3 states strike deals to stock up on abortion pill

The Affordable Affordable Medical Abbirth Act (ACA) – The Case against a Single Judge in the U.S. House of Representatives

— The idea that a single judge in a conservative state could potentially change the health care options of millions of Americans sets up an extraordinary constitutional situation. It also flies in the face of the reasoning advanced by the conservative majority Supreme Court and anti-abortion rights advocates – that the procedure’s availability should be determined by legislatures in individual states.

There was fiery rhetoric between the Republicans and Democrats on Sunday. Health and Human Services Secretary Xavier Becerra vowed that women would have safe and effective medication available after the administration launched a legal appeal to stop the suspension from going into force on Friday.

But Texas Republican Rep. Tony Gonzales told CNN’s Bash that his party could use its House majority to punish the FDA if the agency took such a step. “If the administration wants to … not live up to this ruling, then we’re going to have a problem,” he said. “It may come (to) a point where House Republicans on the appropriation side have to defund FDA programs that don’t make sense.”

It is feared that such a move could severely impede a critical arm of the American health care system and deepen acrimination surrounding the regulatory approval process that was attacked by conservatives.

“It’s important that we have real discussions on women’s health care and … get off the abortion conversation,” Gonzales told Bash. “Women have a whole lot more other issues than just abortion. Let’s talk about the things happening in this world and have those real conversations.

In a statement, President Joe Biden called the decision “another unprecedented step in taking away basic freedoms from women and putting their health at risk,” saying his administration would continue to fight it in court. He also called on voters to elect lawmakers who would pass explicit protection for abortion access, calling it “the only way” to stop future decisions along the same lines.

The Food and Drug Administration didn’t properly approve a drug for medical abortions, which was ruled on Friday by a federal judge in Texas. The drug in question, mifepristone, is found in most medication abortions in the U.S.

Neither the two-drug regime, nor misoprostol-alone medication abortions are available legally in these states. It’s legal to use mmoprostol if you want to treat ulcers or inducing labor.

The case is also notable for relying on the Comstock Act, a 150-year-old obscenity law that, among other things, bans the shipping of materials related to abortion. The opinion approvingly interprets its ban on any “article, instrument, substance, drug, medicine, or thing which is advertised or described in a manner calculated to lead another to use it or apply it for producing abortion” as a ban on mailing mifepristone even for legal abortions. The statute does not require intent from the seller that the drugs should be used illegally, wrote Kacsmaryk. It’s the latest sign that long-dormant obscenity rules are being resurrected following an unsuccessful attempt to ban books in Virginia using a mostly forgotten state statute.

The ruling could have an effect on other areas, but it is dependent on the fifth circuit court of appeals reversing the stay. (The Fifth Circuit is notably the one that allowed a ban on internet moderation to stand in 2022.) In February, members of the nonprofit Women’s Law Project argued that the FDA had substantial power to limit the ruling’s effects even if it were allowed to stand. Its response may determine whether manufacturers and sellers of the drug maintain patients’ access to the pill in the face of legal uncertainty.

Dr. Jamie Phifer, the medical director of Abortion on Demand, says her team is waiting to see how the courts ultimately rule on mifepristone. Unless it becomes illegal, they will continue to provide abortion pills to their patients.

Also, if a patient does not experience any bleeding or cramping, the medication may not have worked to end the pregnancy, and she might need more misoprostol or a procedure to have a complete abortion.

Even though the two-drug protocol is still preferred when possible, there’s ample evidence that misoprostol alone is a very effective alternative, according to the Society of Family Planning, an abortion research organization.

Patients who experience heavy or long term bleeding such as spotting that persists for over 2 weeks, or bleeding so heavy they soak through more than two pads an hour for over two hours might need a procedure to complete their abortion.

Ordering misoprostol at home: How the Newsom office secures a prescription drug stockpile of up to 2 million pills of mifepristone

A long-term high temperature is another reason to seek medical care. If a fever persists for more than a day after taking misoprostol, it’s a sign of an underlying health problem.

The World Health Organization approves the two-drug regimen used to end pregnancies up to 12 weeks. They’re more likely to be less effective after that.

Mayday is an instance of it. Health offers step-by-step instructions for setting up a mail-forwarding address, so patients can list an address in a permissive state on their intake forms for a telehealth abortion, then get the pills sent along to an additional address somewhere else. Plan C is a website that provides up-to-date information about how to get abortion pills at home.

Gov. Gavin Newsom’s office says it’s made plans to secure an emergency stockpile of up to 2 million pills of misoprostol, a drug used in combination with another pill that is now the subject of legal battles in federal courts. Officials say the state currently has more than 250,000 of the pills already on hand, which were purchased for about $100,000.

Massachusetts has 15,000 pills or more of a year’s worth, according to the governor. Last week, Washington Gov. Jay Inslee announced his state had prepared a stockpile of about three years’ worth of mifepristone.

Newsom’s office says the pills were secured through the state’s CalRx prescription drug program, and California is providing information about its purchase agreement to other states that may be interested in taking similar action.

If a pharmacy faces a shortage, they will be directed to the state website where they can request pills from the supply.

The Case against Mifeprex: A U.S. Senator’s Benchmark on the Access to a High-Pt Drug Abuse Prescription Drug

The name-brand drug Mifeprex was first approved by the Food and Drug Administration more than 20 years ago. Since then, it has been used millions of times, and major medical groups say it has a strong safety record. A generic version was approved in 2019.

The Biden administration has appealed the Texas decision, and a federal appeals court is likely to weigh in this week. The Supreme Court is likely to resolve the conflicts.

“Everyone’s eyes are now pointed back towards D.C.,” said Katie Glenn Daniel, the state policy director at Susan B. Anthony Pro-Life America. “We anticipate that eventually, whether it is the merits of this case or these injunctions — now dueling injunctions — that the Supreme Court will have to weigh in in some way.”

The Texas lawsuit, filed by a coalition of abortion rights opponents, raised questions about the process by which the FDA originally approved the drug in 2000.

Meanwhile, there’s a competing ruling out of Washington state, where the attorneys general of 17 states and the District of Columbia had sought to force the FDA to expand access to the drug.

The judge in that case was appointed by the Obama administration. But he did rule Friday that the agency cannot alter access to the drug while the lawsuit proceeds. If the Texas injunction goes into effect, that decision could offer some relief, though it would be limited to 17 state and the District of Columbia.

Providing Mifepristone to Reproductive Health Care Patients in the U.S. After Rice’s Decision, Attorney General Bob Ferguson, NPR

The states with those are Arizona, Colorado, Connecticut, Delaware, Hawaii, Illinois, Maine, Maryland, Michigan, Minnesota, Nevada, New Mexico, Oregon, Pennsylvania, Rhode Island, Vermont and Washington.

For residents of those states, Rice’s decision “preserves the status quo on ensuring that access to mifepristone remains available,” said Washington Attorney General Bob Ferguson to NPR on Friday.

“For example, if medication is already in pharmacy and has already been prescribed, can those prescriptions be filled?” said David Donatti, an attorney at the ACLU of Texas. The lowest court order doesn’t answer these questions.

The appeals court’s decision is likely to come before Friday, April 14. Even if it is decided in a particular way, the decision will most likely be appealed to the Supreme Court.

We hope the Supreme Court resolves this issue once and for all. The attorney with Human Coalition, an anti-abortion-rights group, said that it had been decades in the making.

Clinics that provide reproductive health care across the United States are bracing for more restrictions after the Supreme Court ended legal protection for abortions nationwide.

“It’s going to be working closely with legal advisers in a really rapidly changing environment. “I expect that to be the case in the next seven days and likely beyond that,” saidMelissa Grant, the chief operating officer at Carafem, an abortion provider that provides Mifepristone at its three physical clinics.

Patients at the Northeast Ohio Women’s Center who had planned to have medication abortions next week are being told to change their minds.

The drug helps soften and open the cervix, the neck of the uterus, and doctors depend on it to help when women are having a miscarriage and when a pregnancy needs to be terminated quickly if the life of the mother is at stake.

What doctors can do about misoprostol-only pregnancy care? Dr. Alison Edelman on the need to have someone not be pregnant

In certain situations, when a pregnancy has become too risky, time is of the essence, says Dr. Alison Edelman, who directs the division of Complex Family Planning at Oregon Health and Sciences University.

She said that the better thing to do is to have someone not be pregnant and they can speed that process up.

Doctors say they still have other ways to treat those problems, but when considering the needs of individual patients, they will be missing a valuable tool.

“We have our gold standard of what we provide – the safest, most effective regimen – and then if it’s not available, we use the next best one. And that is what we would have left with.

Carafem, which provides telehealth abortion care, has been using a misoprostol-only regimen since the Covid-19 pandemic began, Chief Operating Officer Melissa Grant says.

The American Congress of Obstetricians and Gynecologists said Monday that clinicians would need to use other options, rather than choose based on their own expertise. I don’t want to do that as a clinician.