PHILADELPHIA -- The pandemic is helping U.S. abortion-rights advocates achieve a long-standing goal: Make it easier for women to use pills to end pregnancies up to 10 weeks.
Federal and state regulations have restricted access to "medication abortion" ever since the Food and Drug Administration approved it two decades ago. Nonetheless, use of the two-drug regimen has grown steadily, accounting for at least 40% of all abortions, even as the national abortion rate has fallen to historic lows, data show.
Before the coronavirus made seeking medical care in person risky for both patients and providers, efforts were well underway to expand access to abortion pills through telemedicine and mail-order pharmacies. Now, those efforts are accelerating and multiplying because suddenly a divisive political issue is also a matter of public health.
"For patients seeking abortion, urgent modifications of current protocols are needed to ensure that patients can continue to obtain this time-sensitive treatment while limiting transmission of infection," 11 prominent reproductive health experts wrote last month in the journal Contraception.
The group, led by obstetrician-gynecologist Elizabeth Raymond, proposed reducing in-person clinic visits by eliminating ultrasounds and other tests that research shows are unnecessary for a safe, effective pill-induced abortion.
Planned Parenthood Southeastern Pennsylvania, which adopted the test-less approach in mid-March, quickly saw a shift. Although the total number of medication and surgical abortions remained about 800 a month, the proportion that used pills increased from 55% before the pandemic to 65% now.
"We wouldn't be offering it if it weren't safe,"' said Dayle Steinberg, president and CEO of the Southeastern Pennsylvania affiliate. "The pandemic is showing us that we have to be nimble and adapt."
WHEN PRECAUTIONS BECOME DANGERS
Some background: Medication abortion starts with a pill called mifepristone, which blocks a hormone vital to pregnancy. That is followed 24 to 48 hours later by at least two misoprostol pills, which induce contractions. (Misoprostol is also used to treat stomach ulcers.)
In 2000, when the FDA made the controversial decision to approve mifepristone, it imposed stringent safety requirements. The drug can be dispensed only by specially certified health-care providers and only in clinics, hospitals, and medical offices -- not pharmacies like most prescription drugs.