The U.S. Senate failed to pass the Women’s Health Protection Act, a bill backed by Democrats to turn access to abortion into federal law, on May 11. The vote took place afterwards draft opinion Information leaked last week that the Supreme Court would overturn the constitutional right to abortion.

Several states have already enacted trigger laws that will immediately ban or severely restrict abortion, including medical abortion, said Eliza Wells, co-founder of Plan C, an information campaign offering guidelines on how to access abortion pills by mail in the United States.

Medical or medical abortion involves the use of two drugs, called abortion pills, to terminate a pregnancy and can be performed without a medical professional. The drug is available in a combined kit consisting of two drugs; mifepristone and misoprostol. Mifepristone is a pill that blocks progesterone, which is needed for pregnancy to develop. While sold under the Mifeprex brand in the US and manufactured by Danco Laboratories, the FDA also approved a generic version of this drug, manufactured by GenBioPro in 2019. Misoprostol, sold as Cytotec, is a prostaglandin that causes the uterus to contract and expel its contents. . Misoprostol is indicated for use a day or two after taking mifepristone and is usually taken by placing the pills inside the cheeks, allowing them to dissolve.

Mifepristone was approved by the FDA in 2000 for medical termination of intrauterine pregnancy within 70 days of pregnancy, but with a drug safety program for risk assessment and risk reduction strategy (REMS). REMS applies to medicines that are considered to have safety concerns. Wales says it was a political decision, as the safety of the drug has been known since its use in Europe. The United Kingdom legalized the home use of early medical abortion pills in England in 2018, following similar regulations in Scotland and Wales the previous year.

In the United States, those who want to terminate a pregnancy can access the drug through mass medical routes or telehealth applications, where the patient’s eligibility is assessed by a clinician or through an online form, Wales explains. However, in some countries the presence of a clinician is required when administering the drug. Besides, according to analysis of the Kaiser Family FoundationMissouri, Arizona, Arkansas, Louisiana, Texas and West Virginia have a total ban on the use of telehealth services to access abortion pills.

One of the original regulations of REMS forbade mifepristone to be dispensed through pharmacies. But on December 16, 2021, the FDA updated its guidelines and lifted the restriction that requires mifepristone to be dispensed only in clinics and medical facilities in person, but added that this should be done by certified pharmacies. This paved the way for the pills to be mailed to states where the law allows it.

To access these medicines, some people use Aidaccess.org, a European-based non-profit organization, while others create a virtual mailbox in a state that allows them to prescribe medicines for abortion through telemedicine and then send the medicine home them.

While the drug combination is approved for use within 10 weeks of the first day of the last menstrual cycle, it is usually prescribed off the label for up to 11 weeks. Depending on the state, the price can range from $ 600 to $ 800 if the drug is sought through mass medical care, while the price through telemedicine services starts at $ 150.

If the Supreme Court overturns the historic Rowe v. Wade ruling, allowing states to decide their own abortion laws, Wales expects people to travel to other areas of the country where the drug or procedure is allowed. However, these service providers may be overwhelmed by the number of people seeking help. She notes that these restrictions will disproportionately affect people who are already marginalized in society, as travel will lead to additional economic and social costs.

There are no laws in most states banning access to abortion pills, but Wales points out that there have been cases of people being criminalized for self-management at the end of pregnancy. Last month, a woman from Texas was charged with murder for self-administered abortion, but was released a few days later after the charges were dropped. When people need to evaluate such decisions, they think not only about the legal risks of abortion, but also about the health, social and economic risks of pregnancy, Wales said.

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