Abortion pill: Will women in states with abortion bans still have access?

The care of abortion has changed drastically in the last two decades with the advent of “drug abortion”. The so-called abortion pill allows women to seek private care and manage the process at home, which has the secondary advantage of helping them prevent anti-abortion protesters outside clinics.

Today, medicated abortion, which is considered safe and effective for up to 10 weeks of pregnancy, accounts for the majority of abortions in the U.S., according to the Guttmacher Institute, a reproductive rights organization. But now access to medication is in question in all states that are expected to ban abortion quickly after the Supreme Court decision. pump dump of the historic 1973 Roe v. Wade decision.

The Supreme Court ruling last week effectively divides the availability of abortion care across the country. The procedure is it will soon be banned about half of the U.S. states and protected the other half. Shortly after Friday’s decision, abortion clinics in states like Alabama, Texas and West Virginia she stopped having abortions for fear of being prosecuted.

But medication abortion raises additional questions and gray areas, as the drug can be prescribed by a telehealth visit and mailed to a woman’s home. Given these differences, it is likely that many women may continue to access abortion with medications in states with abortion bans, even though they may face risks, experts say.

“There are several options ranging from low-risk to high-risk, such as asking for them online, having a friend send them to you,” said Amanda Allen, a senior lawyer and director of the Lawyer Project, who offers assistance. legal to abortion providers and researchers. “You could have a medical appointment at the border [of a state where abortion is legal] and send it to a post office box. “

States banning abortion do not distinguish between medical abortion and surgical abortion, Allen added. Therefore, pursuing abortion with drugs within these states will carry risks, both for the woman seeking care and for the medical professionals who help her, she said.

But there will likely be ways to avoid those hurdles, such as traveling out of state or ordering pills from foreign suppliers, Allen said.

This is what you need to know about medication abortion after Roe’s annulment against Wade.

What is drug abortion?

Also called an abortion pill, drug abortion is a combination of two drugs: mifepristone, which was approved by the U.S. Food and Drug Administration in 2000, and misoprostol.

The first drug prevents the pregnancy from growing, while the second causes the uterus to empty, a process that usually takes four to five hours and is similar to a miscarriage, according to Planned Parenthood.

Why has it been widely used?

The process is “more private” than going to an abortion clinic, noted Elizabeth Nash, senior policy associate, state affairs, at the Guttmacher Institute. “It looks like a lot more that you have control and you don’t have to deal with the protesters,” he added.

Thirty-two states require doctors to prescribe medications, while the remaining states allow advanced-practice physicians, such as nurses and medical assistants, to provide the pills.

Another recent change has also helped make the drug more accessible. In December 2021, the FDA allowed medical professionals to prescribe abortion oil through telemedicine visits. Currently, 31 states allow it.

However, restrictions on telemedicine prescriptions remain, as 19 states, mostly in the south and midwest, prohibit medical professionals from prescribing the abortion pill through telehealth visits, according to the Kaiser Family Foundation.

How much does it cost?

The typical cost of a medical abortion is about $ 550, according to researchers at the University of California at San Francisco. This usually includes the cost of the medication, as well as consultation with a medical professional.

It is also similar in cost to a first-trimester surgical abortion, the researchers found.

Can women in states with abortion bans get pills from states where it’s legal?

Unlikely. Take a woman to Missouri, where abortion is illegal, except in cases where a woman’s life is in danger. She could book a telehealth visit with a doctor in a state where abortion is still legal, such as California, but the California doctor could face legal risks if she prescribes the abortion pill to the patient, Allen noted. of the Lawyer Project.

“Sending these drugs by mail would be in violation of state laws and this provider could be subject to sanctions and license suspension,” Allen said. “These are huge risks, and people work their whole lives to get their medical degrees.”

Because of these risks, experts believe it is unlikely that medical professionals in states where abortion is legal will prescribe and send the pills to states where it is now banned.

Can women travel to have access to abortion pills?

Yes, because people have the right to travel interstate. Women can travel to states where abortion is legal to obtain prescription abortions with medications or to perform a surgical abortion, experts noted.

However, some experts believe that conservative states may try to stop the ability of pregnant women to get care for abortion out of state.

However, traveling can add hundreds of dollars to the cost of seeking an abortion, which usually costs a few $ 515 for a first trimester abortion. This may mean that traveling is an out-of-reach option for many low-income women, as well as for women who have children and cannot travel easily, as well as for those who cannot take time off work. to take a trip.

One provider is trying to bring women closer to states that ban abortion. Just the Pill, a provider of abortion pills in Minnesota, Montana and Wyoming, began a mobile clinic program that operates across state borders.

“Our mobile clinics can quickly adapt to courts, state legislatures and markets, going where the need is greatest,” Just the Pill said Friday.

What about ordering abortion pills abroad?

This can be one of the easiest and least risky options, experts say.

Providers such as Aid Access, a European telemedicine service that prescribes abortion pills to women in the U.S., have already seen a “huge increase” in Americans seeking medication. The increase came as a result of the leaked draft opinion that this month overturned Roe v. Wade.

“So I would say, grab your belt, women of the United States, just put your abortion pills in your pharmacist, so have them in case you need them,” Dr. Rebecca Gomperts, who runs Aid Access , he said CBS News last month.

The process with Aid Access works through an online consultation, with the service then connecting the patient to a U.S. health care provider who can prescribe the pills. If faced with restrictions within their home state, women may be connected to Gomperts herself, who can issue an online prescription and recommend an online pharmacy outside the U.S. to fill it out. The drug takes about 10 to 20 days to arrive.

“We look forward to seeing more people commanding Aid Access,” Allen noted.

But, he added, there is still some risk in doing so. “If a law enforcement official had reason to believe someone was having an illegal abortion, he could prosecute someone who asked for the pills,” she said.

While most states do not prosecute a person requesting an abortion, it is usually the medical provider who faces the legal risk, women have been charged with illegal abortions in their states. For example, Lizelle Herrera was arrested in Texas for a self-induced abortion, “though the charge later dropped.

In 2017, a Mississippi woman called Latice Fisher she was charged with second-degree murder after suffering a fatality at 36 weeks of pregnancy; the accusation was later dismissed.

Is there a legal challenge to state restrictions on abortion pills?

There is a pending case in Mississippi that challenges the state’s right to restrict mifepristone.

Filed by the generic drug manufacturer, GenBioPro, the lawsuit alleges that FDA regulations for the drug precede the Mississippi requirement that a doctor prescribe it in person, according to Bloomberg law. (The FDA allows medical professionals to prescribe through telehealth visits, as mentioned above).

“It’s an exciting legal theory,” Allen of the Lawyer Project noted.

The case It could also form the basis of an argument by the Biden administration, with U.S. Attorney General Merrick Garland, who on Friday nodded to FDA rules that allow the use of abortion pills.

“In particular, the FDA has approved the use of the drug mifepristone,” Garland said in a statement. “States may not ban mifepristone because of disagreement with the FDA’s expert judgment on its safety and efficacy.”

—With CBS News’ Haley Ott report

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• Abortion