US makes abortion pills by mail permanent, not just for pandemic

US President Joe Biden’s administration on Thursday passed a rule making abortion pills accessible by mail permanently, not just for the Covid pandemic, a rare win for the pro-choice movement in the country’s increasingly bitter battle over reproductive rights.

The decision overturns a previous in-person requirement described as burdensome by activist organizations such as the American Civil Liberties Union (ACLU) but also health groups such as the American Medical Association (AMA).

It comes as Republican-led states have enacted increasingly stringent laws curtailing women’s rights to end their pregnancy, while a decision is awaited by the country’s Supreme Court that could reverse abortion as a constitutional right. 

The new rule was described in a letter sent by the Food and Drug Administration to plaintiffs in a court case seeking to ease rules surrounding medication abortions.  

The letter, which was uploaded online by the ACLU, said that the drug mifepristone no longer has to be dispensed only in clinics, medical offices or hospitals. But the FDA added a requirement that pharmacies dispensing it must be specially certified.

The in-person rule was dropped during the Covid-19 pandemic, brought back by the administration of former Republican president Donald Trump, then dropped again by the administration of Biden, a Democrat, on a temporary basis. Thursday’s move makes it permanent.

Medication abortion involves two different drugs, mifepristone and misoprostol, that can be safely used up to the first 10 weeks of pregnancy.

Mifepristone blocks progesterone, a hormone needed for the development of a pregnancy, thus preventing a pregnancy from developing. Misoprostol, taken 24-48 hours after mifepristone, empties the uterus by causing cramping and bleeding, an effect similar to miscarriage.

Since being approved by the Food and Drug Administration in 2000, the drugs’ use has risen sharply, and they now account for at least 40 percent of all abortions.

According to figures compiled by the Kaiser Family Foundation, when administered at nine weeks or less gestation, pregnancy is terminated successfully 99.6 percent of the time, with a 0.4 percent risk of major complications, and a mortality rate of 0.001 percent.

– ‘Time-sensitive medication’ –

“The FDA’s decision to permanently remove the in-person pill pick-up requirement is a major step forward that will enable many more patients to get this safe and time-sensitive medication as soon as they are ready, without travel-related expenses and delay,” said Georgeanne Usova, senior legislative counsel at the ACLU in a statement.

But the decision was slammed by anti-abortion groups.

“The Biden administration’s reckless move puts countless women and unborn children in danger,” said Sue Liebel of the Susan B. Anthony List. 

The decision to ease federal restrictions won’t impact restrictions on mifepristone, passed by roughly half of states, said the ACLU. 

But the group added it would expand the options and capacity of states seeing an influx of out-of-state people seeking abortion as a result of abortion bans in their home states, such as Texas, which recently made it illegal to receive an abortion after six weeks.

Legal observers expect the Supreme Court to also overturn Roe v Wade, which enshrines the constitutional right to abortion, next spring, which would pave the way for total bans at the state level.