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US makes abortion pills by mail permanent, not just for pandemic

Published Dec 17, 2021 12:28 pm

US President Joe Biden's administration on Thursday (Dec. 17 Philippine time) passed a rule making abortion pills accessible by mail permanently, not just for the COVID pandemic, a rare win for the pro-choice movement in the country's increasingly bitter battle over reproductive rights.

The decision overturns a previous in-person requirement described as burdensome by activist organizations such as the American Civil Liberties Union (ACLU) but also health groups such as the American Medical Association (AMA).

It comes as Republican-led states have enacted increasingly stringent laws curtailing women's rights to end their pregnancy, while a decision is awaited by the country's Supreme Court that could reverse abortion as a constitutional right. 

The new rule was described in a letter sent by the Food and Drug Administration to plaintiffs in a court case seeking to ease rules surrounding medication abortions.  

The letter, which was uploaded online by the ACLU, said that the drug mifepristone no longer has to be dispensed only in clinics, medical offices or hospitals. But the FDA added a requirement that pharmacies dispensing it must be specially certified.

The in-person rule was dropped during the COVID-19 pandemic, brought back by the administration of former Republican president Donald Trump, then dropped again by the administration of Biden, a Democrat, on a temporary basis. Thursday's move makes it permanent.

Medication abortion involves two different drugs, mifepristone and misoprostol, that can be safely used up to the first 10 weeks of pregnancy.

Mifepristone blocks progesterone, a hormone needed for the development of a pregnancy, thus preventing a pregnancy from developing. Misoprostol, taken 24-48 hours after mifepristone, empties the uterus by causing cramping and bleeding, an effect similar to miscarriage.

Since being approved by the Food and Drug Administration in 2000, the drugs' use has risen sharply, and they now account for at least 40% of all abortions.

According to figures compiled by the Kaiser Family Foundation, when administered at nine weeks or less gestation, pregnancy is terminated successfully 99.6% of the time, with a 0.4% risk of major complications, and a mortality rate of 0.001%.