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- Last week, the FDA removed a restriction previously requiring medical abortions to be prescribed after a patient had an in-person visit with a medical professional.
- The FDA’s action does not lift state-level restrictions, so telehealth abortion services will remain out of reach for millions of people.
- Research has consistently shown that medication abortions are safe and effective and can be successfully done in the comfort of one’s home.
The Food and Drug Administration (FDA) has decided to permanently allow abortion pills by mail.
Last week, the administration removed a restriction previously requiring the pills to be prescribed only after a patient had an in-person visit with a medical professional.
Many states restrict abortion pills by mail. The FDA’s action does not lift these state-level restrictions, so telehealth abortion services will remain out of reach for millions of people.
During the pandemic, the FDA permitted medication abortions to be conducted entirely via telehealth appointments due to concerns about COVID-19 exposures.
Research has consistently shown that medication abortions are safe and effective and can be successfully done in the comfort of one’s home.
Analyses of telehealth abortions conducted during the pandemic have further shown that telemedicine services help people obtain an abortion in the earlier stages of pregnancy, when abortions are the safest.
States still have the power to restrict access to the pills
The FDA’s ruling does not lift the restrictions many states have in place against abortion pills.
“People desiring a medication abortion will still face barriers in states that banned telehealth abortion or mailing of mifepristone,” said Dr. Josephine Urbina, an OB-GYN and a complex family planning fellow with the University of California, San Francisco.
Telehealth abortion providers who send pills to people in restrictive states could be subject to penalties. Differing laws and policies among states regarding clinician licensing, prescribing authority, and insurance reimbursement makes delivering abortion care services across states difficult.
For example, providers must be licensed to practice medicine in the state where the patient wishes to receive care.
Nicholas Creel, an assistant professor of business law at Georgia College and State University who specializes in constitutional law, expects that some states will introduce legislation permitting abortion care providers to prescribe abortion pills to people in states where it’s illegal to access them.
“For example, California has already been declaring itself a sanctuary and refuge for women in abortion restrictive states. So them passing legislation to explicitly allow California companies to mail abortion pills to women in states where those pills are illegal seems like more a question of when, not if,” Creel said.
Medication abortions are safe and effective
Medication abortion has been safely used in the United States for over 20 years and there is plenty of research showing that the medications can be safely taken at home.
Medication abortion has a success rate of 95 percent if done within the first 10 weeks of pregnancy.
“It is also as safe as undergoing a procedural abortion, it’s safer than continuing a pregnancy to term, and safer than many common drugs in the U.S., such as Tylenol and Viagra,” Urbina said.
According to Urbina, the shift to telemedicine during the pandemic has further demonstrated that abortion services provided via telehealth are extremely safe and effective.
“We have studies that demonstrate that direct-to-patient telehealth for medication abortion is comparable to in-clinic models in terms of safety and efficacy,” Urbina said.
Millions of people live in abortion deserts, where they’re located at least 100 miles from an abortion clinic. When people face barriers to abortion care, they face a higher risk of pursuing riskier abortions or having an unwanted birth.
The use of telemedicine has increased access to abortion, which has helped reduce delays in receiving care and allowed people to obtain an abortion in the early stages of pregnancy, when abortions are the safest.
In the past few years, a handful of companies have popped up that provide medication abortions by telehealth.
Most of these companies — including Hey Jane and Abortion On Demand — only prescribe the pills to patients living in states without restrictions against medication abortion.
Hey Jane recently expanded services to states neighboring more restrictive states — including Illinois, Colorado, and New Mexico — with the goal of providing care to patients residing in these states along with people traveling from Arizona, Texas, Indiana, Missouri, and elsewhere.
Plan C has created a strategic and creative guide for accessing abortion pills in all U.S. states and most U.S. territories.
The bottom line
Last week, the FDA removed a restriction previously requiring that medication abortions could only be prescribed after an in-person visit with a medical professional.
Though the ruling is a win for abortion rights, it does not lift the restrictions many states have on telehealth abortion services.
