Nearly half of adult women across the United States are unsure of the laws regarding medication that will induce abortion in their given states, according to new data from KFF, formerly the Kaiser Family Foundation.
The survey, published Wednesday, concerns access surrounding mifepristone and misoprostol. The two drugs are approved in combination from the Food and Drug Association “to end an intrauterine pregnancy through ten weeks gestation,” defined as 70 days or less after a patient’s last period.
According to KFF, 41% of women between the ages of 18-49 reported they were “unsure” whether medication abortion was legal in their state. An additional 10% of women living in states where abortion procedures are banned falsely believed medication to induce abortions was also illegal where they lived.
The survey also found a general lack of awareness surrounding medication abortion and recent changes to laws surrounding access, with only 39% of respondents reporting they were aware that a prescription is required to get a medication abortion even where abortion is legal.
In early January, the FDA updated its mitigation strategy surrounding mifepristone in order to allow “not only mail-order but also brick-and-mortar pharmacies to dispense mifepristone,” per the ACLU, though it also included requirements that dispensing pharmacies be certified through a Mifepristone Risk Evaluation and Mitigation Strategy Program.
According to KFF, nearly 73% of adults “have not heard anything in the news” regarding the FDA’s changes, including around 77% of women under the age of 50.
Six months after the Supreme Court formally overturned the federal abortion protections afforded by Roe v. Wade, it comes as little surprise that there is persisting confusion over the patchwork of state laws existing across the country.
Access to abortion – both as a procedure and induced by medicine – varies by state. There are 13 states with outright abortion bans, including a ban on mifepristone and misoprostol. Those states are Idaho, South Dakota, Wisconsin, Missouri, Oklahoma, Texas, Louisiana, Mississippi, Alabama, Tennessee, Kentucky, West Virginia and Arkansas.
On top of that, 19 states have separate laws controlling how, when and where physicians can prescribe and dispense abortion drugs.
Soon after the decision was rendered, Attorney General Merrick Garland wrote that states “may not ban Mifepristone based on disagreement with the FDA’s expert judgment about its safety and efficacy.”
Still, some states have taken steps to restrict access to abortion medication, though not banning it outright.
Just last week, supporters of abortion rights filed separate lawsuits challenging two states’ abortion pill restrictions, the opening salvo in what’s expected to be a protracted legal battle over access to the medications.
The lawsuits argue that limits on the drugs in North Carolina and West Virginia run afoul of the federal authority of the U.S. Food and Drug Administration, which has approved the abortion pill as a safe and effective method for ending pregnancy.
The cases were brought by a North Carolina physician who prescribes the pill, mifepristone, and GenBioPro, which makes a generic version of the drug and sued in West Virginia.
While the federal court lawsuits target specific state laws, they represent key legal tests that could eventually determine access to abortion for millions of women. Medication recently overtook in-clinic procedures as the most common form of abortion in the U.S.
The new litigation turns on a longstanding principle that federal law, including FDA decisions, pre-empt state laws. Indeed, few states have ever tried to fully ban an FDA-approved drug because of past rulings in the agency’s favor.
But Wednesday, attorneys general in 20 conservative-led states warned CVS and Walgreens that they could face legal consequences if they sell abortion pills by mail in those states.
A letter from Republican Missouri Attorney General Andrew Bailey to the nation's largest pharmacy-dispensing companies was co-signed by 19 other attorneys general, warning that sale of abortion pills would violate federal law and abortion laws in many states. Missouri is among states that implemented strict abortion prohibitions last summer after the Supreme Court ruling overturning Roe v. Wade.
In an emailed statement to Spectrum News, a spokesperson for Walgreens said the company is not currently dispensing mifepristone, although they are working to become eligible through an FDA-mandated certification process, requiring pharmacies to meet specific standards in shipping, tracking and confidentially storing drug prescribing records.
"We intend to become a certified pharmacy under the program, but we are working through the certification process, necessary training of our pharmacists, as well as evaluating our pharmacy network in terms of where we can dispense Mifepristone consistent with federal and state laws," the statement read in part, adding: "We fully understand that we may not be able to dispense Mifepristone in all locations if we are certified under the program."
Messages left by the Associated Press with CVS were not immediately returned.