Back in April 2021, the FDA temporarily-but-indefinitely eased restrictions on the distribution of mifepristone, also known as RU-486, part of the two-drug regimen that is mostly commonly and effectively used for chemically-induced abortions in the first 70 days of a pregnancy. The drug blocks the production of progesterone, which causes the uterine lining to breakdown; it is typically used in conjunction with another pill, misoprostol, which induces enough cramping to make the uterus shed that lining.
Previous studies have shown this pill to be remarkably safe — according to the New England Journal of Medicine, you're 14 times more likely to die while giving birth than from taking RU-486. Historically, however — because this is America — the drug was regulated with special Risk Evaluation and Mitigation Strategies (REMS), which meant it could only be obtained from doctors who actively sought out certification. Typically, this would mean a place like Planned Parenthood. As Forbes explains:
Women (sic) get the drug at their doctors' offices or a clinic or hospital during an in-person consultation. This has meant that, if a woman's doctor doesn't happen to be certified in Mifepristone REMS and have the drug on hand, the woman has to find a doctor who is and does. That can be particularly difficult in rural areas.
The FDA removed these REMS restrictions for the duration of the COVID-19 pandemic, aware that there would be a significant reduction in in-person medical consultations, which would make it even more difficult for people to obtain the pill when they needed it. As the administration explained:
The Agency intends to exercise enforcement discretion during the COVID-19 PHE with respect to the dispensing of Mifeprex or the approved generic version of Mifeprex, Mifepristone Tablets, 200 mg, through the mail, either by or under the supervision of a certified prescriber, or through a mail-order pharmacy when such dispensing is done under the supervision of a certified prescriber.
This has sent places like the Heritage Foundation into a premature tizzy, assuming it means — insert dramatic gasp! — the radical FDA will allow people to get the medicine they need forever!
Fortunately, this preposterous proposition would actually be supported by scientific evidence. An even newer study from the New England Journal of Medicine reports on abortion pill data collected in Canada, which lifted their REMS-like restrictions in 2017. The study compares the usage and safety of the pills over the final 4 years that the regulations were in effect, to their usage and safety over the last 4 years since the rule were lifted. Here's what they found:
After mifepristone became available as a normal prescription, the abortion rate remained relatively stable, the proportion of abortions provided by medication increased rapidly, and adverse events and complications remained stable, as compared with the period when mifepristone was unavailable.
This conclusion supports the data that's been shown time and time again: people are going to have abortions, because they are human beings with bodies that have various needs and wants. The harder you make it for them to get those abortions, the more dangerous it becomes for the pregnant person, and their fetus. It is literally, objectively, and unequivocally safer to just let people get the damn pills when they want or need them.
Hopefully, the US FDA sees the impact here, and follows suit.
Abortion Safety and Use with Normally Prescribed Mifepristone in Canada [Laura Schummers, Sc.D., Elizabeth K. Darling, Ph.D., Sheila Dunn, M.D., Kimberlyn McGrail, Ph.D., et al. / New England Journal of Medicine]
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