When the Food and Drug Administration approved the first abortion pill in the United States 15 years ago this September, the politics of the decision were so fraught that the agency wouldn’t even name the officials behind its decision. The pharmaceutical company making the drug—a pill called mifeprex—took pains to hide its address.
September 28 marks 15 years since the FDA approved mifepristone. And today, those fears seem misplaced. Since 2000, more than 2 million women have used the drug to have an abortion in the first nine weeks of pregnancy. Twenty-three percent of women who have an abortion today get a so-called medical abortion—most of them, using mifeprex. The drug has radically reshaped abortion availability for rural women, and Danco, the drugmaker, is out in the open.
Violent anti-abortion vigilantes, in other words, are no longer standing between women and mifepristone. Instead, as with so many facets of abortion in modern America, abortion foes are going after the abortion pill with restrictive new laws. It is easy to see why abortion foes are gunning for telemedicine. When polled, patients say they appreciate the privacy afforded by the pill. (Mifepristone is part of a two-drug regimen, and the second course can be taken at home.) It is also less expensive than a surgical abortion. Linda Greenhouse, a legal contributor to the New York Times, called it “the ultimate in women’s reproductive empowerment and personal privacy.” But the 2 million figure belies a sustained, and in many cases, successful campaign by conservative lawmakers and activists to put mifepristone out of reach. A decade and a half after mifepristone came on the market, abortion foes are blocking its progress with a vengeance.
The attacks on mifepristone come in two varieties: those that ban telemedicine, and those that force women taking the abortion pill to spend more travel time and money.
Telemedicine is what has allowed mifepristone to be part of a sweeping change in abortion access for thousands of rural women. Ground zero is in Iowa, at Planned Parenthood of the Heartland: Several times a week, Jill Meadows, a Planned Parenthood physician, appears via video conference to patients in seven other Planned Parenthood clinics across the state. A nurse seats a woman in a room with a computer monitor. Meadows and the patient talk via video feed. The patient takes the mifepristone with Meadows watching. Then, with a remote control, Meadows opens a drawer next to the woman containing pills that will cause the uterus to expel the pregnancy. The woman takes those pills at home; essentially, she has the abortion at home.
“It’s not much different at all whether I’m in the clinic,” Meadows recently told Mother Jones. “It’s the same exact process,” albeit one that saves many women hours of driving.