FDA Lifts Restrictions on Abortion Pill
December 16, 2021 2:52 PM   Subscribe

The FDA has just announced that key restrictions on abortion by medication (a regimen of two pills, but popularly known as the "abortion pill") have been relaxed. Medication abortion is proven to be safe and effective for early termination of pregnancy. Now patients will no longer be required to pick this medication up at a doctor's office or clinic, allowing healthcare providers to prescribe through telehealth consultations and mail abortion pills to patients.

The rule had been temporarily lifted because of the Covid pandemic, and the FDA has now permanently repealed these restrictions. Updated FDA REMS here. This is good news as the Supreme Court has signaled they may overturn Roe v. Wade with their decision in Dobbs v. Jackson Women's Health Organization.

Unfortunately 19 states have their enacted their own unnecessary restrictions on medication abortion requiring in-person visits and limiting telehealth and those still stand. In Texas a new law just took effect that "adds penalties of jail time and a fine of up to $10,000 for anyone who prescribes pills for medication abortions through telehealth or the mail".
posted by kimdog (22 comments total) 36 users marked this as a favorite
 
Organizations like Plan C and the EMAA Project have been working extensively to make medication abortion more accessible. The availability of abortion pills will change the face of what an "illegal" abortion looks like if Roe should fall.
posted by kimdog at 2:54 PM on December 16, 2021 [12 favorites]


How does this new Texas law relate to the anybody but the state can enforce anti-abortion law?
posted by njohnson23 at 3:08 PM on December 16, 2021


❤️
posted by hydra77 at 3:08 PM on December 16, 2021 [5 favorites]


Hypothetically, how thermally shelf stable are these?

If one were to, say, cast some inside a fake rock, spread these rocks throughout a large state, how long could they be extra special Geo-caches?

Or maybe I'd make them look like a discarded empty can of lone star.
posted by nickggully at 3:36 PM on December 16, 2021 [33 favorites]


This is fantastic news.
posted by rednikki at 3:40 PM on December 16, 2021 [1 favorite]


This is great news. Is there a movement to enable wide access to underserved/vulnerable/marginalized/poor women in anti-abortion states?
posted by splitpeasoup at 3:46 PM on December 16, 2021 [7 favorites]


How does that Texas law work with the supremacy clause? Aren't state laws supposed to be prohibited from conflicting with federal law?
posted by Joakim Ziegler at 3:47 PM on December 16, 2021 [5 favorites]


The Texas law works with the supremacy clause by first ensuring that 6 of the 9 human beings who determine what the supremacy clause means are anti-abortion ideologues.
posted by sainttoad at 3:55 PM on December 16, 2021 [50 favorites]


Planned Parenthood's description of the pills and how they work.

It's important to note that according to the article, they're only prescribed up to 11 weeks after the beginning of your last period. So definitely a huge help, but only a partial replacement for access to clinics and doctors.

What happens if someone in Texas or another state where these are illegal or restricted experiences any complications after taking them? If they go get medical care, would they be at risk of investigation or arrest?
posted by trig at 4:03 PM on December 16, 2021 [4 favorites]


What happens if someone in Texas or another state where these are illegal or restricted experiences any complications after taking them? If they go get medical care, would they be at risk of investigation or arrest?

Almost certainly. Expect a significant increase in the already existing serious problem of marginalized people who experience miscarriages being arrested on suspicion of having an illegal abortion.
posted by jedicus at 4:21 PM on December 16, 2021 [18 favorites]


@splitpeasoup Abortion funds remain the first wave of assistance for people needing any type of abortion care, including medication abortion. There is also a movement to widely train people on self-managed abortion, meaning that a person finds and takes the abortion pills at home without consulting a clinician. in particular, Aid Access, based in Amsterdam, is helping pregnant people acquire abortion pills for self-managed abortions in states where they may not be able to access by mail by other means. As someone who works in the repro movement, I can tell you that many activists and orgs are looking at ways to expand this work, especially if Roe falls. Medical professionals cannot tell (by testing or otherwise) if someone has taken the medication, and this basically just presents as a miscarriage (which it is). But it's not fool proof, especially as miscarriages are becoming more criminalized.
posted by kimdog at 4:22 PM on December 16, 2021 [12 favorites]


Suck on that Greg Abbott.
posted by nestor_makhno at 4:27 PM on December 16, 2021 [2 favorites]


As someone who just terminated a (wanted but non-viable) pregnancy today, fuck all these restrictions. They also hurt women who miscarry, which I am learning is extremely common, occurring in somewhere between 1-in-3 and 1-in-4 pregnancies, and because of all this campaigning will now carry enormous guilt about getting what is essentially the same procedure, for their health, and instead try to do it the "natural" (painful, dangerous, carrying the risk of infectoin) way.

Or on preview, what jedicus said. These restrictions hurt all women.
posted by subdee at 4:35 PM on December 16, 2021 [81 favorites]


Can the Texas government be charged with federal felonies if they interfere with mail delivery? Would love to see Greg Abbott and other high-placed Texans be forced to do a perp walk into a federal correction faciltiy.
posted by They sucked his brains out! at 5:10 PM on December 16, 2021 [6 favorites]


Subdee, as a woman who has been there (three times), you have my sympathy, and total agreement.

Being a mother who went through miscarriage made me even more pro-choice than ever. Everyone should have these options. Abortion care is miscarriage care, period.
posted by offalark at 6:15 PM on December 16, 2021 [18 favorites]


Texas was bellicose when those in power stated that they were going to stop the import of the abortion pill. Really? How are you doing on preventing the import of fentanyl and meth into Texas??
posted by robbyrobs at 6:34 PM on December 16, 2021 [9 favorites]


If one were to, say, cast some inside a fake rock, spread these rocks throughout a large state, how long could they be extra special Geo-caches?

A month or so ago, Naiomi Wu was talking about embedding pills into 3d printed widgets to conceal them.
posted by mikelieman at 7:24 PM on December 16, 2021 [4 favorites]


Just hide them in fake-but-real-looking guns. No Texan conservative would dare interfere with your ownership of one of THOSE.
posted by delfin at 7:32 PM on December 16, 2021 [23 favorites]


"Hypothetically, how thermally shelf stable are these? "

Instability of Misoprostol Tablets Stored Outside the Blister: A Potential Serious Concern for Clinical Outcome in Medical Abortion

Not sure if this really answers the question at hand as it constrains the results to "outside the blister" pack.
posted by bz at 7:54 PM on December 16, 2021 [4 favorites]


What happens if someone in Texas or another state where these are illegal or restricted experiences any complications after taking them? If they go get medical care, would they be at risk of investigation or arrest?

Yes. But that is only because law enforcement people seriously investigate people for miscarrying. Which is unbearably awful and ridiculous. You cannot tell a medical abortion and a spontaneous miscarriage apart from each other.
posted by plonkee at 8:56 AM on December 17, 2021 [3 favorites]


You cannot tell a medical abortion and a spontaneous miscarriage apart from each other.

My miscarriage was medically induced because it refused to start on its own. I jumpstarted it using the "abortion pill" currently being talked about here, and after several days of bleeding I had to go to an ER for treatment because my bloodcount was dangerously low and the process (miscarriage, abortion, like you say, there's functionally no difference) still hadn't completed.

To be honest, when I look back on it, I was probably further along than we knew and should have gone in for a D&C, but I wanted to be home and avoid a surgeon. Good or bad, it was my choice, and my doctor and midwife respected me when I asked for the misoprostol tablets instead.

(The older and wiser offalark would go in for the D&C, btw, and not think twice about it. The older and wiser offalark would do a lot of things differently including researching the hospitals where she gave birth to her second child, the NICU, and not sweat formula, but that was for older and wiser offalark to figure out.)

My next two miscarriages initiated on their own before we'd even gotten the blood results back indicating my estrogen was dropping and the pregnancies were non-viable. Very polite blighted ovums, those.

But that first one was wicked and hard. I was on a pseudomorphine drip at the ER, had a wonderful phlebotomist who was very concerned about my bloodcount, and a judgy ultrasound tech who gave me sour looks after telling me there was "nothing there". Four hours later, at home and on heavy medications and no longer experiencing incredibly severe cramping, I finally did pass the last of the tissue, and was able to rest and recuperate. My doctor had told me I would "know" when I passed the pregnancy, and boy was he right. It was unmistakable and something I'll save you all from describing, IDGAF what that technician thought.

As much as I laud free access to Cytotec -- and this is a victory, this is very good -- I really worry about the X% who get into a situation like mine. It's scary, and if I hadn't had my husband there to take me to the hospital, I probably would have passed out from bloodloss. But more than that I worry about laws like Texas's, which want to be suspicious of women like me having miscarriages, or women having abortions, and arrest them for it. Where women like that ultrasound technician can, IDK, act on their worst intentions and make life hell for people.

We're still so far from bodily autonomy, and it's just so fucking depressing sometimes.
posted by offalark at 10:56 AM on December 17, 2021 [13 favorites]


Yeah. After considering all the options, I went for what they euphemistically call "the procedure." It was vacuum suction in my case, not the D&C. It took 15 minutes in my doctor's office, with a visiting doctor from planned parenthood who was amazing, "if it makes you feel better I do these all day and every day." (It did make me feel better.)

I was a bit afraid of the vacuum, maybe because of anti-abortion propaganda, I don't know, but opted for that method because it would be faster and I wanted to go back to work the next day. The pills can take a few days to work and they can be painful. I'd had the fetus for about 13 weeks at that point with no development after week 7, which we only realized looking at the ultrasound. It was not passing by itself.

I have only good things to say about the 'procedure' and the doctors, they were amazing. All women should be as lucky as I am to live in a place where these procedures are not stigmatized and the doctors are skilled and knowlegable in them. For the health of all women.
posted by subdee at 2:15 PM on December 17, 2021 [10 favorites]


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