As the coronavirus pandemic ground almost every U.S. industry to a standstill, the Trump administration urged healthcare professionals to use telemedicine to see patients remotely and stem the spread of COVID-19. But the administration didn't really extend that advice to one big group: abortion providers.
Abortion rights advocates are trying to change that.
On Wednesday, the American Civil Liberties Union sued the Food and Drug Administration and the Department of Health and Human Services, accusing the agencies of jeopardizing public safety by refusing to let doctors dispense abortion-inducing drugs remotely in the middle of a deadly pandemic.
In a medication abortion, people take doses of two drugs several hours apart. The first drug, mifepristone, has long been regulated by what’s called a “risk evaluation and mitigation strategy,” or “REMS.” Under those rules, patients must travel to pick up mifepristone from their clinician in-person, even if they’ve already visited a doctor about getting an abortion.
The agencies, the ACLU alleges in the lawsuit, “have singled out mifepristone prescribers and patients for a special barrier to telehealth care during the COVID-19 pandemic that impedes clinicians’ medical judgment; subjects patients, clinicians, and other health care staff to unnecessary medical risks; serves no rational or legitimate government purpose; and conflicts with [the agencies’] own efforts to mitigate the spread of COVID-19.”
The Centers for Disease Control has recommended that medical professionals try to use telemedicine as much as possible during the coronavirus pandemic. Government agencies have also recently taken extraordinary steps to expand remote healthcare, including waiving REMS requirements for certain tests and controlled substances.
But it’s held firm to its rule that patients must physically pick up mifepristone. And while the FDA regulates more than 20,000 drugs, the ACLU claims that “mifepristone is the only one that patients must receive in person at a hospital, clinic, or medical office, yet may self-administer, unsupervised, at a location of their choosing.”
Plus, those restrictions only apply when someone wants to use mifepristone to induce an abortion. High doses of mifepristone can be used to treat a certain kind of hormonal disease. In that case, people can get their mifepristone from a mail-order pharmacy, according to the lawsuit.
Medication abortion, which is used to end pregnancies before 10 weeks, is very safe. Complications occur in just a fraction of a percent of cases, according to a 2018 study from the National Institutes of Health on abortions in the U.S. Mifepristone is also widely used: In 2017, the most recent year for which data is available, the drug was used 39% of all U.S. abortions.
The ACLU has already sued over the restrictions on mifepristone, in 2017. That case is still pending. If the civil rights organization succeeds in its latest lawsuit, the restrictions on mifepristone would only be lifted during the pandemic.
The ACLU filed this lawsuit on behalf of the American College of Obstetricians and Gynecologists, the preeminent U.S. professional organization for OB-GYNs, as well as SisterSong Women of Color Reproductive Justice Collective and other professional physicians’ groups.
On a Wednesday call with reporters, SisterSong Executive Director Monica Simpson pointed out that women of color already struggle to get the healthcare they need — but now, the coronavirus is also ravaging their communities.
“Women of color have faced enormous disparities across every form of healthcare. Reproductive healthcare is no exception,” Simpson said. Black women are three to four times more likely than white women to die from pregnancy or problems linked to childbirth. “As a black, Southern woman myself, these statistics scare me every day,” she said.
These organizations aren’t the only ones clamoring for an easing of the restrictions on mifepristone. Back in March, more than 20 state attorneys general asked Department of Health and Human Services Secretary Alex Azar to lift the requirements. More than 80 organizations also wrote a similar open letter to the FDA’s commissioner in early May, to no avail.
In March, before the letters, the FDA told VICE that it plans to stand by its restrictions on mifepristone.
“Certain restrictions, known as a risk evaluation and mitigation strategy (REMS), are necessary for mifepristone when used for medical termination of early pregnancy in order to ensure that the benefits of the drug outweigh its risks,” the FDA said in a statement that didn’t mention the pandemic.
The United Kingdom, meanwhile, has already lifted its own restrictions on mifepristone in light of COVID-19. It’s agreed to temporarily let doctors prescribe mifepristone from home, without forcing people to travel to a clinic.
Cover: The abortion drug Mifepristone, also known as RU486, is pictured in an abortion clinic February 17, 2006 in Auckland, New Zealand. (Photo by Phil Walter/Getty Images)