Laws and regulations on mifepristone are rapidly changing across the United States since the District Court for the Northern District of Texas ordered the Food and Drug Administration in April to revoke its approval of mifepristone, one of two pills used in medication abortions, in Alliance for Hippocratic Medicine v. US FDA. As a result, some information here may be out of date. Our team is working diligently to update this resource. Thank you for your patience.
Medication abortion has been available in the United States since 2000, when the US Food and Drug Administration (FDA) approved the use of mifepristone for early abortion. Unlike procedural abortion, medication abortion does not have to be done in a clinical setting; the pills—mifepristone, followed by misoprostol—can be taken in one’s own home. Decades of studies have shown that medication abortion is safe and effective. By 2020, medication abortion accounted for more than half of all abortions obtained in the United States, up from 39% in 2017.
In the wake of Dobbs v. Jackson Women’s Health Organization, the US Supreme Court decision in June 2022 that overturned the federal constitutional right to abortion, states across the country have banned the procedure. Near-total or early gestational age bans in those states have restricted both procedural and medication abortion.
In January 2023, the FDA lifted restrictions that prevented patients from obtaining medication abortion pills from a retail pharmacy. Pharmacies must complete a certification form from the manufacturer to dispense the pills. Individuals cannot obtain the medication at a pharmacy in states that have a near-total abortion ban.
Many of the states that allow abortion have imposed unnecessary restrictions on medication abortion that only serve to increase barriers to care; almost half of those states limit its provision solely to physicians. This policy contradicts findings from the World Health Organization and other health and medical organizations that advanced practice clinicians, such as physician assistants and advanced practice nurses, can safely provide medication abortion. Currently, medication abortion is approved by the FDA for use up to 10 weeks of gestational age and it is used safely off-label at later gestations.
Some states require a physician to be in the same room as the patient when administering the medications, effectively prohibiting telemedicine provision of medication abortion despite clinical evidence that this practice is appropriate and safe. Other ways to limit access to medication abortion are requiring that the provider observe the patient taking the first dose and prohibiting a provider from mailing the medications to a patient. Allowing use of telehealth would expand access to medication abortion, particularly for patients in rural areas and in areas with few abortion providers.