Abortion pill providers are aiming to broaden access in stricter states
As bans and restrictions proliferate across the country, abortion pill providers are pushing the envelope of regulations and laws to meet the surging demand for medication abortion in post-Roe America.
Some are using physician discretion to prescribe pills to patients further along in pregnancy than the 10-week limit set by the Food and Drug Administration. Some are making pills available to women who are not pregnant but feel they could need them someday. Some are employing a don’t-ask-don’t-tell approach, providing telemedicine consultations and prescriptions without verifying that patients are in states that permit abortion.
These changes are easing access to the pills for patients in states that have curtailed abortion and also in states where it remains legal but where clinics have longer wait times as patients flood in from restrictive states.
Some of the practices, like not confirming that telemedicine patients are located in states that allow abortion, may run afoul of anti-abortion state laws or fall into uncharted legal territory, but they may also be challenging to police, reproductive health experts said.
Medication abortion, which was legalized in the United States in 2000, typically involves two drugs: mifepristone, which blocks a hormone necessary for pregnancy development, followed 24 to 48 hours later by misoprostol, which causes contractions that expel pregnancy tissue.
Patients with some medical issues, like bleeding disorders, are not prescribed abortion pills. But for the many patients who are medically eligible, data indicates medication abortion is safe and effective, with a small percentage of patients requiring a procedure to fully remove pregnancy tissue and an even smaller proportion experiencing serious complications.
The method is less expensive, less invasive and, especially with telemedicine, more private than surgical abortions. By 2020, it accounted for more than half of U.S. abortions and has become even more sought-after since Roe was overturned.
In the fast-changing abortion landscape, new online medication abortion services are starting, and existing services are expanding, often adopting some of the new practices. Legally, this is a new frontier, both supporters and opponents of abortion rights say. It’s unclear, for example, whether any anti-abortion state laws — which typically target providers, not patients — address providing pills to someone who is not pregnant.