On behalf of medical associations that favor unlimited legal abortion, the American Civil Liberties Union has sued the Food and Drug Administration to remove safety requirements for chemical-abortion drugs.
Current FDA Risk Evaluation and Mitigation Strategy (REMS) requirements for mifepristone — the drug used in the first few months of pregnancy to induce abortion — stipulate that pregnant women must be handed the pill at a clinic, office, or hospital, under the supervision of a health-care professional. Contrary to Roll Call reporting on the new lawsuit, there is no requirement that women remain at the health center when ingesting the drug.
The lawsuit aims to erase this safety regulation so that doctors or pharmacies can mail the abortion drug directly to women during the pandemic and argues that picking up the drug in person is a health risk. The plaintiffs insist that the COVID-19 outbreak is the reason for the suit, but in reality they are using the pandemic as cover to push for a policy they already wanted.
It is difficult to imagine that such a policy, if enacted, actually would be reversed when the COVID-19 outbreak dissipates. It is far easier to imagine that, if the policy were enacted and later reversed, the ACLU would then sue the government a second time. In fact, the ACLU already has a separate lawsuit pending against the Health and Human Services Department pushing to remove the safety regulations entirely.
In late March, a coalition of nearly two dozen Democratic attorneys general wrote to the FDA over the safety restrictions, insisting that they are medically unnecessary and harmful to women during the pandemic. The letter asserted, with no substantiation, that chemical-abortion drugs are “fourteen times safer than carrying a pregnancy to term.”
In fact, mifepristone carries a sizable risk of serious side effects and complications, some of which necessitate immediate follow-up care. Somewhere between 5 percent and 7 percent of women who obtain a chemical abortion will require a surgical abortion. According to one study, more than 3 percent of women who underwent a medical abortion in the first trimester required emergency-room admission to manage complications.
The safety regulations, then, are not without reason, and are actually quite lax considering the potential risks involved in at-home abortion. Far from becoming less necessary during a pandemic, those safety concerns are of critical importance when health-care resources are already stretched thin. As the ACLU points out in its own press release, it makes little sense to require in-person pickup for a drug that can be ingested at home alone later. The better response to that discrepancy is not to remove the safety requirements entirely; it is to end the practice of at-home chemical abortions.