Status of Medication Abortion in the USA

 

Medication abortion At Risk?

Medication Abortion Now Accounts for More Than Half of All US Abortions (Guttmacher 2022)

Medication Abortion Is a Safe and Effective Option 

Currently, medication abortion is approved for use up to 10 weeks of pregnancy. The FDA approved that limit based on research the agency reviewed at the time. However, additional research shows provision beyond 10 weeks is safe and effective and some providers administer medication abortion “off label” after that point in pregnancy. 

Patients initiate a medication abortion by taking mifepristone, followed by misoprostol one or two days later, as directed by a provider or the manufacturer’s instructions. Medication abortion differs from procedural abortion, which is provided in a clinical setting via vacuum aspiration or another method. Patients should always have the full scope of options available to them, including in-person care with a clinician. 

Medication abortion can be completed outside of a medical setting—for example, in the comfort and privacy of one’s home. Pills can be provided at a clinic or delivered directly to a patient through the mail. The latter option can be especially useful in addressing logistical burdens abortion patients often face when they have to visit a provider to obtain care, such as arranging for child care and time off work and paying for transportation costs. And, in areas of the country that are rural or underserved by providers, medication abortion can save a patient hundreds of miles of travel. 

Throughout the more than 20 years that it has been used in the United States, medication abortion has been proven to be overwhelmingly safe and effective

Guttmacher Institute Reports Attacks and Progress on Medication Abortion – Oct 2023

A legal case with national implications advanced in 2023 that threatens the availability of mifepristone, one of two drugs in the most common medication abortion regimen in the United States.

Several states also took aim at medication abortion with new attempts to restrict its use.

  • In Arkansas, a new law threatens physicians with loss of their medical license if they mail medication abortion pills; abortion is already banned in the state with very limited exceptions.
  • Florida banned mailing medication abortion pills to patients. The law could go into effect if a separate 15-week abortion ban is upheld by the state supreme court.
  • Montana passed a law, effective this October, targeting medication abortion by requiring new reporting requirements for providers that are not required for other drugs and procedures.
  • Wyoming banned medication abortion with limited exceptions. The law is scheduled to take effect July 1 despite ongoing litigation. 

Other states took proactive steps to expand and protect access to medication abortion.

  • Colorado passed a law specifying protection for health care workers and providers who supply medication abortion to a patient who took the pills in another state, and also prohibited medical providers from offering the medically unsupported procedure of medication abortion “reversal.”
  • Illinois clarified that medication abortion is included in the state’s existing insurance coverage requirement for abortion care.
  • Massachusetts, New York and Vermont all took action to expand medication abortion access on college and university campuses.
  • Washington state ensured the Department of Corrections can sell, deliver, distribute and dispense medication abortion pills, following the governor’s decision to stockpile medications in light of the threat to future mifepristone access.
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