Abortion providers, clinics and telehealth providers all over the United States are facing uncertainty over how to continue offering medication abortions after federal appeals court announced new restrictions on the drug, mifepristone. This is the second time in a week the legal landscape has changed around medication abortion. Providers must now find legal loopholes to dispense the drug. Some providers are looking into moving to a one-drug regimen that uses misoprostol, another medication that is not facing legal challenge, but is considered slightly less effective. Meanwhile, other doctors are facing having to stop dispensing mifepristone entirely.

The restrictions have been called an enormous blow for women, particularly those who live far from abortion clinics. Restrictions could also lead to people having to travel long distances for care and stay for days. This is likely to impact vulnerable rural populations most severely, according to Kirsten Moore, the director of the Expanding Medication Abortion Access Project.

The ruling by the federal appeals court narrows a Texas judge’s decision to block the Food and Drug Administration’s (FDA) approval of mifepristone. The drug is used to block the hormone progesterone and also to treat miscarriages. Millions of women worldwide have used the drug, and the rate of complications from its use is lower than for routine medical procedures, such as wisdom tooth removals or colonoscopies. Providers worry that the restrictions imposed by the courts could affect thousands of people if they come into effect on Saturday.

Telehealth providers, who have more than doubled their services since Roe v. Wade was overturned in 2021, with virtual clinic telehealth providers responsible for 11% of all abortions, are facing challenges. Six states have at least one restriction in place for at least one trip to a clinic. Telehealth remains a crucial aspect of accessibility for abortion providers, but the time to get an in-person appointment is often 20-30 days, which telehealth providers can help to fill. Aid Access, an order-by-mail abortion provider based in Europe, won’t allow a U.S. court order to stop it from prescribing medication by telehealth.

The ruling has made it incredibly inconvenient for providers, as patients are required to make three in-person visits and pay more for a higher dosage of the medication. Jessie Hill, who represents independent clinics in Ohio, said that the state’s laws require doctors to follow federal label guidelines when prescribing mifepristone. Planned Parenthood in Fairview Heights, Illinois, is not affected by the new court order as prescribing off-label is allowed in the state. This gives providers the ability to prescribe a drug not given government approval, so long as the provider deems it safe. David Cohen, a law professor at Drexel University in Philadelphia, has stated that many providers can still prescribe mifepristone off-label in states where it is not explicitly prohibited.

In conclusion, providers of medication abortions are scrambling to ensure access for patients, even as the legal landscape shifts rapidly. The new restrictions on mifepristone threaten to create barriers and make it more difficult and expensive for people to access abortion care across the United States.

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By Sarah Johnson

Sarah Johnson is a renowned investigative journalist with over two decades of experience. She has won several awards for her in-depth reporting on social justice issues, government corruption, and environmental concerns. Sarah's fearless approach to journalism has earned her a reputation as one of the most respected journalists in the industry.

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