GOP attacks on medication abortion will just delay care

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Republicans are attacking the safest way to get an abortion during the pandemic.

During the COVID-19 crisis, conservative states have worked hard to suppress the right to abortion. Now, the Trump administration is joining them in attacking medication abortion and, if it succeeds, it could mean women are forced into having abortions later than they wanted.

In late May, the American Civil Liberties Union sued the Food and Drug Administration on behalf of the American College of Obstetricians and Gynecologists. The lawsuit sought to suspend, for the duration of the pandemic only, the FDA rule that requires patients to pick up mifepristone, one of the drugs used for a medication abortion, in person.

Medication abortion is a very safe procedure. Additionally, administering it requires very little personal protective equipment for doctors, unlike many other medical procedures. Several conservative states cited the need to preserve PPE as the rationale behind their COVID-era abortion bans. 

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The ACLU argued that requiring patients to pick up the pills in person after they've already consulted with a clinician, either in-person or via telehealth, exposes people to unnecessary additional risk. If that rule was to be suspended, medication could be mailed directly to the patient — a much safer alternative during the pandemic. 

In July, a federal court agreed with ACOG and the ACLU, holding that the in-person pickup requirement was a "substantial obstacle" for people seeking abortion care and was probably unconstitutional given the danger of the coronavirus pandemic. 

The Trump administration immediately appealed, continuing to argue that patients can only safely use medication for abortion  by swallowing it in a clinic setting. The administration also argued there's no evidence patients haven't been able to obtain a medication abortion or needed to have an abortion later in pregnancy because of pandemic-related delays. 

While that specific evidence may not have been provided in this case, there is ample anecdotal evidence people were forced to cancel appointments in states where abortion was restricted and travel to those where it was not, which likely created delays. 

The Guttmacher Institute, which tracks abortion restrictions, has said that it is too soon to fully understand the impact of these bans but that the cost of additional travel was likely to have posed a barrier to care.

Similarly, it isn't yet possible to understand how many people might forego a medication abortion during the pandemic because they are worried about making multiple trips to a clinic. 

This is yet another attempt by the GOP, along with anti-abortion activists, to block a highly safe abortion procedure that is available early in pregnancy. These GOP attacks on medication abortion may force people to have them later in pregnancy. Even worse, the requirement of multiple clinic visits during a pandemic may deter people from even seeking an abortion in the first place.

One study found that the "overwhelming majority" of people who had later abortions in their second trimester would have preferred to have the procedure earlier, but delays made that impossible. Limiting access to a highly safe abortion procedure is just another way to create that delay, exploit confusion, and work to put abortion out of reach.

Published with permission of The American Independent Foundation.