Receiving abortion pills by mail is already more difficult than it may seem

The search for the term “abortion pills” on Google reached a record high on May 3, that day. Politico has published a draft of the leaked opinion noting that the Supreme Court is likely to overturn Ron v. Wade.

Two-drug abortion regimens, as known clinically, have been available since the Food and Drug Administration approved them in 2000. People have been able to receive the pills by mail since April 2021, when the FDA suspended compliance. to take the first pill in person. Agency: In December, that option became permanent.

But the possibility that the constitutional right to abortion may cease to exist has raised a new set of questions about whether states can legally – logistically prohibit residents from taking or receiving pills. The landscape is particularly complex, say two legal experts, given that the drugs are federally approved.

“Although the federal government may say. “No, we think it’s good for suppliers to prescribe this drug,” states can turn around. “Make it illegal,” said Chiara M., a law professor at the University of California, Berkeley. Bridges.

When it comes to taking abortion pills, it is possible that “pregnant women can get medical abortions without criminal penalties,” even if Roe fails, Bridges said, “state lawmakers can improve those laws.”

But even today, access to medical abortion is difficult in many states, and regulations vary considerably.

Getting abortion pills is “really difficult in most parts of the country, it may be legally impossible in most parts of the country relatively soon,” said Wendy Parmett, director of the Center for Health Policy and Law at North East University.

How do abortion pills work?

Drug abortion has been calculated Half of all abortions in the United States In 2020, compared to 39% in 2017, according to the Guttmacher Instituteabortion rights group.

The first pill in the regimen, mifepristone, blocks progesterone, a hormone that supports pregnancy. The second, misoprostol, consists of four pills, usually taken after 24-48 hours, which cause contractions to effectively empty the uterus.

The regimen can be taken up to 10 weeks after the first day of a patient’s last period. According to him, it is 97% effective in terminating pregnancy Overview of 2015 studies. FDA regulations require that pills be supplied only by specially certified suppliers.

By 2020, the full mode would have cost about $ 560 on average, according to: a recent study, except when it is covered by insurance, which varies by state ագրական insurance provider. The procedure for abortion in the first trimester of pregnancy is about the same.

Medical abortion is different from plan B, a pill that is taken during unprotected sex for three days to prevent pregnancy.

A wide range of state regulations

Most of the United States have at least one limitation Drug Abortion Outside of FDA Rules, According to the Guttmacher Institute

Thirty-two states require pills to be prescribed by doctors, not nurses or medical assistants. Nineteen requires physicians to be physically present for one or more visits, effectively eliminating mail access. (These include Alabama, Arizona, Arkansas, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, North Carolina, North Dakota, Oklahoma, South Carolina, North Dakota, South Dakota, Tirota, Dakota.

Six of those states, Arizona, Arkansas, Louisiana, Missouri, Texas and West Virginia, also outsourced the use of telemedicine to access abortions in February. Kaiser Family Foundation.

In addition to that: Texas: և: Oklahoma have passed laws that allow it Private citizens sue anyone who provides abortion care or helps someone have an abortion after heart activity is detected. about six weeks pregnant.

Aid Access, a non-profit organization that provides access to abortion pills by mail, said Surveys in Texas spicted by: 174 percent Within three months of the six-week state ban. However, in December, an additional Texas law came into force that made it illegal to send abortion drugs to the state.

What happens to the availability of abortion pills if Roe turns around?

The overthrow of Roe, whose Supreme Court ruling is expected in late June, will propose laws in 13 states banning abortions. The laws would make it illegal for people to obtain or assist in abortion pills, but governments could make it harder to enforce that part, Parmet said.

“It will be very difficult for states to completely prevent access to medical abortions for the people of their state,” he said. “We have not been very successful in preventing people from accessing all kinds of drugs, therapies, illicit drugs.”

An additional complication, according to two experts, is the question of whether state sanctions can ignore FDA approval.

“There is an argument that I do not know that is victorious with the current US Supreme Court, that up to 10 weeks of federal licensing will be lifted, will prevent a six-week ban in the state,” Parmet said. Oklahoma և Texas Laws.

It is unclear whether states will have the legal authority to prohibit out-of-state physicians from prescribing abortion pills to their residents.

“The argument that the Red States are going to make is that even Zoom access provides health care. So if a New York provider logs in with someone from Zoom Texas, that provider provides health care. “A resident of Texas,” said Bridges.

But, he added, “if the easing of restrictions on telecommunications during the epidemic persists, the New York physician should refrain from persecution.”

Abortion pills are safe

Complications of medical abortions occurs in only a fraction of patients, according to the National Academies of Sciences 2018 More recently to studyPublished in February, it was found that about 1% of people who self-administered medical abortions had adverse effects.

The pills, however, cause convulsions and bleeding that can last for hours or more. (Bleeding or spots may continue for several weeks).

The safety of the regimen is less guaranteed if the pills are ordered from abroad, as some Texas women have done in non-regulated pharmacies in Mexico. NPR: և: The Texas Tribune: reported.

“There are bigger risks to your health if you take medication, you do not know where it comes from,” Parmett said. “What we are really going to have is chaos.”

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