For the first time ever, U.S. women seeking to terminate a pregnancy using medication abortion will be able to legally obtain the pills through the mail, avoiding the need for an in-person doctor’s visit.
A federal court ruled on Monday that the U.S. Food and Drug Administration must suspend a rule that requires patients to visit a hospital, clinic or medical office to obtain mifepristone, a drug used to terminate pregnancies, during the coronavirus pandemic.
Under existing regulations, patients seeking medication abortion ― a protocol that involves taking mifepristone in combination with a second drug, misoprostol ― must pick up the medicines in person from an abortion clinic, even though the pills are usually swallowed at home. For some patients, this can mean traveling hundreds of miles just to obtain a prescription.
About 40% of all abortions in the U.S. are performed at home using medication abortion, which can be taken up to 10 weeks of pregnancy.
Monday’s decision allows healthcare providers to send mifepristone to eligible patients through the mail so they don’t have to travel during the pandemic. The ruling comes in response to a lawsuit filed by the American Civil Liberties Union on behalf of a coalition of reproductive rights advocates and medical experts, including more than 60,000 OB-GYNs.
“The In-Person Requirements, combined with the COVID19 pandemic, place a substantial obstacle in the path of women seeking a medication abortion and that may delay or preclude a medication abortion and thus may necessitate a more invasive procedure,” U.S. District Judge Theodore Chuang wrote in the ruling. “Particularly in light of the limited timeframe during which a medication abortion or any abortion must occur, such infringement on the right to an abortion would constitute irreparable harm.”
The in-person dispensing rules will be suspended until at least 30 days after the end of the federal government’s declared public health emergency, Julia Kaye, staff attorney at the ACLU Reproductive Freedom Project, said in an interview.
She noted that the FDA already allowed doctors to prescribe mifepristone using telemedicine, however women were required to physically pick the drugs up in person. “Now, if a doctor can determine that a patient is eligible for a medication abortion without an additional in-person visit, that patient can stay home during the pandemic and get the medication safely by mail,” she said.
The new rules should go into effect in the next few days, she added.
The FDA has come under increasing pressure to change the dispensing rules around mifepristone since the coronavirus outbreak began. In April, Democratic Sens. Elizabeth Warren (Mass.), Patty Murray (Wash.) and Tammy Baldwin (Wis.) sent a letter urging the agency to allow patients to receive the medications without having to go into a medical facility. A coalition of state attorneys general sent a similar letter to the agency in March.
Since it was approved in 2000, over 3 million U.S. women have used mifepristone to end a pregnancy. The American College of Obstetricians and Gynecologists (ACOG) opposes the FDA’s restrictions on the drug, and has called for mifepristone to be made available in retail pharmacies.
“Today’s ruling represents a victory for patients, who should not have to face the additional burden of increased COVID-19 exposure as a condition of receiving their prescribed mifepristone,” said Eva Chalas, the president of ACOG. “It also represents a victory for the dedicated clinicians who are working to provide needed care without unnecessary exposure of patients, their families and the members of the healthcare team, to the novel coronavirus.”