Abortion pills available by mail in Washington, but access is not equitable

In April, the Biden administration rescinded a Trump-era requirement that prevented doctors from remotely prescribing mifepristone, one of two drugs commonly used in medical abortion. The ruling made abortion care accessible the same way other forms of health care have been since March 2020, when clinicians turned to telehealth during the pandemic. But while providers in Washington state and across the country have embraced the new system of delivering medical abortion by mail, advocates say access remains far from universal, including in the Northeast. western Pacific.

This might surprise some. With abortion insurance and Medicaid coverage and state-level protections to keep abortion legal if Roe v. Wade is overruled, Washington bucks national trends toward anti-abortion legislation. But even here, 59% of counties, where 10% of Washington’s women live, don’t have an abortion clinic, according to data from the Guttmacher Institute, a reproductive health policy organization.

Medical abortion by mail is a new way for people living in these underserved areas to access care. Washington patients can now seek care at digital clinics such as Hi Jane or virtual consultations with established local physical clinics like Cedar River, which has offices in Seattle, Tacoma and Renton. Since medical abortions typically end pregnancy using mifepristone and a second drug, misoprostol, making the pills available by mail means patients can safely abort at home without visiting a clinic. The non-surgical option, which is effective in terminating pregnancies up to 10 weeks gestation, is becoming increasingly common, accounting for 39% of all abortions in the United States in 2017, according to Guttmacher. During the COVID-19 pandemic, medical abortion had the added benefit of not requiring in-office surgery – and the risks of exposure that came with it.

Ying Zhang, a Seattle-based family physician, said that during the pandemic, many family planning providers across the country had “put protocols in place to provide no-contact medical abortion where patients could seek care without having to to get there. ”

This would not have been possible before the overthrow of the Biden administration. The Food and Drug Administration previously subjected mifepristone to what is called a risk assessment and mitigation strategy. or REMS, a restriction limiting distribution to specific providers in hospitals, doctors’ offices and clinics. This means the drug was not available in pharmacies, despite objections from the American College of Obstetricians and Gynecologists that “there is no safety reason for the restrictions”.

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