The Food and Drug Administration approved the over-the-counter sale of abortion pills which will increase access to reproductive health services to women in need.
For the first time, the Food and Drug Administration (FDA) has given the green light to retail pharmacies like CVS and Rite Aid to sell abortion pills to the public.
Before this regulatory change took effect, mifepristone was only available through certain mail-order pharmacies or by doctors or clinics with special certifications. Patients will still have to get a prescription from a doctor to obtain the pills.
This medication has been at the center of political and legal battles since the Supreme Court overturned Roe v. Wade last year, ending the decades-long federal right to an abortion.
After Roe was overturned, many Republican-run states immediately moved to put limitations on or to end access to abortion altogether. This has resulted in some American women being forced to travel long distances to a state that still allows abortion.
In July, it was reported that a ten-year-old girl was raped and impregnated by a 27-year-old man in Ohio. After the Supreme Court’s June 2022 Roe ruling, an Ohio law took effect that prevents abortion once there is any “cardiac activity” detected, which usually happens around 6 weeks gestation. Most women don’t know they’re pregnant at this stage, drastically reducing the number of women that would be able to have an abortion in Ohio.
This law also makes no exception for those pregnant women who are victims of rape or incest.
Because of this law, the ten-year-old girl was forced to drive across state lines to neighboring Indiana in order to have an abortion. She was six weeks and three days gestation when she went to see a doctor.
That Ohio physician called a colleague in Indianapolis, Indiana, Dr. Caitlin Bernard, and asked her to see the 10-year-old and provide much needed reproductive health services.
In December 2021, the FDA permanently eliminated the regulation that required women receiving mifepristone to obtain a prescription from a doctor in person. This opened the door for women to be seen by a certified doctor online through telehealth services, which provide medical consultations over a video conference online.
This allows women to have a quick, private consultation with a doctor and to receive their pills through the mail or in person at a pharmacy with relative ease.
Mifepristone works by blocking a hormone necessary for a pregnancy to develop. It can be taken up to ten weeks gestation, although some doctors and clinics are prescribing it up to 13 weeks as there is scientific evidence that it is still safe and effective.
The second drug used in the abortion drug cocktail is called misoprostol and has never been the subject of political and legal scrutiny like mifepristone. This is likely because misoprostol is prescribed for a number of different medical conditions.
The misoprostol is taken 24 to 48 hours after ingesting mifepristone and it works by causing contractions that discharge pregnancy tissue from the body.
The question is whether large chains and small, local drugstores will carry mifepristone for their patients.
A spokesman for Walgreens, Fraser Engerman, said the company would review the F.D.A.’s decision and would “continue to enable our pharmacists to dispense medications consistent with federal and state law.”
The availability of mifepristone is likely to be based on political and religious considerations and the public’s perception, especially when it comes to small, one person-owned pharmacies. We’ve seen in the past that some religious pharmacy owners refused to fill birth control and Plan B (the “morning after” pill) prescriptions.
There’s almost guaranteed to be a disparity in pharmacists who are willing to fill a mifepristone prescription due to their religious or political affiliations. Also, in pharmacies in about half of the states, it could be illegal or extremely taxing to provide mifepristone to women due to these states’ bans or restrictions on abortion.
Mifepristone is currently only able to be prescribed for abortion, although it may be used during some miscarriages as well. There may also be pressure from the medical field and women’s reproductive health care advocates for pharmacies to carry the drug for that reason alone.
Even before the Supreme Court overturned Roe, some states had passed laws that prevented pharmacy owners from refusing to fill prescriptions based on religious or personal beliefs. Other states leave the decision to each independent pharmacy and don’t even require pharmacists to help their customers find alternative care in the case that they refuse to fill the prescription.
There are six states that have passed laws making it legal to refuse to fill prescriptions like birth control or Plan B. Those states are Arizona, Arkansas, Georgia, Idaho, Mississippi, and South Dakota.
Eight states have laws that require pharmacists to provide care, despite objections: California, Nevada, Washington, Wisconsin, Illinois, Maine, Massachusetts and New Jersey.
Seven states allow pharmacists to refuse to fill prescriptions that may be morally objectionable but requires that they find alternative care for the customer. Those states are Oregon, Texas, Alabama, North Carolina, Pennsylvania, New York and Delaware.
If anyone has difficulty getting their prescriptions filled, they can file a complaint with their state’s pharmacy board. It’s also helpful to alert the pharmacy’s corporate office (if they have one) about what happened.
You can also file a complaint with the Federal Office of Civil Rights at the Department of Health and Human Services on their website. You can fill that out here.
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