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4 Things to Know About the FDA’s Move to Expand Access to Abortion Pills
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4 Things to Know About the FDA’s Move to Expand Access to Abortion Pills

The U.S. Food and Drug Administration’s new guidance on medication abortion has the potential to increase access to care, though challenges remain.

A women holds up mifepristone and misoprostol.
A women holds up mifepristone and misoprostol pills, which are used for medication abortion, on July 1, 2022, in Washington, D.C. (Getty/The Washington Post/Amanda Andrade-Rhoades)

On January 3, 2023, as court challenges continue over abortion access, the U.S. Food and Drug Administration (FDA) released new guidance to allow retail pharmacies—the types of places where most people pick up their medications—to provide medication abortion for the first time. Already, Walgreens and CVS have announced they plan to offer the medication in states where abortion is legal.

This news represents a potential major step forward in access to care. Since first approved by the FDA more than 20 years ago, medication abortion has been used by more than 4 million women, such that it now makes up the majority of abortion care in America. Furthermore, the ready willingness of two of America’s largest pharmacy chains to offer access to these drugs is yet another sign that the U.S. Supreme Court’s decision to end Roe v. Wade does not reflect the values of the strong majority of the American people.

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Here are four important facts you should know about the FDA’s new guidance:

1. Medication abortion is safe to take in the privacy of one’s home

The “abortion pill” is actually a two-step regime of two different medications, mifepristone and then misoprostol, approved for use in the United States for up to 10 weeks of pregnancy. A wealth of evidence demonstrates the method’s safety and effectiveness. With fewer complications than drugs such as Tylenol, medication abortion makes up the majority of abortion care in America.

The full regime has also proven to be safe to take at home. Doing so can have three primary benefits. First, it allows patients to end their pregnancies in the location of their choosing, in a place they feel comfortable and can be supported by their loved ones. Second, it allows them to time their abortion to balance their responsibilities, as the majority of patients are already mothers, many of whom are working jobs in which they do not control their schedule. Finally, medication abortion cuts down on logistical hurdles that force patients to travel what can often be long distances to a provider simply to pick up the medications.

Underscoring the safety of medication abortion at home, the World Health Organization has explained that with proper support, medication abortion is safe even without the involvement of a provider. This is often called “self-managed abortion,” which occurs when laws limit people from accessing abortion through the traditional health care system, as now more than a dozen of states have done through their abortion criminalization schemes.

2. The FDA’s decision is designed to increase access to care

There remain unanswered questions about exactly which, and in what manner, individual pharmacies will provide the medications. Still, the potential is clear. The FDA’s update is a continuation of the agency’s moves to expand access to care beginning during the pandemic, when the agency temporarily allowed the medications to be mailed to patients after a telemedicine appointment with a provider. In December 2021, the agency made that change permanent—though the types of providers and pharmacies that were allowed to actually mail the drugs were limited.

This newest change greatly expands the number of pharmacies eligible to both mail the drugs and make them available for pickup. That said, some limits remain that aren’t imposed on other medications with similar safety rates. For example, the FDA requires the newly eligible pharmacies to take certain steps to become certified and to ensure providers are also certified, while patients must secure a prescription before being able to access the medications.

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3. State interference in medical expertise is unacceptable

Despite the FDA’s moves to increase access to care—increases that have long been called for by leading organizations such as the American Medical Association, American College of Obstetricians and Gynecologists, and American Academy of Family Physicians—states continue to ban access to abortion. In fact, even before Roe v. Wade was overturned, many states had put in place additional medically unnecessary restrictions on medication abortion that were designed to limit its use as well as stigmatize those who sought to end their pregnancies.

Politicians interfering with medicine to assert their own ideology is unacceptable, as it can put patients at risk. Already, in states that have banned abortion, doctors are being put in fear of criminalization. As a result, there have been continued reports of women being denied the best standard of care when miscarrying or otherwise facing significant pregnancy complications—instead being sent home in pain and with their health at significant risk.

4. No one deserves to be punished for abortion care or denied basic rights

The FDA’s change is a welcome one. But those living in states that have banned or severely restrict abortion still face unacceptable hurdles to accessing care. This includes nearly one-third of women between the ages of 15 and 49 living in the United States, with disproportionate harms falling on women of color who already face significant health disparities.

Everyone should have the freedom to determine their own future. Unfortunately, the Supreme Court, in concert with politicians, has made that an impossibility for far too many today.

Approximately 1 in 4 women in America will need abortion care at some point in their lifetime, demonstrating just how critical it is that access to abortion be meaningfully restored nationwide.

Conclusion

It is essential that the FDA’s new expansion of care is implemented effectively and to the maximum extent possible. At the same time, approximately 1 in 4 women in America will need abortion care at some point in their lifetime, demonstrating just how critical it is that access to abortion be meaningfully restored nationwide. The health and basic dignity of all people depend on it.

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Authors

Maggie Jo Buchanan

Senior Director, Women’s Initiative

Kierra B. Jones

Policy Analyst

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