How would the Noem rule change abortion pills?

SIOUX FALLS, SD (KELO) — Governor Kristi Noem continues to push for legislation restricting telemedicine abortion in South Dakota on the grounds that it is unsafe for women. But doctors are pushing back, saying the proposed rules and legislation on medical abortion pose greater danger to women in South Dakota.

At a press conference this week, Governor Noem answered questions about a recent lawsuit filed by Planned Parenthood and the American Civil Liberties Union (ACLU) over a rule requiring patients seeking chemical abortions to make three visits to a doctor. A district court judge granted Planned Parenthood a temporary restraining order, delaying the rule from taking effect until January 27.

Governor Noem would like to see a ban on telemedicine abortion in South Dakota.

“The reason we’re pushing it is because it’s so dangerous for women to have this procedure,” Governor Noem said of the rule.

A reporter asked if it was already illegal, and Noem added that there was not yet a specific statute in South Dakota law prohibiting telemedicine abortion.

Noem’s concerns revolve around the idea that patients as young as 13 could receive these drugs in the mail to their homes and take these drugs without a doctor’s supervision. But Planned Parenthood told KELOLAND News on Friday that as the only abortion provider in the state, they are required by law to meet with a patient at their Sioux Falls clinic before a chemical or surgical abortion. There is a 72-hour waiting period in place in South Dakota for all abortions according to Sioux Falls Planned Parenthood Chief Medical Officer and Medical Director Dr. Sarah Traxler.

“It is 4 times more dangerous for a woman to have this procedure and four times more likely to end up in the emergency room,” Governor Noem said on Thursday about medical abortion at home.

Noem pulls this statistic from a study titled “A Longitudinal Cohort Study of Emergency Room Use After Chemical and Surgical Mifepristone Abortions, 1999-2015” which was funded by the Charlotte Lozier Institute.

The study says that compared to surgical abortions, chemical abortions among their sample population between 1999 and 2015 were four times more likely to visit the emergency room within 30 days of an abortion procedure. The study also notes that chemical abortions began to increase in 2012 and nearly doubled in 2015.

“The reasons for the increased rate of ER visits after mifepristone abortions are not obvious, but may be influenced by mifepristone abortion providers who are unable or unqualified to manage post-abortion complications. chemicals,” the study states in its conclusions.

The study analyzes the utilization and hospitalization of patients who use mifepristone, not misoprostol. The governor is concerned that people could receive mifepristone over the internet and take it home. But Dr. Traxler says that in South Dakota, patients are already required to take mifepristone under the supervision of a physician. The rule put forward by the Legislative Rules Committee would add an additional visit to take misoprostol under the supervision of the same physician.

How the Chemical Abortion Procedure Works

Dr. Traxler explained to KELOLAND News that mifepristone and misoprostol must be taken to complete the chemical abortion procedure. According to Traxler, a patient seeking a medical abortion would come to the clinic in Sioux Falls where she would receive abortion counseling and education. After a period of 72 hours, they returned to the clinic and took mifepristone under the supervision of the doctor who had advised them.

Mifepristone blocks progesterone, which is a hormone needed to maintain pregnancy according to Traxler. She explains that by binding to progesterone receptors, mifepristone increases uterine muscle contractions and prepares the cervix to open.

In the current abortion process in South Dakota, once the mifepristone is taken at the clinic, the patient is then given misoprostol to take home 24 to 48 hours later. Misoprostol causes uterine contractions and improves the effectiveness of the abortive drug and completes the procedure.

Traxler says timing is important when taking mifepristone and misoprostol.

“People who take mifepristone and then don’t take misoprostol are at increased risk of bleeding than people who complete treatment,” Dr. Traxler said.

The rule put in place by the state of South Dakota would require patients to make a third visit to take the misoprostol pill in person, rather than at home. Dr. Traxler said she was concerned that patients might return to the clinic for a third visit within the appropriate time frame to take misoprostol.

“Most of our patients are already parents, and most of our patients travel long distances to get to the abortion clinic,” Traxler said. Traxler adds that she doesn’t think the rule provides a medical reason for this third visit.

In a letter sent to the Legislature Rules Committee, the South Dakota Medical Association echoed Traxler’s concerns. Doctors said the rule does “not reflect evidence-based care” and that requiring in-person dispensing of misoprostol creates a burden on the patient.

Currently, Planned Parenthood has three doctors who travel to South Dakota from Minnesota twice a week to perform abortion procedures. If the rule goes into effect, Traxler says it would be difficult to operate due to staffing issues at the Sioux Falls clinic.

“It’s pretty impossible for us, at this point, to operationalize medical abortion in South Dakota if the rule were to go into effect,” Traxler said.

The rule would not impact surgical abortions, however, Traxler notes.

A U.S. District Court judge agreed with the ACLU and Traxler in their ruling this week and granted Planned Parenthood a temporary restraining order. Judge Karen Schreier ruled that Planned Parenthood and its patients would “suffer irreparable harm if the temporary restraining order is not granted.” Schreier said the balance of prejudice is in favor of Planned Parenthood.

A witness hearing is scheduled for February 1 in Sioux Falls.

Back To Top