Access to abortion pills by mail was made permanent by the U.S. Food and Drug Administration on Thursday.
Patients will be able to have a telemedicine appointment with a provider who can prescribe the pills and send them to the patient by mail, the FDA said in new guidance issued Thursday.
Abortion pills are approved in the United States for pregnancies up to 10 weeks’ gestation and are an increasingly common method of ending an unwanted pregnancy.
Medication abortion is a two-drug regimen that was approved in the United States in 2000, with restrictions only on the first drug, mifepristone.
Earlier this year, the FDA said that for the duration of the pandemic, it would temporarily lift the in-person requirement on mifepristone. The new announcement on Thursday makes that decision permanent.
“It’s really significant,” Mary Ziegler, a law professor at Florida State University, told The New York Times. “Telehealth abortions are much easier for both providers and patients, and even in states that want to do it, there have been limits on how available it is.”
Other experts welcomed the news.
“This decision follows the science, something we could only hope for from our nation’s regulatory body on medications. And the science shows that medication abortion care is safe to administer via telehealth,” Dr. Jamila Perritt, president and CEO of Physicians for Reproductive Health, said in a statement. “We knew this before the pandemic, and during this ongoing public health emergency, telehealth became a critical way for health care providers to offer this essential care while we all attempted to reduce exposure to the COVID-19 virus. This should have always been an option for pregnant patients and we’re relieved this is now possible.”
The FDA’s decision comes as the Supreme Court is weighing abortion rights, and the agency’s ruling is likely to deepen divisions between liberal and conservative states.
Nineteen states—mostly in the South and Midwest—ban telemedicine visits for medication abortion, and it’s likely that they and other conservative states will pass more laws to reduce access to abortion pills even more, the Times reported. In contrast, liberal states such as California and New York are expected to make medication abortion more widely available and to take steps to help women in states that don’t allow telemedicine for abortion pills.
Currently, women in states that don’t allow telemedicine for abortion must travel to a state that does, but they don’t need to go to a clinic. They just have to be at any location in the state—even a car—for their telehealth visit and can get the pills sent to any address in that state, the Times reported.
Abortion rights advocates are likely to try to find ways to make abortion pills available without requiring a woman to travel, such as launching legal challenges to state bans on telemedicine for abortion.
“Despite the FDA’s action, states across the country continue to impose medically unnecessary, dangerous restrictions on medication abortion care,” Perritt noted. “We will keep the work up until all people, no matter where they live, can get the care they need.”
Medication was used in 42% of all abortions and 54% of abortions before 10 weeks in the United States in 2019, according to data released last month from the U.S. Centers for Disease Control and Prevention. That’s the most recent year for which CDC data is available.