A federal appeals court recently imposed new restrictions on a key abortion medication called mifepristone. The decision limits the drug usage to patients that are seven weeks or fewer pregnant and increases the dosage. Furthermore, the ruling requires patients to have three in-person visits with their doctor to take the medicine and bans the drug from being sent by mail. In response, doctors, clinics, and telehealth providers are scrambling to find a way to continue offering the most common type of abortion, and people who live far from abortion clinics are particularly affected. The legal shift surrounding mifepristone usage is the second time healthcare providers have been forced to adjust in less than a week.
Planned Parenthood in Illinois will continue to provide medication abortions by combining mifepristone and misoprostol because the state allows providers to write prescriptions “off-label”. People who live in states that allow providers to prescribe mifepristone off-label can still access the drug in places where it’s not prohibited by state law, but the requirement for an in-person appointment is unavoidable. Monica Cepak, the chief marketing officer of telehealth medication abortion provider Wisp, is considering switching to a one-drug regimen that uses misoprostol and offering that instead.
Telehealth medication abortions have become more popular since Roe v. Wade was overturned last year. Since December 2021, the number of abortions by virtual clinic telehealth providers has risen to 8,540, accounting for 11% of all abortions, compared to 3,610 in April 2022. Mifepristone blocks the hormone progesterone and is also used to treat miscarriages, and medical groups say complications occur at a lower rate than with routine medical procedures such as wisdom teeth removal and colonoscopies.
Although telehealth remains a critical factor in the accessibility puzzle, six states that have not banned abortions require at least one in-person visit to the clinic. Therefore, telehealth abortion providers were already imposing restrictions. Some doctors are exploring legal loopholes to continue to provide medication abortions, while others may limit their intake of patients or ditch the drug. However, Aid Access is planning to continue prescribing both mifepristone and misoprostol by telehealth.