Doctors, clinics and telehealth providers across the country are scrambling to figure out how they will continue to provide the most common type of abortion after a federal appeals court imposed new restrictions on a key abortion drug.
A telehealth provider will have to close for two weeks. Some abortion clinics in Ohio are considering ditching the drug entirely. Meanwhile, other doctors are looking for legal loopholes to distribute the drug called mifepristone.
Abortion rights advocates say that people who live far from abortion clinics will be hit hard. Kristin Moore, director of the Expanding Abortion Access Project, said the restrictions could force people to travel hundreds of miles for care and stay for days.
“This will have a severe and serious impact on access,” she said, adding that it would be “devastating” for underserved rural populations.
This is the second time in less than a week that the legal sands have shifted around medical abortions, which account for more than half of all abortions in the United States.
the Late decision Wed narrowed a effort of a texas court judge To prevent FDA approval of mifepristone. Patients are allowed to continue using the drug, but only at a higher dose and if the patient is seven weeks or less pregnant. The decision also bans sending the drug through the mail and requires people to have three in-person visits with their doctor to take the pills. The Justice Department plans to appeal the decision to the US Supreme Court.
Mifepristone, which was approved by the Food and Drug Administration in 2000, blocks progesterone and is also used to treat miscarriages. Millions of women around the world have used the drug, and medical groups say complications occur at a lower rate than with routine medical procedures such as wisdom tooth removal and colonoscopies.
Abortion providers and patient advocates said the court-imposed restrictions could affect thousands of people if they go into effect on Saturday.
Since Roe v. Wade was overturned last year, telehealth abortions have more than doubled, according to a report released this week by Planned Parenthood. The report said abortions performed by telehealth providers in virtual clinics rose to 8,540 last December, or 11% of all abortions, compared to 3,610 in April 2022.
Wisp, a company that provides telemedicine abortions in nine states, plans to close for two weeks if the ruling goes into effect Saturday to switch to a single-drug regimen that uses misoprostol, a drug that has not been challenged in courts but has been considered lightly. less effective.
They are also looking at making misoprostol available to people who want to stock up on this drug, said Monica Sepak, the company’s chief marketing officer.
“Telehealth remains a really important piece of the accessibility puzzle because as demand for in-person care probably increases, the time to get an in-person appointment is often 20 to 30 days, and telehealth fills that really important gap for patients,” she said.
Telehealth providers were already facing limitations. according to February report From the Kaiser Family Foundation, six states that have not banned abortion have at least one requirement for at least one trip to the clinic.
But abortion-by-mail provider Aid Access will not allow a US court order to prevent it from prescribing mifepristone and misoprostol via telehealth, Dr. Rebecca Gomperts wrote in an email.
Gomperts is based in Europe, and the company’s website advertises that they can mail cereal to all 50 states in the United States.
The company has a history of flouting US laws and rules on this issue. In 2019, Aid Access defied an order from the US Food and Drug Administration to stop distribution of the drug in the country.
Some abortion clinics in Ohio may stop dispensing mifepristone altogether by Saturday, said Jesse Hill, an attorney who represents several independent clinics in the state. State law requires doctors to follow federal labeling guidelines when prescribing mifepristone, which means clinics will have to follow the court order. It would “make it incredibly inconvenient” to prescribe mifepristone, she said, because patients would have to make three in-person doctor visits and pay more for a higher dose.
Clinics are also considering a medical abortion method that contains only misoprostol.
In Illinois, operations will largely continue at the Planned Parenthood clinic in Fairview Heights, Dr. Colleen McNicholas told The Associated Press.
The clinic, which expects to serve about 10,000 abortion patients this year, will continue to offer medical abortions through a combination of mifepristone and misoprostol.
In part, this is because the state allows doctors to write prescriptions “off-label,” which gives providers the ability to prescribe a drug in a way that has not been approved by the federal government. McNicholas said the practice is common among physicians who have medications long proven safe for patients.
She added that gives abortion providers an extra layer of protection because the clinic is located in one of the most abortion-friendly states in the country.
Providers of the drug in many states can still prescribe mifepristone off-label in places not prohibited by state law, said David Cohen, a law professor at Drexel University in Philadelphia, meaning they can offer the drug to patients later than seven in pregnancy. weeks.
But he does not see how they can legally circumvent the requirement to be appointed in person.
“It will still be available for up to and possibly more than ten weeks, depending on what your provider feels comfortable prescribing,” he said. “But while the pills could have been mailed to you at home…now, you have to get them in person from the doctor.”