After six months of mailing the abortion pill directly to patients, this brief trial has come to an abrupt halt. A recent U.S. Supreme Court order has forced medication abortion providers to cancel hundreds of shipments of the abortion pill.
"We had to call and let them know that we wouldn't be able to mail their medication,"said Dr. Colleen McNicholas, the chief medical officer of Planned Parenthood of the St. Louis Region. "Would coming into the clinic be an option for them? What some patients said was 'I don't know when I'm going to be able to do that. So I'm going to have to wait and then you know reschedule my appointment at another time when I can get a day off of work or when I know that I have child care.'"
The abortion pill, or mifepristone, is the first drug taken to begin a medication abortion, a method of early pregnancy termination available within the first 10 weeks of gestation.
For more than 20 years the Food and Drug Administration restricted access to the abortion pill – it was only available at the office of an approved provider – but all that changed with the pandemic.
"This felt like sort of the icing on the cake to really be able to say to a patient, 'We can now from start to finish, deliver your care to you in your home where you want and need that care,'" said McNicholas.
Last July, a federal judge temporarily blocked the FDA from preventing providers like McNicholas from mailing the abortion pill to patients.
"It's certainly in these times folks are looking for ways to minimize exposure to other people," she said. "This provides a good opportunity for that."
Patients no longer needed to drive to a certified clinic to pick up the abortion pill, only to turn around and go home to take it. Many clinics enlisted the help of online pharmacies like HoneyBee Health to help with shipping.
"We essentially act as a storage facility and we dispense the mifepristone once we verify that a certified prescriber prescribed it and that we've gone through all the necessary steps," said Dr. Jessica Nouhavandi, co-founder of HoneyBee Health, an online pharmacy based in Southern California. "We've proven that it's safe and effective. And really the genie is out of the bottle."
But in addition to federal restrictions, states have passed their own laws limiting access. And for many, the temporary block didn’t change anything.
Nineteen states require providers to be physically present when a patient takes the abortion pill. That includes Missouri, where McNicholas practices.
"We have an injunction, which allowed us to mail it to folks in Illinois, but all of our Missouri patients were still prohibited from receiving that," said McNicholas.
As COVID deaths continue to rise, providers say now more than ever they need to lower the risk of exposure to the virus. They are asking the new Biden administration to let them mail the drug to patients as long as the pandemic continues.
"We're ready to go if things change and we just have to keep talking about it," said Nouhavandi. "And the fight is not over."