Repeal of Roe v. wave | The abortion pill, an emergency exit?

Within hours of the Supreme Court ruling overturning abortion rights in the United States, nearly 100 appointment requests were received by Just the Pill, a nonprofit organization that enables patients to obtain the abortion pill in several states.

Posted at 6:00 am

Pam Belluck
The New York Times

That’s about four times the usual daily number of appointment requests the organization receives, and many of them are from patients in Texas and other states that quickly shut down abortions following the United States Supreme Court ruling.

Abortion pills, already used in more than half of recent abortions in the United States, have been on the rise since the fall of Roe v. Wade, and they’ll likely be the focus of upcoming litigation as nearly half of states plan to ban abortion and take other steps to improve access.

Known as a medical abortion, the method is approved by the Food and Drug Administration (FDA) for use in the first 10 weeks of pregnancy. It involves taking two different drugs 24 or 48 hours apart to halt the development of the pregnancy and then triggering miscarriage-like contractions to expel the fetus, a process that usually causes bleeding similar to heavy periods.

Many patients choose medical abortion because it is less expensive, less invasive, and offers more privacy than surgical abortion. The pills can be received by mail and taken at home or anywhere after an initial consultation with a doctor via video, phone, in person or even by filling out an online form.

The patient must come to the clinic from a state that allows abortion, even if it’s just a matter of making a phone call in a car just across the border. The clinic can use the IP address of the computer or phone they are using to determine where they are located.

For states that ban all forms of abortion, medical abortion likely poses significant enforcement challenges. It’s one thing to shut down a clinic, but it’s much more difficult to stop activities like sending or receiving pills through the mail or the Travel to a state where pills are legal to control and reclaim them, legal experts say.

“People say we go back in time before Roe, but there is no time machine; we have a very different pharmaceutical landscape,” said Katie Watson, a constitutional scholar and medical ethicist at Northwestern University’s Feinberg School of Medicine.

Abortion laws enacted in many conservative states prohibit all forms of abortion, including medical abortion. In addition, 19 states already had laws prohibiting the use of telemedicine for abortions. Texas recently passed a law banning the mailing of abortion pills. So groups and some state governments that support abortion rights are mobilizing to help patients get the pills in states where they’re legal.

Mobile clinics

As of October 2020, Just the Pill has conducted over 2,500 telemedicine consultations with physicians to deliver abortion pills through the mail to patients in Colorado, Minnesota, Montana and Wyoming. Within days, it plans to deploy the first of a “fleet of mobile clinics” in Colorado that will be stationed along state lines to offer medical abortion consultations and dispense pills, the agency said. DD Julie Amaon, the organization’s medical director.

The mobile clinic program, called Abortion Delivered, which will also offer surgical abortions to patients who prefer it or whose pregnancy is too far advanced for a medical abortion, is set to quickly reach patients in neighboring states like Texas, Oklahoma and South Dakota, who have banned abortions after the court ruling , and other states like Utah, which should ban or severely restrict abortion.

“By operating across state lines, we will reduce travel restrictions for patients in states that ban or severely restrict abortion,” said amon.

Going beyond a traditional stationary clinic, our mobile clinics can quickly adapt to courts, state legislatures and marketplaces and go where the need is.

The DD Julie Amaon, Medical Director of Just the Pill

Similar medical abortion providers are also preparing for an influx. Hey Jane, an organization that has served nearly 10,000 patients in California, Colorado, Illinois, New Mexico, and the states of New York and Washington, plans to expand into other states. “We have strengthened our team to meet this significant increase in demand,” said CEO Kiki Freedman.

Anti-abortion groups are attempting to counter growing interest in medical abortion by claiming it is unsafe and calling it a “chemical abortion”. James Studnicki, vice president of data analysis at the Charlotte Lozier Institute, a branch of Susan B. Anthony Pro-Life America, said Friday that “the safety of the abortion pill is being grossly exaggerated” and called the rise in medical abortion “serious.” danger to public health”.

insecurity and obligations

Much is still unknown about how states that ban all or most abortions will seek to enforce their laws in medical abortion cases. But as the Biden administration scrambles to respond to the court’s ruling, two cabinet members were quick to release statements pledging to protect the right to take state-approved drugs.

“We remain steadfast in our commitment to ensuring that every American has access to, and the opportunity to make, health care choices, including the right to a safe and legal abortion, such as: Health and Human Services Minister said in a statement.

In a separate statement, Merrick Garland, the country’s attorney general, made specific reference to the medical abortion regime’s first drug, mifepristone.


Box of mifepristone, the first drug in the medical abortion regimen

In December, the FDA significantly eased access to the drug by permanently removing the requirement for patients to obtain mifepristone by visiting a clinic or licensed physician in person.

“We stand ready to work with other branches of the federal government that are trying to use their statutory powers to protect and preserve access to reproductive care,” Garland said. Specifically, the FDA has approved the use of the drug mifepristone. States cannot ban mifepristone if they disagree with the FDA’s expert judgment on its safety and effectiveness. »

But what the Justice Department can do is unclear. Some legal scholars have argued that federal drug approval supersedes government measures to restrict the use of a drug. Others say it only applies to cases where a state claims safety or efficacy is an issue.

This article was originally published in New York Times.

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