Last week, the FDA announced a change to how the abortion medication mifepristone may be prescribed—one that’s been a long time coming. Before the rule change, you couldn’t get the pills from your neighborhood pharmacy, as you would with any other drug. You still can’t, but that can now change—but the ball is now in the pharmacies’ court. Indeed, several big chains have said that they intend to pursue certification that would allow them to stock abortion pills.
Medication abortion is the type of abortion most often used in early pregnancy. Although the name might suggest it’s a surgical procedure, medical or medication abortion just refers to taking pills that cause a miscarriage. The pills can be safely taken at home, with risks similar to a natural miscarriage.
What has changed in the FDA’s regulations?
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Until a few years ago, the only way to get mifepristone legally was to have it dispensed to you in person by the prescriber. So instead of seeing a doctor and then picking up your prescription at a local pharmacy, the doctor would have to give you the pill while you were in the office.
Medication abortions typically use two medications, mifepristone and misoprostol. While misoprostol can be dispensed normally, access to mifepristone is only available through a cocoon of red tape called the REMS system. The prescriber must be specially certified, the patient must sign an agreement, and if it’s a telehealth appointment—only available since 2021—the pharmacy that mails the pills must be specially certified as well.
While states may have their own laws further restricting access to abortion in general or to mifepristone specifically, the paperwork described above is a federal requirement, from the FDA. Organizations like the American College of Obstetricians and Gynecologists have long argued that all of this runaround is ridiculous, since mifepristone is no more dangerous than other prescription medications.
The FDA hasn’t ditched the REMS system yet, but they did add a provision that pharmacies can apply to be certified to dispense the drug even if it’s not from a telehealth appointment—so in theory, you could get the pills prescribed at a local clinic and stop by the pharmacy to pick them up. You know, like you would for any other safe, effective prescription medication.
When will my local pharmacy begin stocking abortion pills?
Now that the FDA is allowing pharmacies to apply to the REMS program, the next step is waiting to see which of them actually will. Walgreens and CVS have announced that they intend to apply for certification in states where it would be legal to dispense the pills. Other pharmacies are also likely working on certification.
You will still need a prescription for the medication; this isn’t the same as making the drugs available over the counter. (Emergency contraception like Plan B is available over the counter, but that is for use immediately after unprotected sex. Mifepristone is for an actual abortion, when you already know that you are pregnant.)
The use of medication abortion is also subject to state law, as Kaiser Health News explains here. That means medication abortions are illegal in states that ban abortion. Some states allow medication abortion, but impose additional restrictions, like banning telehealth appointments for abortion or requiring the provider to tell you that medication abortions can be “reversed,” which is not actually a thing. Check your local laws before getting your hopes up.