A study on abortion pills by mail could help bolster abortion access across the U.S.
Since we elected a man who equates abortion with “ripping the baby out” just “days before birth,” we’ve seen emboldened anti-choice lawmakers floating all kinds of restrictions and been forced to consider the possibility of Roe v. Wade being overturned by new anti-abortion Supreme Court justices. But a solution to struggles with accessing abortion is in the works, as Gynuity Health Projects researchers study the safety and effectiveness of abortion pills by mail in four different states: Hawaii, New York, Oregon, and Washington.
While the service is not yet allowed by the U.S. Food and Drug Administration (FDA), the agency approved this project, which suggests that, depending on its findings, it’s entirely possible abortion pills by mail could become legal in the U.S. in the not-so-distant future. The study aims to determine if medical abortions, abortions performed through doses of misoprostol used together with mifepristone (a drug inhibiting the hormones necessary for pregnancy) through an online consultation with a doctor and pills mailed to a woman’s home are safe.
In recent years, the internet and phone apps have lent a surprisingly helpful hand to the reproductive rights movement. For example, just over the summer, birth control prescriptions became available through an app, allowing women to consult with doctors by phone and receive birth control within days. Additionally, the Netherlands-based online abortion pill provider Women on Web has provided abortion medications to about 50,000 women in 130 countries, most with severe restrictions on access to safe, legal abortion over the past 10 years.
In order to obtain the pills, women involved in the study first engage in a video chat with a doctor who evaluates their medical history and explains the process of taking abortion pills and what to expect, and must additionally take medical tests including an ultrasound and blood work. In addition to helping women who may feel threatened by anti-abortion protesters outside of clinics and just being more convenient, for some women involved in the study, the process also saved them money from cost of travel.
CNN reports that of 12 Hawaii-based women who have participated in the study, one did not end up using the pills and the 11 other women reported no complications. Ten of these 11 women claim they would recommend the abortion pill by mail service.
In response to backlash by the National Right to Life League and other anti-abortion groups and portrayals of it as dangerous, Gynuity’s principal investigator, Dr. Elizabeth Raymond, told CNN, “All kinds of dangerous drugs are prescribed and available at pharmacies, including drugs for heart disease and Viagra. There is no justification for why this safe drug should not be in pharmacies now.” If concerns about abortion from anti-choice groups were truly related to safety and public health, this would be a valid point. However, as we all know, that’s not the case, as surgical abortion itself remains mired in stigma and restrictions despite its objective safety.
Medication abortion experienced a surge in popularity in recent years, to the extent that 43 percent of pregnancy terminations at Planned Parenthood clinics in 2014 were medication abortions, up from 35 percent back in 2010, a report by Reuters revealed earlier this month. This was in part attributed to the declining availability of abortion clinics offering surgical abortion, due to TRAP (targeted regulation of abortion providers) laws, imposing medically unnecessary and expensive requirements on clinics offering abortions with the purpose of shutting them down. And though some TRAP laws were struck down in the June Supreme Court ruling of Whole Women’s Health v. Hellerstedt, rebuilding the many clinics closed by these laws, often in states with very few to start with, isn’t going to happen over night.
But that being said, laws regulating access to abortion pills vary widely across states, and still require multiple medical visits. New federal prescribing guidelines for the abortion pill took effect in March, allowing the drugs to be prescribed as far as 10 weeks into pregnancy, reducing the number of required medical visits from three to two, and allowing trained professionals (not just physicians) to provide the pills. Additionally, the FDA reduced the required dosage of mifepristone from 600 milligrams to 200 milligrams.
But online consultations and abortion pills by mail would obviously be more convenient, and in states with almost no clinics and particularly stringent anti-abortion laws (which are bound to become even more pervasive now that we’ve elected an anti-choice presidential administration and the Republican Party quite literally owns southern state legislatures), it could also be life saving. However, even upon hypothetical FDA approval, abortion pill by mail services would still find uphill battles in the 19 states where telemedecine for abortions, rather than physical consultations with doctors, remain banned.
The election of Donald Trump signals a scary time for the reproductive rights movement, with birth control access appearing tenuous without Obamacare and funding for Planned Parenthood, and abortion providers feeling increasingly unsafe. However, anti-abortion restrictions have plagued women for decades and never kept abortions from happening. If all goes well with the Gynuity Health Projects’s study, the potential legalization of abortion pills by mail could offer the reproductive rights movement a critical boost.