Republican state lawmakers are working to restrict access to abortion pills. : NPR

Mifepristone, an abortifacient drug, was approved by the FDA more than 20 years ago. The FDA recently relaxed some of the drug’s distribution rules. Now some legislatures are trying to restrict access.

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Mifepristone, an abortifacient drug, was approved by the FDA more than 20 years ago. The FDA recently relaxed some of the drug’s distribution rules. Now some legislatures are trying to restrict access.

Phil Walter/Getty Images

For most of the nearly 50 years since the Roe vs. Wade The Supreme Court ruling legalized abortion across the country, clinics have been at the center of the battle over abortion rights.

Protesters gather outside on sidewalks. And Republican state lawmakers are trying to regulate what goes on inside — through laws limiting which health care providers can perform abortions, what kind of counseling is required, and what procedures are allowed.

But now more than half of abortions take place with pills.

“For many people, having the ability to have an abortion in the privacy and comfort of their own home is appealing,” said Rachel K. Jones, a researcher at the Guttmacher Institute, which supports abortion rights.

According to data published by Guttmacher earlier this year, abortion pills – not surgical procedures – accounted for 54% of abortions in 2020. This makes medical abortion the dominant choice in the United States for the first time since the Food and Drug Administration has approved an abortion. pill, mifepristone, more than 20 years ago. It is part of a two-drug protocol approved to terminate pregnancies up to 10 weeks gestation. This protocol is also prescribed to manage certain miscarriages.

During the pandemic, the FDA relaxed rules so that mifepristone, a tightly regulated drug, could be obtained through telehealth appointments and mail-order pharmacies, rather than in person. This made it easier for patients in some states to get a medical abortion at home. The Biden administration recently made these changes permanent.

Now Republican lawmakers in several states are pushing back.

In South Dakota, Governor Kristi Noem recently signed legislation to restrict access to drugs.

Already, more than a dozen states limit the use of telemedicine to deliver abortion pills. And this year, Planned Parenthood says new restrictions have been introduced in two dozen states, some of which would ban the pills altogether if Roe vs. Wade is overthrown.

In Georgia, Republican State Senator Bruce Thompson sponsored SB 456, a bill banning the delivery of abortion pills by mail and requiring doctors to examine patients in person before prescribing them. During the debate on the floor, Thompson said his bill was intended to “protect the valuable doctor-patient relationship.”

But that position is at odds with that of major medical groups, including the American College of Obstetricians and Gynecologists and the American Medical Association, which have long supported easier access to pills and have called for lifting the ban. in-person delivery requirement.

Thompson opposes abortion rights, but he claims the bill is about patient safety.

“Why wouldn’t we do everything in our power to protect the health and safety of women during this difficult time in their lives?” he said.

But opponents say the bill would make patients less safe. Several lawmakers have noted that Georgia is among the states with the highest maternal death rates — and those death rates are significantly higher for black women.

State Senator Kim Jackson, a Democrat, noted that many people, especially in rural areas, do not have access to pregnancy care.

“What’s really cruel about this bill is that those who are already the most vulnerable are the ones most at risk of being burned by this injustice,” Jackson said. “Poor people, people who live in rural communities. People with disabilities and people of color.”

The bill passed the Georgia State Senate on March 1 and is awaiting a vote in the House.

“As soon as the FDA made medical abortion more accessible, Georgia pretty much turned around and said, ‘No, we actually want to make it really hard for people to get one. said K. Agbebiyi, a Georgia-based lawyer with the reproductive rights group URGE, which is fighting the bill.

Agbebiyi said medical abortion could become the only option for a growing number of people in states where clinics are scarce due to abortion restrictions.

“We know, and our opponents know, that medical abortion will gain popularity if deer is overthrown,” Agbebiyi said. “And that is precisely why they are trying to put up as many barriers as possible.”

It is more difficult to erect barriers on the Internet, where abortion pills are available from mail-order pharmacies and other groups.

Ushma Upadhyay, a reproductive health researcher at the University of California, San Francisco, warned that if states tried to block access to abortion pills, patients would find them online without the help of a doctor.

“That’s what worries me,” she said. “It’s extremely safe, but all patients should have access to clinical support if they need it, have questions about how to take it, or if what’s happening is normal.”

Meanwhile, some states are trying to facilitate access to medical abortion. A bill moving forward in Delaware would allow a wider range of health care providers to prescribe the pills to their patients.

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