US states unsure how to stop online sales of abortion pills amid clinic crackdown

NEW YORK (Reuters) – American women facing new restrictions on abortions passed by a dozen U.S. states this year are turning to abortion pills from foreign vendors online, and states say they can’t do much to stop it.

A pharmacist poses with pills of the drug Misoprostol, manufactured by Lupine Pharmaceuticals, in his hand at a pharmacy in Provo, Utah, U.S., June 19, 2019. Picture taken June 19, 2019. REUTERS/George Frey

In the year before many of these new restrictions were passed by Republican-controlled state legislatures, more than 20,000 American women applied for the pills online from vendors willing to defy the rules. federal laws on the sale of drugs that cause miscarriage.

One of them was Kayla, a 24-year-old mother of two from Mississippi who terminated a pregnancy in January. She and her husband decided they could neither afford to raise another child nor have an abortion at the nearest clinic in Memphis, Tennessee.

“I wouldn’t know what to do if I didn’t have access to it,” said Kayla, who asked to be identified only by her first name. “I would probably be six months pregnant and unhappy right now. It was my lifeline.

Abortion is one of the most divisive issues in American society. Opponents cite religious beliefs about the sanctity of life, while abortion rights campaigners say bans rob women of control over their bodies and their future.

The U.S. Food and Drug Administration has imposed strict rules on the distribution and use of abortion pills, but state drug regulators have said they have no effective way to track and monitor orders in line of foreign doctors and pharmacies.

“We wouldn’t know unless someone told us,” said Larry Hadley, director of the pharmacy board of Kentucky, one of six states that passed a law banning abortion this year after six weeks, often before a woman knows she is pregnant. .

Pharmacy board officials in Alabama, Ohio, Louisiana, Missouri, Georgia and North Dakota also said they were unaware of drug shipments from suppliers. unauthorized aliens or how they would take action against them.

From March 2018 to March 2019, some 21,000 American women searched for the abortion pills misoprostol and mifepristone on the Austrian website AidAccess.org, according to research from the University of Texas at Austin.

“It is reasonable to expect that as states make it even more difficult for people to access clinic abortion care, more people will seek alternatives, including self-directed abortion,” said said Jill Adams, executive director of the If/When/Comment reproductive rights legal group.

In another metric of growing interest, PlanCPills.org, a website that assesses the safety of online pill suppliers, said visitor numbers had risen to 8,000 people a day from around 1,000 over the past few years. last months.

FDA WARNINGS

The FDA has sent warning letters to foreign online vendors, threatening them with seizures and injunctions unless they stop selling the abortion pills to American women.

“We remain very concerned … because this circumvents important safeguards designed to protect women’s health,” an FDA spokesperson said in an email.

But some medical experts describe FDA regulations on these drugs as excessive. They cite studies published in medical journals showing that they pose a relatively low health risk and cause far fewer deaths in American women than natural childbirth.

There is currently only one FDA-approved product, which the agency requires to be dispensed in a doctor’s office, clinic, or hospital.

The pills, usually taken during the first trimester of pregnancy, thin the uterine lining to prevent the embryo from remaining implanted and cause the uterus to contract causing a miscarriage. They should not be confused with the morning after pill which prevents pregnancy.

Abortion pill risks include possible heavy bleeding and, in rare cases, the abortion may fail, requiring follow-up with a surgical abortion, according to the Mayo Clinic, a major US hospital system.

Of the 3.7 million women who took the FDA-approved brand of mifepristone to terminate a pregnancy between September 2000 and December 2018, 24 died of complications, according to FDA records.

AidAccess founder Rebecca Gomperts, a physician based in Austria, received a letter from the FDA in March warning her to stop prescribing abortion pills. She ignored him.

“I’m responding to an urgent medical need for my patients,” Gomperts said in a phone interview. “I have a medical duty to do it and I do.”

Abortion pills usually cost a fraction of the hundreds of dollars for an in-clinic abortion. Gomperts sometimes waives the cost entirely for women who cannot afford it.

Gomperts said she writes prescriptions for the pills for women less than nine weeks pregnant, which are then filled by an Indian pharmacy. About three in four women who contact her opt against the pills for various reasons, she said.

Officials in Arkansas, Indiana, Tennessee, Utah and Mississippi declined to comment or did not return calls.

In Texas, where the number of abortion clinics has nearly halved since 2013, Kerstin Arnold, general counsel for the Texas State Board of Pharmacy, said the state has no way to regulate pharmacies outside of United States.

“I don’t even know where we would go to try to enforce that,” she said.

Reporting by Gabriella Borter; Editing by Scott Malone and Bill Berkrot

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