An Update on Access to Abortion Pills

Written by: Vaishnavi Peyyety, Current Events Staff Writer

The "abortion pill" is a colloquial term that refers to either mifepristone and/or misoprostol. (Photo Courtesy Everyday Health)

FEB. 8, 2023 - In June of 2022, the Supreme Court overturned Roe v Wade, allowing states to set their own rules and regulations for abortion. In turn, there are no longer federal standards preserving safe abortion access. As a result, the need for abortion medication has increased for many, including people experiencing barriers to safe abortions. In specific, abortion medication involves two different drugs: mifepristone and misoprostol which can be used during the first ten weeks of pregnancy according to the U.S. Food and Drug Administration (FDA). World Health Organization has approved the use of abortion medication up to 12 weeks of pregnancy. Mifepristone is sold under the name Mifeprex by the pharmaceutical company GenBioPro. This drug blocks progesterone, an essential hormone without which an existing pregnancy cannot progress. Misoprostol is taken 1-2 days after mifepristone, emptying the uterus by causing cramping and bleeding. To confirm the pregnancy was terminated, an ultrasound or blood test can be carried out. Clinical trials have found that this medication is effective and safe, terminating pregnancies 99.6 percent of the time. There is a 0.4 percent risk of major complications and a mortality rate of 0.00064 percent. At the end of 2021, around half of the abortions in the U.S. were carried out through abortion medication.

In 2000, the FDA approved Mifeprex. The FDA later approved a regimen of utilizing abortion medication for up to 70 days, which is used to guide current clinical practice. Changes in 2011 initiated by the FDA Risk Evaluation and Mitigation Strategy (REMS) resulted in changes allowing only medical providers who obtained mifepristone certification to prescribe and dispense the drug. This limited the number of physicians who can prescribe the medication. Also, through this process, individuals were required to go through an in-person visit and were unable to access the medication from a retail pharmacy. However, in 2021, the FDA removed this requirement, allowing people to access the medication through certified clinicians and without undergoing an in-person visit. Nevertheless, prescribers are still required to be certified by manufacturing companies. Recently, the FDA has approved for certified pharmacies to dispense this medication to patients directly.

Recently, the FDA has "approved for certified pharmacies to dispense this medication to patients directly"

Following the decision in the Dobbs vs Jackson Women’s Health Organization case, states can ban abortion medication. This has taken place in various southern and midwestern states. Nevertheless, even before this decision was made, states could restrict access to abortion medication by mandating in-person visits and blocking telehealth abortion visits. Also, some states require in-person dispensing and/or limit only MDs to dispense these pills. In some states, patients must be counseled about the ability to reverse an abortion after utilizing mifepristone despite a lack of scientific evidence. For example, patients have been told that abortion medication can be reversed by a high dose of progesterone after mifepristone. In Utah, some patients were told that mifepristone itself is ineffective in terminating a pregnancy even though records have repeatedly proven its effectiveness.

The cost of the medication is ever-changing, raising from $495 in 2017 to $560 in 2020. Insurance coverage of abortion services depends on the plan, the policyholder’s state of residence, and employer coverage. Additionally, Federal Medicaid funding pays for this medication when the pregnancy results from rape or incest or is a threat to the individual's life. Including funding sources and low-income clinics, however, there are very few options for lowering abortion costs. As the political climate continues to change in this country, access to abortion medication will also change, impacting many individuals’ lives.