modification [mifepristone regulations]To reduce the burden on patients and health care delivery systems and ensure that the benefits outweigh any risks. It is still required that all health care professionals who have approved the use of Mifepristone must obtain special certification. Patients also need to sign an agreement acknowledging that they were informed about the risks. This policy adds certification requirements for the pharmacies that provide the drug. Women who wish to take mifepristone home won’t need to see a doctor, no matter what COVID-19 says.
The FDA policy change was met with new regulations by state legislators. Guttmacher Institute for Pro-Choice reports that 19 states mandate that the doctor who performs a medication abortion be present during the procedure. Telemedicine is prohibited in order to provide medication for abortion. This requirement was enacted by seven of these states this year. Six other states banned the delivery of abortion pills via mail.
It is much easier to get around these restrictions than it is to travel out of state for an abortion. “The current practice is that women who live in states that don’t allow telemedicine for abortion must travel to a state that does — although they don’t have to visit a clinic,” The New York Times reports. The reports state that they can travel to any state in order to have telehealth, such as a car. They may also receive pills from any state.
You can also use less-legal solutions. Interview with the TimesMary Ziegler (Florence State Law Professor), author of American Law on AbortionAccording to a study, “plenty” people will use the internet. [abortion pills]They are illegal in certain states without having to travel out of the state. According to her, such clearinghouses might be set up to facilitate ‘fudging’ addresses to get it and create a black market.
This black market exists already. The October report discusses the Texas law which prohibits abortion if fetal heart activity is detected within six weeks. Times noted that “some women…cross the border to Mexico, where one of the pills that causes abortions is sold over the counter,” adding, “These methods are not technically legal.” Sites selling misoprostol or mifepristone online are an alternative, but they can be dangerous to the users.
Because abortion pills are now legal to obtain by mail, they will also be available without the need for an appointment at a hospital in many parts of the country. This means that local restrictions may become easier to avoid. You don’t think that states have the ability to prevent medical abortions. This is because of the failure of the war on drugs. It has been unsuccessful for over a century in stopping Americans from purchasing politically disfavored substances, which are still illegal in all 50 states.
In 2019, according to the CDC, drug-induced abortions accounted for 42 percent of the total, and that share is likely to rise under the new FDA policy, especially if the Supreme Court allows states to ban or severely restrict surgical abortions, as seems likely. Medical abortions are more prevalent in other countries than they are currently, but that gap will shrink.
Some countries permit medical abortions after 10 weeks. An 2021 survey of 46 regions or countries BMJ Sexual & Reproductive Health The limit that was the most permissive was almost 12 weeks. If the FDA adopted that limit, it would cover all but a small percentage of abortions—something like 12 percent, according to the Guttmacher Institute’s analysis of CDC data for 2016.
The Supreme Court decided six years ago that the 14th Amendment gives women the right to end a pregnancy prior to “viability.” This is a short story from the TimesThe implications of “doing-it-yourself” abortion were considered. According to the paper, self-medication could soon be sufficient to end pregnancies. The author also asked if “scientific advancement” will “soon render obsolete centuries-old legal and religious arguments regarding abortion.” This much is beyond scientific progress’s capabilities, as over 50 years of debate has shown. Legislators who want to end most abortions through force must face an impossible task in finding a viable and safe DIY solution.