On April 12, FDA Acting Commissioner Janet Woodcock, MD, said the agency would temporarily stop enforcing the requirement under Risk Evaluation and Mitigation Strategy (REMS) guidelines that mifepristone, the first drug in a two-drug regimen taken for medication abortion, be dispensed by a doctor. For the remainder of the COVID-19 pandemic people can receive it by mail.

This decision offsets a January Supreme Court ruling to keep the distribution restriction in place. The FDA’s Centre for Drug Evaluation and Research evaluated telemedicine abortion studies that it felt did not show “increases in serious safety concerns (such as hemorrhage, ectopic pregnancy, or surgical interventions) occurring with medical abortion as a result of modifying the in-person dispensing requirement during the COVID-19 pandemic,” Dr. Woodcock’s letter reads.

Colleen McNicholas, DO, obgyn and Chief Medical Officer at the Planned Parenthood of the St. Louis Region and Southwest Missouri, explained to POPSUGAR that whether you had to actually take the first drug in the health centre or doctor’s office, or you could instead go pick it up and then bring it home with you, completely depended on state law. The American College of Obstetricians and Gynecologists (ACOG), which was among one of the groups who sued to suspend the distribution requirement, wrote in a statement that mifepristone has proven to be a “safe, effective medication,” and that in-person dispensing during the pandemic was dangerous and burdensome, especially for those hit hardest by the pandemic including low-income communities and communities of colour.

The Guttmacher Institute estimates that in 2017, 39 percent of abortions were medication abortions, and among abortions that happened within a 10-week gestation window, medication abortions accounted for 60 percent that year. Ahead, find out more about medication abortions.

How Do Abortion Pills Work?

The FDA first approved mifepristone, known as Mifeprex, in 2000, and it is ordered, prescribed, and dispensed by a qualified healthcare provider up to 70 days — or up to 77 days in some cases — of pregnancy (the FDA decision from this week makes it easier for mifepristone to be distributed by mail). Then, 24 to 48 hours after taking Mifeprex, a different pill, misoprostol, is taken in the location of your choice, meaning it can be administered at home.

Dr. McNicholas said mifepristone stops a pregnancy from progressing because it blocks progesterone, one of the hormones that holds the pregnancy to the uterus. Misoprostol then causes the uterus to contract and results in cramping and bleeding that expels pregnancy tissue, which usually starts in one to four hours. According to Planned Parenthood’s national website, nausea, mild fever, tiredness, heavy bleeding with large clots, and dizziness are also side effects from taking misoprostol. Nausea and slight bleeding may begin after taking mifepristone, though it’s not common.

Expelling the pregnancy tissue can usually last five hours or longer, and the cramping may persist for a few days. Planned Parenthood noted that if you don’t have any bleeding within 24 hours of taking misoprostol, you should call your doctor. You’ll have a followup appointment a week or two after the medication abortion, which Melissa Grant, COO of abortion and reproductive health service provider Carafem, told POPSUGAR can happen virtually (after checking in about symptoms, providers may later ask you to take a home pregnancy test to confirm a negative test result).

How you qualify for a medication abortion pill will depends on where you live, but in terms of gestation, Dr. McNicholas explained, the FDA approved the medication through 70 days of gestation, and the medical community has since developed and supported use up to 77 days.

How Effective Is the Abortion Pill?

According to Planned Parenthood, if you are eight weeks pregnant or less, a medication abortion works about 94 to 98 percent of the time. For people who are between 10 and 11 weeks pregnant, it’s about 87 percent effective. Though rare, if the abortion doesn’t work and you’re still pregnant, you may need additional medication or to go for an in-clinic procedure. Complications from medication abortion are also rare but could include pregnancy tissue left in the uterus, infection, allergic reaction, blood clots in your uterus, and too much bleeding. Call your doctor if you feel sick more than 24 hours after taking misoprostol.

Both Grant and Dr. McNicholas wanted to stress that mifepristone and misoprostol used for medication abortion are not only effective but safe. “It’s really important that regardless as to whether we’re in a pandemic or not, that people, particularly in a country as advanced as the United States, should be able to have access to the health care that they want, that they are medically eligible for, and that they deserve,” Grant said. “The additional barriers do nothing to make it safer and, if anything, actually delay appointments, increase costs, and create more stress and strife for the people in the situation.”

Where Can You Get Abortion Pills?

Typically, you get these pills from a doctor’s office or clinic such as Planned Parenthood or Carafem. Grant suggests using the National Abortion Federation as a resource where you can find a list of accredited providers from across the country. Some doctors will give mifepristone to you in their office and then write a prescription for misoprostol to pick up at a pharmacy separately, or they might have misoprostol at their disposal already and send you home with it (now it will be easier to get both sent to you via mail or through a mail-order pharmacy). The cost varies and also depends on many factors like the facility you go to, state law, other tests you may need to get before or after your medication abortion, and insurance coverage.

The FDA’s decision opens up the opportunity for telemedicine visits, such as the service Abortion on Demand. And as of Tuesday, the Planned Parenthood of the St. Louis Region and Southwest Missouri offered telemedicine for medication abortions, what Dr. McNicholas called “direct-to-patient” visits.

You can also check out the TelAbortion Study, a clinical study sponsored by reproductive health nonprofit Gynuity Health Projects that uses telemedicine for medication abortions and sends these drugs through the mail. The project is currently available through certain Planned Parenthood locations, Carafem, and other partners for people living in Colorado, Georgia, Hawaii, Illinois, Iowa, Maine, Washington DC, Maryland, Massachusetts, Minnesota, Montana, Nevada, New Jersey, New Mexico, New York, Oregon, Virginia, and Washington. The TelAbortion Study is ongoing, and data collected about the effectiveness of telemedicine medication abortions versus procedural and medication abortions done in-person will continue likely until the restrictions on sending mifepristone through the mail are lifted indefinitely, not just for the duration of the pandemic.

Carafem has participated in the study since 2017. “We did this primarily because we serve a large number of rural clients, particularly in the south and in the midwest, who are travelling great distances to receive medication abortions,” Grant said. Additionally, Carafem just launched a virtual health care assistant, fittingly named Cara, to act as a 24-hour support service.

A Win, but Not a Complete Victory For Medication Abortions

“When we have big federal wins like this, where the FDA is approving access, that access gain isn’t appreciated for everybody equally.”

Though the FDA’s decision is a win, obstacles on the state level remain. For example, bans on telemedicine abortions are still advancing in Texas, Arkansas, Oklahoma, Indiana, Alabama, Iowa, Wyoming, and West Virginia, Politico reports. And, laws in 19 states already prohibit medication abortions from taking place virtually simply because they require clinicians be physically present when the medication is administered.

“The rules and regulations that guide abortion care unfortunately oftentimes sit squarely in the political realm and not just in the medical and scientific realm,” Dr. McNicholas said. “When we have big federal wins like this, where the FDA is approving access, that access gain isn’t appreciated for everybody equally.”

Grant noted that abortion is not an uncommon experience (the abortion rate in 2014 was one in four by age 45), adding that untended pregnancies are often complicated by financial instability and inadequate access to healthcare. “It’s important that people have safe options that are respectful of their own personal needs, their own personal belief systems, if they decide that they want to have an abortion,” she said. “Whether you prefer to have your abortion at home with a pill, in the clinic with medication, in the clinic with a procedure and maybe additional pain killer, these are all legal, safe options the patient themselves should be able to choose.”

Image Source: POPSUGAR Photography / Matthew Kelly

Source: https://www.popsugar.co.uk/fitness/fda-allows-abortion-pill-taken-at-home-48273315?utm_medium=redirect&utm_campaign=US:RO&utm_source=l.facebook.com

“Abortion Helpline, This is Lisa” is a national rallying cry: It’s time for the Hyde Amendment to end. (Abortion Helpline, This is Lisa)

Oscar-shortlisted documentary short “Abortion Helpline, This is Lisa” is 13 gut-wrenching minutes of the impacts of the Hyde Amendment, showcasing the devastating reality of the lack of abortion access in the U.S.

When the difference between feeding your kids, forgoing your life-saving medication, or losing everything in your life is $275, what do you do when there’s no one left to call? This is the question viewers are left with when watching “Abortion Helpline, This is Lisa,” a short documentary film offering a glimpse into the lives of five callers to an abortion fund hotline in Philadelphia—each left with an unplanned pregnancy, no options, and everything to lose.

At the Women’s Medical Fund, the counselors depicted in the film (all referred to as Lisa) are often the last call before there’s no one left for thousands of people every year. One caller in the film—who needs only $275 more for her abortion—has already survived one life-threatening pregnancy, has just lost her job, and barely has enough left for groceries.

“All my savings that I had are going towards my insulin and making sure my kid is set,” she tells Lisa, “I have $100 and have enough to cover my rent for this coming month.” The film glaringly shows us the counselor’s computer screen: There’s only $19 left in funds for the current shift. They will need to call again tomorrow and hope there will be more.

Hope is not going to be enough, but it is all viewers are left with—we never learn how this caller’s situation turns out. The outlook is grim: People who are denied wanted abortions are four times more likely to live below the federal poverty line, and three times more likely to be unemployed than people who receive an abortion, leaving them with chronic economic insecurity. Additionally, those who are denied abortions are more likely to experience complications during birth, raise the child on their own, and remain in an abusive partnership.    

This the reality for over 7 million people under the Hyde Amendment, a 1976 federal policy prohibiting the use of Medicaid and other federal funds for abortion, leaving many low-income people in a similar place to the caller above: with no options left.https://www.youtube.com/embed/T_KxUvT1B-E?feature=oembed

Directed by Janet Goldwater, Barbara Attie and Mike Attie, “Abortion Helpline, This is Lisa” is 13 gut-wrenching minutes of the impacts of the Hyde Amendment, showcasing the devastating reality of the lack of abortion access in the United States. The film has been sweeping through global film festivals, and was recently named to the 93rd Academy Awards shortlist.

Source: https://msmagazine.com/2021/04/10/abortion-helpline-this-is-lisa-abortion-restrictions-feminist-documentary-hyde-amendment/?fbclid=IwAR3VgSEmoWXF6HnYqnwF4pPve6QQl9xZZWMnFAhU-WmMZtXp5uUxSl-Ld0c

Remote care amid COVID-19 illustrates abortion rights are resilient even in the face of a hostile Supreme Court or state laws designed to gut them.

Near-total bans on abortion became law recently in Arkansas and South Carolina, suggesting a dire future for abortion rights if the Supreme Court overturns Roe v. Wade — a possibility that seems more likely than ever before. But the road ahead will not be shaped by anti-abortion legislators or Supreme Court justices alone.  A different path to abortion access has emerged. 

Over the past year, new virtual clinics have begun delivering medication abortion entirely remotely. Last July, a federal court suspended a Food and Drug Administration rule that requires patients to obtain the first drug in a medication abortion at a health care facility during the pandemic. That drug, mifepristone, is the only one of 20,000 FDA-regulated medications that requires in-person dispensation but can be taken at home. 

The ruling created an opening for virtual clinics like ChoixHey Jane and Just the Pill to offer “no touch” services for people less than 10 weeks pregnant. Patients complete a medical history form online, consult with a clinician over video or telephone, and if eligible, receive two medications from a mail-order pharmacy.

An ongoing study one of us is leading at the University of California, San Francisco (UCSF) demonstrates that the care offered by virtual clinics is safe and effective. The California-based company, Choix, served approximately 140 patients over two months. Patients were overwhelmingly satisfied with the service. It allowed them to have an abortion with privacy and without having to take time off work, find child care or travel long distances. One grateful patient called it a godsend to be able to go through the process while safe at home. 

In front of the White House on March 09, 2021, in Washington, D.C.

In front of the White House on March 09, 2021, in Washington, D.C.  SHANNON FINNEY/GETTY IMAGES FOR THE CENTER FOR HEALTH AND GENDER EQUITY

The same results bear out for Hey Jane, which provides services in Washington and New York and saw demand double week after week in the first month of operation. “I especially loved the fact that the medication came to my house via mail,” said Nicollette Roe, a Hey Jane patient. “I made a plan with my partner about doing it at night, after our daughters were asleep. I had no stress around how to do everything because Hey Jane made it so that the doctor was moments … away via the app or by calling.”

At the moment, these virtual clinics cannot use mail-order pharmacies to deliver medications to their patients. That’s because in January, the Supreme Court reinstated the FDA rule while litigation is ongoing. But virtual clinics illustrate the resilience of abortion care even in the face of a hostile Supreme Court or state laws designed to gut abortion rights. 

After the Supreme Court’s order, networks of advocates and providers figured out how to provide abortion outside of brick-and-mortar operations, regardless of a patient’s residence. Start-ups have found innovative ways to deliver medication abortion to patients, like Just the Pill’s pop-up mobile sites. And nonprofit organizations such as Aid Access and Plan C have helped people receive medications by mail regardless of the state in which they live.

Stop unscientific abortion regulation

Remote care is all the more important given the number of states that make gaining access to abortion as difficult as possible and the prospect that the Supreme Court will abandon the core holding of Roe v. Wade. But even if Roe remains on the books, Americans in roughly half of the country live in states without meaningful access to abortion care. The expansion of medication abortion will help navigate these “abortion deserts,” or regions where patients must travel over 100 miles to reach a clinic. Virtual care can overcome the barrier of distance (and its related costs) by reaching patients at their homes and across state borders.

This month, in deciding whether to defend restrictions on medication abortion, the FDA  will consider the public health evidence that supports extending virtual services. The UCSF study and others like it provide the proof that remote care is safe and effective — without the financial, social, logistical and interpersonal constraints of clinic-based services. Over the long run, the FDA should allow studies on telehealth for abortion to proceed, enabling a formal review of the safety of direct-to-patient dispensing without the interference of politics. More immediately, the FDA should suspend the unnecessary and scientifically unsupported regulation of medication abortion.

Telehealth may well be the future of more affordable and more accessible abortion care in the first 10 weeks of pregnancy. The Biden administration must act now to help realize that future.  

Source: https://eu.usatoday.com/story/opinion/2021/04/12/medication-abortion-rights-protected-online-clinics-column/7106777002/

HONOLULU (AP) — Gov. David Ige on Monday signed legislation that would make Hawaii the latest state to allow some nurses to perform abortions.

Hawaii law previously said only physicians could perform early, in-clinic abortions. But because of a doctor shortage, several smaller islands lack abortion providers which forces residents of those islands to fly to Honolulu if they need the procedure.

“This act will enable people who desperately need reproductive health care services to receive health care from very high quality health care providers, including advanced practice registered nurses, where they need it, when they need it, and … in their own communities,” Laura Reichardt, the director of the Hawaii State Center for Nursing, said a bill signing ceremony.

The new law, which took effect when the governor signed it, allows advanced practice registered nurses to prescribe medication to end a pregnancy and to perform aspiration abortion, a type of minor surgery during which a vacuum is used to empty a woman’s uterus. The nurses will be able to do both during the first trimester of a pregnancy. The aspiration abortion may be performed in a hospital, clinic or nurse’s office.

Advanced practice registered nurses are nurses who have obtained at least a master’s degree and are trained and certified to diagnose and manage patient problems and prescribe medications.

Several states already allow this category of nurses to perform medication or aspiration abortions, including California, Colorado, Maine, Massachusetts, Montana, New Hampshire, Virginia, Vermont and West Virginia.

Hawaii has a long track record of favoring abortion rights. In 1970, it became the first state in the nation to allow abortion at a woman’s request.

But the state’s doctor shortage means that the islands of Kauai, Molokai and Lanai have lately lacked local abortion care providers. On the Big Island, abortion has only been available in Hilo but not on the west side. On Maui, a provider has had to fly in from another island twice a month.

Early in the coronavirus pandemic, doctors weren’t able to fly to Maui and abortion care was unavailable on the island for several months, said Dr. Reni Soon, the chairperson of the Hawaii Section of the American College of Obstetricians and Gynecologists.

The legislation Ige signed said studies have found abortions provided by a qualified licensed health care provider other than physicians were just as safe as those provided by doctors. Advocates say advanced practice registered nurses already provide procedures that are similar to or more complicated than abortions, such as inserting an IUD and conducting an endometrial biopsy.

Most testimony to the Legislature supported the new law. Those in opposition included groups that oppose abortion more broadly and those concerned that advanced practice registered nurses wouldn’t have the same training as doctors.

Source: https://apnews.com/article/legislation-david-ige-abortion-hawaii-coronavirus-pandemic-7a359902e1e252eaf755f2bfe6a4816a?fbclid=IwAR2JrLup4NZ0vxEc54800OmomYDRMTNnF5xnmWeQH0RetxL_g6OMY8zsr_4

Arkansas, Indiana, Louisiana, Ohio, and Texas all have enacted laws regulating the disposition of fetal tissue (though all but Indiana’s have been blocked by the courts).
 Getty Images

If we’re so afraid of death—and we are—then equating fetal burial legislation with abortion will only impede access.

Americans are afraid of death. Like, really afraid of it.

It’s this reticence to embrace the inevitable, with healthy open discussions and accessible care, that makes the funeral industrial complex a thriving, moneymaking machine. The U.S. funeral industry is currently estimated at about $16 billion market size, with the median U.S. funeral costing around $7,640. It’s an industry fraught with cost barriers, old-school and outdated practices, and an aversion to progress.

So what happens when you cross that with the anti-abortion movement? Well, as you might imagine, it’s not great.

You’ve probably heard of fetal burial laws, which require the disposition of fetal tissue in a manner similar to that of well … a dead person. Most recently, an Ohio judge temporarily blocked the enforcement of a fetal burial law, which requires the burial or cremation of fetal remains. It was signed into law by Republican Gov. Mike DeWine last December; the judge’s decision earlier this month was handed down a day before the law was set to go into effect.

But the Ohio fetal burial law is far from unique. Arkansas, Indiana, Louisiana, and Texas all have enacted laws regulating the disposition of fetal tissue (though all but Indiana’s have been blocked by the courts), and lawmakers in numerous other states have introduced similar legislation.

Fetal burial laws are harmful for a number of reasons. For starters, they’re an abortion restriction, which means they’re de facto unecessary and dangerous. But you might be asking: If they’re legislating the disposal of fetal remains, doesn’t that mean the abortion has already happened? So how is it a restriction?By invoking images of death through the requirement of burying or cremating fetal tissue, lawmakers are forcing patients to confront their abortion decision as a death.

And honestly, that’s a solid question. Fetal burial laws are insidious the same way laws that require abortion providers to have admitting privileges at local hospitals are insidious: They force providers into agreements with outside organizations that may not be amenable, and in many circumstances are openly hostile, to what abortion providers do. What ends up happening is that a clinic can’t find a hospital—or in this case, a funeral home—to help it comply with these laws, forcing it to close.

But fetal burial laws invoke an even more nuanced obstruction to care by playing into the country’s largely death-phobic nature. Death-phobia is more than just the fear of death and dying: It’s a culture of shame and stigma surrounding death and end of life that breeds anxiety and misunderstanding.

Progressive death-care workers, like those at the Order of the Good Death (where I work as a social media contributor), are pioneering a movement, deemed death positive, to combat the toxic culture around death in the United States, and instead encourage open communication about death and a shift toward understanding that shrouding death in silence does more harm than good.

By invoking images of death through the requirement of burying or cremating fetal tissue, lawmakers are forcing patients to confront their abortion decision as a death. But many don’t see abortion as a death or loss of life at all. And while we know that some people do grieve their abortions as they would a pregnancy loss, we also know that for many people abortion brings on feelings of relief and everything in between.

This forced association could cause patients to forgo or second guess an abortion because of the guilt or ill feelings it evokes, just like laws requiring fetal ultrasounds. These laws are, by design, a cruelty; subjecting pregnant people who choose abortion to emotional torment in the hopes that it will delay or exhaust them into changing their mind. And if they fail to change their mind, laws like those mandating fetal burial make sure that no matter how you feel about your abortion, it’s going to be a heavy and traumatic experience.

Invoking death-phobia to restrict abortion is not unique to fetal burial laws—other laws like those mandating perinatal hospice, which would require a person to carry an unviable pregnancy to term instead of having an abortion, also play to our fears and inability to talk about death openly.

Lawmakers who support fetal burial laws are counting on this country’s death-phobia. They need constituents to hear words like “cremation” or “remains” and recoil. If we’re so afraid of death—and we are—then equating it with abortion will only impede access.

Source: https://rewirenewsgroup.com/article/2021/04/17/how-politicians-exploit-fears-about-death-to-attack-abortion-care/

FILE – This Sept. 22, 2010 file photo shows bottles of the abortion-inducing drug RU-486 at a clinic in Des Moines, Iowa. On Tuesday, April 13, 2021, the acting head of the Food and Drug Administration said women seeking an abortion pill will not be required to visit a doctor’s office or clinic during the COVID-19 pandemic, in the latest reversal in ongoing legal battles over use of the medication. (AP Photo/Charlie Neibergall)

WASHINGTON (AP) — Women seeking an abortion pill will not be required to visit a doctor’s office or clinic during the COVID-19 pandemic, U.S. health officials said Tuesday in the latest reversal in an ongoing legal battle over the medication.

The Food and Drug Administration announced the policy change a day earlier in a letter to the American College of Obstetricians and Gynecologists, one of several medical groups that has sued over the restriction put in place under the Trump administration.

The FDA’s acting head, Dr. Janet Woodcock, said an agency review of recent studies “do not appear to show increases in serious safety concerns,” when women take the pill without first visiting a health facility and discussing the drug’s potential risks, including internal bleeding.

The change clears the way for women to get a prescription for the pill — mifepristone — via telemedicine and receive it through the mail. However, abortion opponents are pushing legislation in several Republican-led states that would head off easier access.

Medication abortion has been available in the United States since 2000, when the FDA approved the use of mifepristone. Taken with a hormone blocker called misoprostol, it constitutes the so-called abortion pill. About 40% of all abortions in the U.S. are now done through medication — rather than surgery — and that option has become more pivotal during the COVID-19 pandemic.

Last year, the FDA waived in-person requirements for virtually all medications, including tightly controlled drugs such as methadone. But the FDA and its parent health agency argued the rules were necessary to ensure the pills were used safely. The rule requires patients to pick up the single tablet of mifepristone at a hospital, clinic or medical office and sign a form that includes information about the medication’s potential risks.

The obstetricians and gynecologists group sued to overturn the rule, setting off a series of conflicting court decisions. Most recently, in January, the Supreme Court sided with the Trump administration to reinstate the longstanding rule on getting the drug in person.

The obstetricians group said in a statement Tuesday the FDA’s about-face on the requirement shows “it is arbitrary and does nothing to bolster the safety of an already-safe medicine.”

The move was also hailed by congressional Democrats, some of whom had called on FDA to reverse its policy in a February letter.

But abortion opponents said the move would jeopardize women’s health.

“With this action, the Biden administration has made it clear that they will prioritize abortion over women’s safety,” said Jeanne Mancini, president of the anti-abortion group March for Life. “Chemical abortions should have more medical oversight, not less.”

The FDA policy only applies during the COVID-19 health emergency. The obstetricians and gynecologists group and several other medical organizations are pushing to make medication abortion permanently available via online prescribing and mail-order pharmacies.

Source: https://apnews.com/article/us-news-medication-abortion-coronavirus-pandemic-covid-19-pandemic-1bd5c161f8e0f9f80e98b63002f50d37?fbclid=IwAR28FXmC27cBS8S3uuqWn3WuzZd0i4zjJfv6ICvspewrK3sGsKrlObI1-L4

A WOMAN SPEAKS DURING A PROTEST AGAINST RECENTLY PASSED ABORTION BAN BILLS AT THE GEORGIA STATE CAPITOL BUILDING, ON MAY 21, 2019 IN ATLANTA, GEORGIA. (PHOTO: ELIJAH NOUVELAGE/GETTY IMAGES)

Texas, famous home of small-government enthusiasts, has a novel plan to shrink its entire body politic to fit inside a woman’s uterus.

A bill passed by the state Senate this week would ban physicians from performing abortions after six weeks of pregnancy, before many people even know they’re pregnant. 

But that’s not the exciting part for Republicans: Rather than rely on big government to send the doctors who violate the law to jail, or slap them with fines, the bill would let individual Texans sue doctors for providing abortion—even if they don’t know anybody who was involved in the procedure. 

Anyone who “aids or abets” an abortion after six weeks could also be sued, including the person who drove the patient to the clinic or helped pay for the procedure. There are no exceptions for rape or incest.

Texas’ proposal is unprecedented, but the state is far from the only one to attempt to pass a bill this year that would abolish virtually all abortions. So far this year, state legislators have introduced at least 516 abortion restrictions and enacted 12, according to a Planned Parenthood report out this week. By this week in 2019, abortion opponents had introduced just over 300 and enacted only one. 

Despite all the other, seemingly more pressing obligations facing state legislatures—like, say, the pandemic that’s killed upwards of half a million people in the U.S.—Republicans are really committed to making 2021 the worst year for abortion access in a decade. 

“The doors are kicked open,” Elizabeth Nash, who tracks abortion restrictions for the Guttmacher Institute, told VICE News earlier this year, after lawmakers in multiple states proposed attacking abortion providers with murder charges. “In the midst of a pandemic, where states need to be thinking about how to get out the vaccine, how to provide education, how to support the unemployed, how to provide health care—we’re seeing this real trend around abortion restrictions and really comprehensive abortion bans.”

A bill to ban abortion after six weeks of pregnancy passed out of committee in Arizona on Wednesday. At least 15 other states have introduced similar legislation, according to the Guttmacher Institute. Earlier this month, Arkansas passed a law that bans almost all abortions at any stage of pregnancy. The only acceptable abortions, under that law, are those sought to save the life or health of the mother.

Unlike in 2019, when the nation erupted in outrage over the passage of a near-identical law in Alabama, the public response to the Arkansas law has been far more muted. But that may be a sign of just how successful Republicans’ decade-long strategy to hack away at abortion access has been. 

Many of the 500-plus abortion restrictions passed in the U.S. since 2010 have seemed relatively small. Rather than stripping patients of their right to an abortion altogether, legislators have pushed for laws that make patients wait longer for an abortion or force them to listen to medically inaccurate counseling ahead of the procedure. Several abortion restrictions introduced this year follow that pattern, making some deeply random proposals: In Iowa, Republicans want the state use “targeted digital marketing” to convince people to continue their pregnancies; in Arkansas, they want abortion patients to call an anti-abortion hotline.

These regulations can reshape the course of abortion patients’ lives by making it too expensive or onerous to get the procedure. But because they’re so common, they can seem like background music. And even when abortion restrictions initially seem unimaginable—like in the case of Alabama’s 2019 ban—they quickly become so widespread as to look mundane. 

Americans may also be failing to pay attention due to the simple fact that many of these regulations get bogged down in court challenges anyway—which is also part of the GOP’s plan. After signing his state’s near-total ban, Arkansas Republican Gov. Asa Hutchinson admitted that the law was unconstitutional. But that’s the point: He wants to use the law to hand the majority-conservative Supreme Court a chance to overturn Roe v. Wade, the 1973 Supreme Court decision that legalized abortion nationwide. 

The new conservative majority on the Supreme Court, cemented by Justice Amy Coney Barrett’s appointment last year, may be fueling the state arms race of abortion restrictions. After nearly a half-century of Roe, many abortion opponents believe its demise is now only a matter of time.

Source: https://www.vice.com/en/article/g5bzmx/2021-is-the-worst-year-for-abortion-access-in-a-decade?fbclid=IwAR3N1VjHvUlkWtLD5NvEFsOyg3gKbaKGUQBUxo7f0KW10FNT-qKCOOQDb14

The Food and Drug Administration recently lifted restrictions on abortion pills to allow patients to get them through telemedicine.
 Katharina Staerck—Getty Images

The Biden Administration is removing restrictions on mailing abortion pills during the COVID-19 pandemic, a reversal from the Trump Administration’s policy that marks a new phase in the national debate over abortion rights.

The move temporarily changes longstanding Food and Drug Administration (FDA) rules governing mifepristone—one of two drugs used to terminate early pregnancies—that required patients to pick up the pills in-person from a medical provider. Acting FDA Commissioner Janet Woodcock sent a letter to the American College of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine on Monday saying that her agency reviewed recent evidence and found that using telemedicine to provide abortion pills would not increase risks and would help patients avoid potential exposure to COVID-19.

The change only lasts through the public health emergency, and the FDA has not said how it will handle the requirement after the pandemic. But abortion pills have become the latest front in the heated battle over reproductive rights in the United States, and these medication abortions will continue to animate both sides of the issue even after the COVID-19 crisis recedes. As conservative states have passed hundreds of laws in recent years restricting all aspects of how people can obtain abortions, demand for the more convenient abortion pills has increased. Now as activists on all sides watch to see whether the conservative Supreme Court will curtail or overturn Roe v. Wade, looser rules around medication abortion could expand access far beyond traditional abortion clinics.

“Access to medication abortion is going to be really significant. Because if people in states where abortion is illegal can still readily get access to illegal but legal elsewhere medication, it’ll be very hard for states to enforce the laws,” says Mary Ziegler, a Florida State University law professor who studies abortion. “It’s important in the short term, but it’s also very important in the longer term when you’re imagining what a post-Roe landscape would look like.”

While the issue has received more attention over the past year due to COVID-19, the debate around medication abortion has been simmering for much longer. The FDA first approved medication abortion in 2000, and the pills have grown in use over the years. By 2017, about 40% of patients in the U.S. chose medication abortion, according to the Guttmacher Institute, a research organization that supports abortion rights. The FDA requires mifepristone to be dispensed in health clinics or hospitals, but reproductive rights advocates, doctors and medical professional groups including ACOG have said for years the restriction is medically unnecessary. Now they are hoping Biden’s FDA could permanently change the requirement.

Conservative groups and state lawmakers have already launched efforts to curb the pills’ expansion, with bills to ban or otherwise restrict the medication introduced in at least a dozen states so far this year. A state court recently blocked a ban on telemedicine abortion in Ohio, but Montana’s governor is expected to sign a similar bill soon. Others are making their way through legislatures in Alabama, Arkansas, Indiana, Iowa, Maryland, Oklahoma, Texas, Wyoming and West Virginia. Many of these bills have been championed by a group of conservative organizations led by the Students for Life of America and Susan B. Anthony List, which supports politicians who oppose abortion. Students for Life of America is also lobbying for bills that would ban abortion pills outright in several states, and plans to launch a documentary series this spring featuring Charlotte Pence Bond, the former Vice President’s daughter, aimed at raising more concerns about medication abortions.

Democrats in Congress have urged the Biden Administration to loosen the abortion pill restrictions beyond the pandemic, arguing that the in-person requirement creates barriers for people seeking access to abortions. HHS Secretary Xavier Becerra supported this position when he was California’s attorney general, leading other Democratic attorneys general to ask the FDA last year to remove the in-person requirement during the pandemic. But Republicans in Congress took the opposite tack, with both House and Senate lawmakers writing letters in the fall of 2020 to ask the FDA to remove the pill from the market completely and classify it as an “imminent hazard to the public health.”

ACOG sued to lift the in-person rule last year, but the Supreme Court sided with the Trump Administration in January to reinstate the requirement. A federal appeals court is currently hearing the case, and the Biden Administration asked for more time last month as it reviewed the restrictions. Its next court deadline is this week.

With the restrictions temporarily lifted, many patients will now be able to make an appointment to talk with a doctor over video or by phone and then receive abortion pills in the mail. Medication abortion consists of two pills: mifepristone, which the FDA regulates tightly, and misoprostol, which is not heavily regulated. Getting the pills by mail helps patients avoid exposure to the coronavirus in the current environment, doctors say, but it also eliminates obstacles that exist beyond the pandemic, such as traveling to an abortion clinic, taking time off work, arranging child care, and privacy concerns. Reproductive rights advocates also note that many of these barriers fall disproportionately on poor patients, people of color, and other already marginalized groups. “We want people seeking abortion care to be to be able to access it whenever they need it, and to really have the ability to access whatever type of abortion care they need,” says Destiny Lopez, co-president of All* Above All, a group that has pushed the Biden Administration to permanently loosen federal rules for abortion pills. “Medication abortion is part of that fight for abortion justice, because we know that the barriers that folks face are rooted in systemic racism and reflect ongoing inequities in our healthcare system.”

This flexibility is exactly what abortion opponents are concerned about. Kristan Hawkins, president of Students for Life of America, says her group got involved in the fight against medication abortion because it saw the pills expanding access and particularly being made available on college campuses. “It’s very clear with everything that’s been happening in the past few years within the abortion industry, that they’re trying to change the model,” she says. “Especially when you’re distributing these drugs on college campuses or via webcam, you don’t have to operate a facility that’s going to have people praying in front of it.”

Still, the increased availability of the pills doesn’t solve all abortion rights advocates’ problems. Abortion pills can only be taken in the first 10 weeks of pregnancy, when many people are still learning they are pregnant. And even with the FDA’s new decision, 19 states already have laws effectively prohibiting telemedicine for medication abortion. Taking the pills in states where they have been outlawed could be legally risky. While most abortion opponents say they do not want to punish the women seeking abortions and new state laws focus on restricting providers’ actions, some states have already prosecuted women for self-managed abortions.

The past year has given doctors a test run of how telemedicine works for medication abortion. A March article in the journal Contraception published findings from a long-term study by Gynuity Health Projects evaluating the use of telemedicine for medication abortion, which found that “direct-to-patient telemedicine service was safe, effective, and acceptable.” Planned Parenthood expanded its telemedicine offerings during the pandemic, and for the roughly six months that providers could use the method last year, many abortion clinics around the country prescribed medication abortions without in-person visits.

Researchers found similar success in the United Kingdom, where authorities loosened the in-person requirement for medication abortion when the pandemic began last spring. A new study published in the British Journal of Obstetrics and Gynecology examined more than 52,000 medication abortions and found that women waited an average of 4 days less to get telemedicine abortions and there was little difference in safety or effectiveness compared with in-person abortions. “I think we witnessed an innovation that will suddenly transform care and provide patients with much better quality, probably for the next generation,” says Dr. Jonathan Lord, co-author of the study and chief medical officer of nonprofit MSI Reproductive Choices, which performed more than 20,000 telemedicine abortions during the first year of the pandemic.

Advocates hope that this kind of evidence will help persuade Biden’s FDA to make the changes permanent. But even if that happens, they say, the fight over medication abortion is just ramping up.

“We know that they’re safer than most medications that you can buy over the counter, like Tylenol, for example. And yet, and still we see these onerous restrictions being put in place with the sole purpose of trying to limit access to abortion care,” says Dr. Jamila Perritt, an OBGYN and abortion provider in Washington, D.C. who is president and CEO of Physicians for Reproductive Health. “There is still work to do.”

Source: https://time.com/5954429/fda-biden-abortion-pills/?fbclid=IwAR26eoBCLRqkb0r4KwcPs8wCKimKtgwy8G7Pj25MENsSVpW72un4yg4Wmo4

Studies shows it’s safe to prescribe medication abortion via telemedicine during early stages of pregnancy and to distribute medication abortion pills by mail.
 Shutterstock

The Biden administration is allowing patients to receive medication abortion pills by mail for the duration of the COVID-19 pandemic.

As vaccinations roll out and some parts of the world start to reopen, we need to envision what the new normal will be. This means addressing existing inequalities illuminated during the pandemic, by looking at how we’ve adapted and bringing innovations into the future instead of reverting to how things were before. Making medication abortion readily available via telemedicine does both.

On Monday, the Biden administration took an important step in envisioning that new reality by announcing it was continuing to suspend a requirement that patients pick up abortion medications in-person during the pandemic.

Over the last year, the COVID-19 pandemic has created significant barriers to accessing basic health-care services, with women in the United States more likely to report experiencing major gaps in routine medical care, according to a survey.

But there is a silver lining: Research suggests telemedicine may improve access to health care and dismantle barriers to health-care services. While access to telehealth services has, to this point, been relatively limited in scope and unevenly available, the number of survey respondents who reported having a telehealth visit in the last year roughly tripled from pre-pandemic use. People who used telehealth reported high levels of satisfaction, meaning expansion of telemedicine could be a more permanent solution to gaps in access to in-person medical care—including reproductive health care.

Multiple countries have set up telemedicine services as a means of accessing abortion during the pandemic, with some temporarily allowing medication abortion pills to be distributed via mail. Still, the United Nations Population Fund estimated that 12 million women across 115 low-and middle-income countries lost access to contraception in 2020 due to the pandemic, leading to an estimated 1.4 million unintended pregnancies.

In August, a World Health Organization survey revealed family planning is one of the health services most frequently disrupted during the pandemic. Estimates last spring from the Guttmacher Institute painted a bleak picture: If 10 percent of safe abortions become unsafe because women cannot access services amid lockdowns and clinic closures, there would be an increase of 3 million unsafe abortions and 1,000 more maternal deaths. With major disruptions to national health systems caused by the need to respond to people affected by the virus, high-quality self-care interventions can provide an important alternative.Abortion is essential health care, and access to abortion plays a key role in reducing health inequities across socioeconomic groups.

Scientific evidence shows it’s safe to prescribe medication abortion via telemedicine during early stages of pregnancy and to distribute medication abortion pills by mail. A recent Scottish study concluded “telemedicine abortion without routine ultrasound is safe and has high efficacy and high acceptability among women.” An English study similarly concluded that a “telemedicine‐hybrid model for medical abortion that includes no‐test telemedicine and treatment without an ultrasound is effective, safe, acceptable and improves access to care.”

There’s a window of opportunity to make access to medication abortion more easily available, including through telemedicine. In the United Kingdom, where temporary rules installed during the pandemic allowed medication abortion to be prescribed via telemedicine, the English and Welsh governments are consulting the public about whether or not to make those rules permanent.

In the United States, more than 150 members of Congress filed an amicus brief in February, challenging the Food and Drug Administration’s in-person requirement for dispensing mifepristone during the COVID-19 pandemic. Democrats from the House Oversight Committee also sent a letter to acting FDA Commissioner Dr. Janet Woodcock urging the agency to lift the Risk Evaluation and Mitigation Strategy (REMS) requirement that medication abortion pills be obtained in-person from a health-care provider. The FDA listened: This week, Woodcock said the agency would stop enforcing the requirement and would allow patients to receive medication abortion pills by mail—for the duration of the COVID-19 pandemic.

Women should always be in control of their health and reproductive lives—not just during global pandemics. Abortion is essential health care, and access to abortion plays a key role in reducing health inequities across socioeconomic groups. While telemedicine doesn’t address all access issues—problems and inequities with telecommunications infrastructure mean we will always need in-person access to abortion care—measures taken during the pandemic to increase abortion access should remain in place post-pandemic.

Let’s stand up to political opposition and follow the scientific facts: Make medication abortion available via telemedicine to women around the world.

Source: https://rewirenewsgroup.com/article/2021/04/14/abortion-patients-get-big-win-from-the-fda/

Acting FDA Commissioner Janet Woodcock informed the American College of Obstetricians and Gynecologists that allowing patients to receive abortion pills through the mail will not increase risks. | Jose Luis Magana/AP Photo

The FDA concluded that allowing patients to receive abortion pills through the mail will not increase risks.

The Biden administration is lifting restrictions on dispensing abortion pills by mail during the Covid-19 pandemic, reversing a Trump administration policy that the Supreme Court backed in January.

Acting FDA Commissioner Janet Woodcock informed the American College of Obstetricians and Gynecologists in a letter Monday that her agency concluded that allowing patients to receive the pills via telemedicine and through the mail will not increase risks and will keep people safe from contracting the virus.

The decision marked the latest turn in a battle over longstanding FDA rules on the drug mifepristone that require people seeking medication abortions to obtain the pills in-person from a medical provider.

ACOG challenged the requirement last year but a short-handed Supreme Court following the death of Justice Ruth Bader Ginsburg in October declined to intervene. That allowed abortion clinics to continue dispensing the pills remotely, which they say has kept patients and staff safer during the pandemic.

The justices in January granted the Trump administration’s request to reinstate the rules, in a 6-3 decision that broke along ideological lines and marked the high court’s first major action on abortion since Justice Amy Coney Barrett was confirmed.

The Biden administration earlier this month asked an appeals court for more time to respond to ACOG’s lawsuit, and indicated that the FDA could decide to “exercise its enforcement discretion.”

ACOG’s Chief Executive Officer Maureen G. Phipps said Monday the lifting of the restrictions means “those in need of an abortion or miscarriage management will be able to do so safety and effectively by acquiring mifepristone though the mail — just as they would any other medication with a similarly strong safety profile.”

The move only covers the public health emergency and doesn’t spell out how the Biden administration will deal with the restrictions after the pandemic is over. Permanently lifting the curbs would vastly expand access to the drugs.

Demand for abortion pills has soared as conservative states have moved aggressively in recent years to restrict access to surgical abortions. In 2001, the drugs were used in just 5 percent of abortions in the U.S. By 2017, that jumped to 39 percent, according to the Guttmacher Institute, a research organization that supports abortion rights.

Scientists and doctors are increasingly supportive of medication abortions, which can only be used during the first 10 weeks of a pregnancy, and have long called for looser rules around how patients can obtain the pills. The pandemic brought the issue into high relief, as the government has moved to limit in-person dispensing and promote telemedicine.

Mifepristone “has very few risks at all,” said Jen Villavicencio, a health policy fellow with ACOG. “It is more safe than over-the-counter medications like ibuprofen and Tylenol. We know this medication can be safely administered via telemedicine because we’ve studied it.”

ACOG, along with the American Medical Association and other leading medical groups, has been lobbying the Biden administration and arguing in court that the federal rules for dispensing the pills should be loosened permanently. Their push has been echoed by Democrats in Congress, who have urged Biden to allow telemedicine abortions both during the pandemic and beyond.

But anti-abortion lawmakers and advocacy groups, anticipating Monday’s policy shift, have been working to preemptively ban the pills or make them more difficult to obtain.

A new ban on telemedicine abortions in Ohio that was set to take effect on Monday was blocked by a state court, while others are still advancing in Indiana, Arkansas, Iowa, Alabama, Texas, Oklahoma, Wyoming and West Virginia.

Source: https://www.politico.com/news/2021/04/12/abortion-pills-481092?fbclid=IwAR2NlZb_n_A-2RhU7B4a2hnRNCYWOrc8ZKws7uql6lt-9E0D0daKhgUhTt0