FDA to permanently allow abortion pills by mail, a major win for advocates

The Food and Drug Administration said Thursday that it will permanently allow patients to receive abortion pills by mail, expanding access to abortion as the Supreme Court wrestles with the future of Roe v. Wade.

The new rule could help some women circumvent restrictions on abortion in states like Texas, where patients must pick up the medication in person and can’t acquire it through telehealth appointments.

During the coronavirus pandemic, the FDA temporarily eased restrictions on mifepristone — which, taken with another medication called misoprostol, ends early pregnancies — so patients could temporarily order the pills by mail.

The expansion of telehealth services during the coronavirus pandemic spurred greater access to the regimen, which the FDA approved in 2016 to terminate pregnancies up to 70 days' gestation.

The FDA is expanding access as the Supreme Court scrutinizes access to abortions and as several GOP-led states have taken steps to ban access to abortion medication through telehealth services.

The Biden administration said in May that it would review requirements for mifepristone. Last year, a group of doctors and advocates, led by the American College of Obstetricians and Gynecologists, challenged the previous FDA restrictions on receiving abortion pills by mail.

The FDA temporarily lifted the restrictions on mifepristone in July 2020 in response to a court order that was later reversed by the Supreme Court. The FDA again temporarily rolled back the restrictions on mifepristone in April.

The FDA has said that the regimen is largely safe and that it's the most common method for ending pregnancies in the first 10 weeks. The likelihood of complications is less than 1 percent, according to the American College of Obstetricians and Gynecologists.

Nearly 4 million patients have taken the drug regimen since 2000, according to the FDA, which says only 26 deaths linked to mifepristone had been reported as of June 30. The agency cautioned, however, that the deaths couldn't be causally linked to the drug with certainty because of the patients' use of other drugs, their receipt of medical or surgical treatments, their co-existing medical conditions or gaps in information about their health status.

The Supreme Court ruled this month that abortion providers in Texas can move forward with their lawsuit challenging a near-total abortion ban in the state. But it kept the law in effect while the legal fight plays out.

Texas also passed a law this year that would further tighten restrictions on the pill, narrowing the window for its use from up to the 10th week of pregnancy to the seventh and prohibiting it from being mailed.