I woke up the morning after the election dizzy with joy. Sadly, I was pushed off cloud 9 by a New York Times op ed looking at court challenges to the latest slew of abortion restrictions. This piece was a stark reminder that even with recent gains and electoral wins, there is a concentrated effort to limit women’s access to a full range of reproductive health services, including medical abortion.
Medical abortion consists of the administration of mifepristone and misoprostol to terminate a pregnancy and induce contractions. It is a non-surgical option for a woman to safely and effectively end her pregnancy. It is non-invasive, more private than surgical abortion, and carries no risk of uterine perforation (a hole in the wall of the uterus).
Some politicians don’t want abortion to be legal in America. Since they haven’t been able to ban it outright, instead they try to pass bills that make abortion harder to get or that threaten providers. This includes unnecessary requirements around administration of the medications and a bill prohibiting providers from receiving grants to develop health information technology systems, and banning the off-label use of mifepristone.
Ohio lawmakers passed legislation that would shorten the window of time that medical abortion is available to women and require them to use an outdated FDA regimen that uses a higher dose than the current practice standard that has been used safely and effectively for more than a decade. It is being challenged in the courts, but this bill is just part of a push to decrease access through onerous regulations created to make it more difficult to access care.
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The fact is that research and real world experience has shown that alternatives to the Food & Drug Administration (FDA) approved regimen for mifepristone are in many cases preferable to the regimen approved twelve years ago. Evidence-based regimens or “off-label” use of medication is standard medical practice.
The FDA has not attempted to regulate off-label drug administration and has disclaimed any interest in regulating physicians’ prescribing practices. So why are legislators threatening providers with criminal and civil penalties simply for providing care using the most current, scientific information?
This is not just about abortion. It’s about the practice of medicine and the rights of our patients to receive the highest standard of care based on the latest research. It’s about doctor and patient privacy and trust in identifying the best option for their unique circumstances. And it is about the authority of doctors to practice medicine without being threatened by politicians without medical training who are simply looking to advance their agenda.
Eliminating options or trying to scare away providers just to make it impossible for a woman to have an abortion is not only unconscionable, it truly is bad medicine.