Doctors and activists call for advance provision of the abortion pill

Medication abortion, which is a protocol that involves taking two different drugs, mifepristone and misoprostol, has been a safe alternative to surgical abortions in the U.S. since 2000, and in 2017 it accounted for 39% of all abortions in the country. According to a 2016 Advancing New Standards in Reproductive Health (ANSIRH) study, mifepristone, otherwise known as “the abortion pill,” is medically safer than Tylenol and Viagra. But 32 states have imposed limitations that contradict World Health Organization recommendations ensuring that midlevel providers can safely provide medication abortion, two states have entirely banned the use of it at a specific starting point, and 19 states require the prescribing physician to be physically present when the medication is administered, ruling out telehealth and mail options. Under S.B. 4, medical providers who prescribe mifepristone after seven weeks, via telehealth, or dispense them through the mail will face state jail time and a fine up to $10,000.

“We’ve had 21 years of experience with this medication, and it’s been shown to be very safe and effective,” says Dr. Daniel Grossman, director of ANSIRH. “There is no medical reason for mifepristone to have to be administered in person.”

For pregnant people who find themselves in states with strict abortion laws, or rural towns with few, if any, abortion care providers, and cannot afford to travel to another state for care, receiving the abortion pill by mail has been a vital resource. Despite state restrictions, initiatives like Shout Your Abortion and Aid Access raise awareness about the abortion pill and helping people acquire the medication who cannot access local abortion services.

“Abortion pills by mail is the best way that we have to mitigate the impacts of whatever anti-choice legislation we see past in coming years,” says Amelia Bonow, founding director of Shout Your Abortion. “Even if abortion is banned in their state, we hope that people know they can still have a safe, effective abortion early in pregnancy, and they can also have a lot of support in that process.”

Many activists are still unsure how S.B. 4 will enforce “abortion-by-mail” bans since it would imply a breach of privacy to inspect people’s mail, which is a federal offense. “[S.B. 4] is really just meant to instill fear in people who are trying to do this work,” says Nancy Cárdenas Peña, Texas director of policy and advocacy for the National Latina Institute for Reproductive Justice.

Grossman is a firm advocate for advanced provision, when medication is provided before it is immediately needed, in a “wrap-around service” that would allow a clinician to provide educational information about the pills and how to recognize potential complications or recognize if they are not working. He also suggests that clinicians make themselves available to patients through the phone in case they have any questions about taking the medication. Medical and legal hotlines are available at the Repro Legal Helpline and the Miscarriage and Abortion Hotline, which is a hotline staffed by pro-choice medical professionals who will anonymously answer any questions and provide medical advice and support to self-manage an abortion.

Alexandra Martinez is the senior news reporter at Prism. She is a Cuban-American writer based in Miami, Florida, with an interest in immigration, the economy, gender justice, and the environment.

Prism is a BIPOC-led non-profit news outlet that centers the people, places, and issues currently underreported by national media. We’re committed to producing the kind of journalism that treats Black, Indigenous, and people of color, women, the LGBTQ+ community, and other invisibilized groups as the experts on our own lived experiences, our resilience, and our fights for justice. Sign up for our email list to get our stories in your inbox, and follow us on Twitter, Facebook, and Instagram.

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