Demand for abortion pills rises after ruling

Following the US Supreme Court's overturning of the constitutional right to an abortion, demand for pills to terminate a pregnancy has risen, according to a pill advocacy group.

Elisa Wells, co-founder of Plan C, told China Daily: "We have heard from abortion pill providers that they have seen an increase in requests, especially for getting pills now to have on hand just in case. We saw traffic [on our website] surge to 209,000 visitors on the day of the SCOTUS (Supreme Court of the United States) decision, up from 3,400 the day before."

The court's ruling on June 24 immediately created uncertainty about how women could get access to terminations, particularly in states where "trigger laws'' took immediate effect after the court's ruling, including Alabama, Kentucky, Missouri, South Dakota and Utah.

Medication abortion, also known as plan C, is an abortion done with pills that a woman can take without the help of a doctor. However, approximately 19 states have laws that require a medical clinician to be present as the medication is taken.

To make the pills work, two drugs are needed. Mifepristone is the first one; it works by blocking the hormone, progesterone, needed for a successful pregnancy. The second pill, misoprostol, is taken one to two days later and empties the uterus. Misoprostol alone can be used if mifepristone isn't available.

Last year, the Food and Drug Administration (FDA) removed the long-standing requirement that a woman must obtain mifepristone in person.

In the US, abortion pills are widely available with a prescription from a doctor or from an online pharmacy. They are safe and effective, studies show. Under federal law, the pills can then be delivered directly to where a person lives.

The pills in the US, approved by the FDA for 20 years, work to terminate a pregnancy of up to 10 weeks. They also work beyond the 10-week mark, according to the American College of Obstetricians and Gynecologists.

The pills are 95 to 98 percent effective in the first 10 weeks of pregnancy. They cost from $40 to $750, according to Planned Parenthood. But their effectiveness diminishes with gestation time.

Women who want to terminate an abortion later in their term can take the pills alongside their doctor.

In 2020, at least 54 percent of all abortions were done with pills, not surgery, according to the Guttmacher Institute, a research organization. Approximately 90 percent of abortions take place in the 13 weeks after a woman gets pregnant.

Plan C offers an online US map showing which states have telehealth abortions. It says that women in states with restrictive abortion laws are getting access to pills in a variety of ways, including buying from other states and getting it delivered, picking it up from other states and mail forwarding.

Wells added: "It is essential that people know that they can still access medication abortion pills by mail in all states."

Some women have been choosing to get the pills from abroad without a prescription. Aid Access, an international telemedicine abortion provider founded by Dutch physician Dr Rebecca Gomperts, said it will continue to mail pills to women in all US states.

Several Republican states including South Dakota, Texas, Kentucky, Arkansas, Ohio, Tennessee and Oklahoma want to restrict access to abortion pills further.

South Dakota's Republican Governor Kristi Noem announced last week that starting July 1 her state plans to ban telemedicine appointments with abortion providers who prescribe pills online. Anyone who prescribes medication for an abortion without a license from the South Dakota Board of Medical and Osteopathic Examiners could be charged with a felony.

Noem said that doctors, not their patients, would be the ones who would face prosecution for violations.

"I don't believe women should ever be prosecuted. I don't believe there should be any punishment for women, ever, that are in a crisis situation or have an unplanned pregnancy," she said.

Tennessee Republican Governor Bill Lee signed a bill that makes getting mail-order abortion pills a criminal offense. Louisiana will ban them staring Aug 1.

It isn't known how a state could stop abortion pills bought online from being delivered. President Joe Biden has pledged that he would work to ensure women have access to medication abortions nationwide.

Attorney General Merrick Garland has said that the Justice Department strives to protect access to abortion pills.

"The FDA has approved the use of the medication mifepristone. States may not ban mifepristone based on disagreement with the FDA's expert judgment about its safety and efficacy," Garland said.

The US Department of Health and Human Services (HHS) said that it plans to increase access to medication abortion.

"Working to increase access to this drug is a national imperative and in the public interest," HHS Secretary Xavier Becerra said at a press conference on Tuesday.