Happy New Year! You can now buy safe abortion pills from pharmacies in the US. Finally! The Food and Drug Administration (FDA) authority of the country changed its regulations on January 3, 2023, in a move that makes access to safe abortion easier for those seeking it. According to this new change, anyone with a prescription from a health provider can get safe abortion pills from any certified pharmacy. You can do this either in person or via home delivery. At last, something to bring the sexual and reproductive health arena in the US into the 21st Century.
The regulation about the sale of safe abortion pills is part of FDA’s Mifepristone REMS Program. Under this program, the safe abortion pills can only be issued by certified prescribers or by certified pharmacies on prescriptions from certified prescribers. As FDA reviews medicines for safety, effectiveness, and quality, it strongly discourages people from buying safe abortion pills from places not part of the Mifepristone REMS Program. This includes unverified online stores or foreign countries.
Abortion Pills in Post-Roe USA
This new change has massive significance, keeping in view what has been happening to safe abortion access around the world, but particularly in the US. In June 2022, the US Supreme Court overturned the historic Roe vs Wade court decision from 1973, which had made safe abortion a right in the country. Under this landmark decision, the Supreme Court had declared that safe abortion was a matter of personal privacy – a right protected by the US Constitution. As a result, safe abortion became a federal matter and states could no longer ban abortion with their state-level legislation. For the following 50 years, people could access legal abortion without any fear across the country.
Sadly, this right has been taken away from the people. The current US Supreme Court, which is dominated by anti-abortion judges, heard the Dobbs v. Jackson Women’s Health Organization case in June 2022. This court case challenged the constitutionality of a Mississippi state law that banned most safe abortion operations after the first 15 weeks of pregnancy. In the end, the judges decided that the Mississippi state can ban abortion and that abortion is not protected by the US Constitution.
The History of Abortion Pills at Pharmacies
Given this unfortunate backdrop, FDA’s decision to allow the sale of safe abortion pills at pharmacies comes as a breath of fresh air in the toxic environment that people in the US currently live in. Before this change, mifepristone — one of the two pills used for non-surgical abortion — could only be issued by a few mail-order pharmacies or by certified health providers.
Mifepristone was first approved for use in the US in 2000. The restriction on getting Mifepristone only from specific pharmacies and certified doctors has been in place since then. In 2021, due to the pandemic, the government temporarily suspended this restriction, so that people consulting doctors online and not in person – because of the lockdown – can also get safe abortion pills. The FDA’s latest decision makes this temporary change permanent. It is part of the federal government’s efforts – led by President Joe Biden – to expand the access to safe abortion.
It is important to mention that the two other restrictions on sale and purchase of safe abortion pills are still in place. They are: the health providers should be certified to prove their knowledge and ability to manage safe abortion and patients should complete a consent form.
What Are Abortion Pills?
Now that you can buy safe abortion pills at pharmacies near you, it is useful to know what they are. Safe abortion pills are medicines used for a medical safe abortion. It is also known as self-induced abortion, self-managed abortion or do-it-yourself (DIY) abortion.
When someone says safe abortion pills, they usually mean two things: a combination of two pills called Mifepristone and Misoprostol or just one pill – Misoprostol. As mentioned above, the FDA has allowed the sale of Mifepristone at US pharmacies. The sale of Misoprostol, on the other hand, was never tightly restricted as it is used for many different medical conditions and is easily available at pharmacies with a prescription.
Mifepristone pills block the flow of progesterone – a hormone that supports the pregnancy. Without progesterone, the pregnancy cannot grow. Mifepristone alone cannot cause an abortion. You also need Misoprostol to complete the procedure.
Misoprostol pills cause the uterus to contract, which helps to expel the pregnancy. You can have a safe abortion by just using Misoprostol. But it is effective to use both Mifepristone and Misoprostol together.
Access to Abortion in the US
While the FDA decision is a big win given the state of safe abortion access in the US, these are still dark times. Since the repeal of Roe vs Wade, the landscape of safe abortion rights has changed drastically. Below is an overview of what safe abortion looks like in the US.
Safe abortion is banned: Alabama, Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, South Dakota, Tennessee, Texas, West Virginia, and Wisconsin.
Safe abortion is banned after certain weeks: Georgia, Arizona, Florida, Utah, and North Carolina.
Safe abortion ban is blocked by the courts: Indiana, Iowa, North Dakota, Montana, Ohio, and Wyoming.
Safe abortion is legal but with limitations: Colorado, Delaware, Kansas, Nebraska, Nevada, New Hampshire, Rhode Island, Pennsylvania, South Carolina, Virginia, and Washington, D.C.
Safe abortion is legal: Michigan, Alaska, California, Connecticut, Hawaii, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New Mexico, New York, Oregon, Vermont, and Washington.
It is unfortunate that something as basic as health has been politicized for ideological wars. Every person has a right to make decisions about their body but this right is not being respected. Banning safe abortion prevents people from making choices freely and traps them into bad situations for a very long time. Given the importance of easy access to safe abortion, it is crucial that we keep pushing for better health laws and facilities. Luckily, there are several people and organizations that are fighting the good fight. Organizations filing court cases against abortion bans such as ACLU, activists fighting for fundamental rights, and enterprises providing counselling and accurate information about safe abortion such as safe2choose.
Michell Mor, eHealth Content Specialist at Women First Digital, an organization helping women about contraception and sexual health.
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