After more than a year of the COVID-19 pandemic, the Food and Drug Administration (FDA) will temporarily remove requirements around the abortion pill to allow people to get the medication by mail rather than in person.
Earlier this year, after pressure from former president Trump, the Supreme Court ruled that the abortion pill still must be picked up in person according to FDA requirements. Those rules essentially require that people get the medication in person from a health clinic, hospital, or doctor’s office rather than through a pharmacy. There are 19 states that also require that the health care professional who is prescribing the medication be physically in the room with the patient while they take the medication, the Guttmacher Institute says, essentially banning medication abortion via telemedicine.
But this week, in a letter sent to the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine (SMFM), acting FDA commissioner Janet Woodcock, M.D., said the FDA will “exercise enforcement discretion” regarding the in-person requirement to accessing the abortion pill. This decision means the FDA will also permit people to get the abortion pill by mail through a certified prescriber or a mail-order pharmacy, provided they have a prescription from a certified prescriber. (One thing to note, though, is that this does not override local laws that restrict or ban medication abortions.)
The decision is based on an FDA review of existing scientific literature looking at possible complications from taking the abortion pill. “The overall findings from these studies do not appear to show increases in serious safety concerns (such as hemorrhage, ectopic pregnancy, or surgical interventions) occurring with medical abortion as a result of modifying the in-person dispensing requirement during the COVID-19 pandemic,” Dr. Woodcock writes in the letter.
What’s commonly called the abortion pill is actually two medications: Mifepristone (RU-486, brand name Mifeprex), which terminates a pregnancy by blocking the hormone progesterone, and misoprostol, which makes it easier for the uterus to expel the pregnancy. These medications are used specifically to terminate pregnancies at 10 weeks or earlier. They’re also used in some cases to manage miscarriages in early pregnancy.
There can be some side effects with these medications, such as bleeding, cramping, and nausea. In very rare cases (estimated to be about 0.3%), people may develop complications after using these medications that require hospitalization, such as excessive bleeding or infection.
But the abortion pill and the entire medication abortion process are generally considered to be quite safe in the vast majority of cases, which is why experts and advocacy groups have been pushing for years to make it easier for people to access this option for abortion care—especially in the midst of a pandemic when there are even more barriers to accessing health care in person. The FDA’s review suggests that allowing people to get and take the medications at home doesn’t pose any extra risks to their health and can make it significantly easier for them to access the care they need.
“Thanks to the FDA’s intent to exercise discretion in enforcing the in-person dispensing requirement, those in need of an abortion will be able to do so safely and effectively by acquiring mifepristone through the mail—just as they would any other medication with a similarly strong safety profile,” the American College of Obstetricians and Gynecologists (ACOG) said in a statement, adding that the group hopes this will be a permanent change. “We are pleased to see mifepristone regulated on the basis of the scientific evidence during the pandemic, rather than political bias against comprehensive reproductive health care, and we look forward to working with policymakers to ensure this principle governs post-pandemic care.”
Related:
- 9 Questions You Probably Have About the Abortion Pill, Answered by Doctors
- 15 Ways to Mentally and Physically Prepare for Your Abortion Procedure
- The Complicated Reality of Buying Abortion Pills Online