Abortion via Pharmacy Is the New Pro-Life Frontier

Published February 3, 2023

National Review

In early January, major pharmacies CVS and Walgreens announced that they will take advantage of a new Biden administration rule granting them permission to distribute the chemical-abortion drug mifepristone, which now accounts for more than half of all abortions in the U.S. A couple of weeks later, rival company Rite Aid announced that it will do the same, dispensing abortion drugs at a limited number of its pharmacies either in person or via mail delivery.

Now, nearly two dozen state attorneys general have written to CVS and Walgreens executives, warning that the new Food and Drug Administration regulation apparently permitting this distribution could bring trouble for pharmacies that follow it, particularly if they use mail delivery.

“Many people are not aware that federal law expressly prohibits using the mail to send or receive any drug that will ‘be used or applied for producing abortion,’” the letter states. “The text could not be clearer: ‘every article or thing designed, adapted, or intended for producing abortion . . . shall not be conveyed in the mails.’ And anyone who ‘knowingly takes any such thing from the mails for the purpose of circulating’ is guilty of a federal crime.”

Earlier this month, Walgreens said it is “working through the registration, necessary training of our pharmacists, as well as evaluating our pharmacy network in terms of where we normally dispense products that have extra FDA requirements and will dispense these consistent with federal and state laws.”

In response to Wednesday’s letter, a Walgreens spokesperson told CNN, “We intend to become a certified pharmacy under the program, however we fully understand that we may not be able to dispense Mifepristone in all locations if we are certified under the program.”

Meanwhile, CVS said it plans “to seek certification to dispense mifepristone where legally permissible.” CVS was one of dozens of major companies to begin covering abortion-related travel expenses for employees who live in states with pro-life laws after Roe v. Wade was overturned. A CVS spokesman said the company had created its plan for such a policy in advance of the Supreme Court decision in Dobbs.

Neither Walgreens nor CVS has yet begun to offer abortion drugs via its pharmacies, nor has either company indicated whether it plans to distribute the drugs via mail in addition to in person. The letter from the attorneys general offers a compelling case as to why doing so would be a violation of federal law and the laws of several states.

This latest development in the battle over chemical-abortion policy has created further concerns for the health and safety of women who obtain these drugs. As Michael New points out on the Corner, significant evidence — including the FDA’s own data — suggests that these drugs can pose serious risks to pregnant mothers:

Indeed, recently updated FDA data provide further evidence of the health risks posed by chemical abortions. Between September 2000 and June 2022, chemical-abortion pills caused 28 deaths among pregnant women. Additionally, during the same period, chemical-abortion pills caused 414 infections, 616 instances of blood loss requiring transfusions, and 1,048 hospitalizations. Overall, in the past 22 years, the FDA has reported over 4,200 adverse events caused by chemical abortions. Given the lax abortion-reporting standards in the United States, this figure is probably higher.

Before the FDA’s latest rule change, women could obtain chemical-abortion drugs only in person from a doctor or, as a result of another recent policy shift, via telemedicine distribution. This latter provision has been a focus of concern for pro-lifers for the past several years, as the health risks to women escalate if the drugs are prescribed without an in-person doctor’s visit.

One major risk of chemical abortions obtained via telemedicine is that a woman could easily misidentify how far along she is or not realize that she has an ectopic pregnancy, both of which could put her in significant danger if she ingests mifepristone. “At-home abortion means that the gestational age is simply the woman’s best guess and the timeline extends as she waits for the pills to arrive by mail. For the one to two percent of pregnancies that are ectopic, telemedicine abortion is going to be both ineffective and dangerous to the mother’s health, a tradeoff that activists seem to have calculated is worth accepting to ensure access to at-home abortion on demand,” a 2021 report from Americans United for Life states.

The World Health Organization has acknowledged “that it is more difficult to diagnose an ectopic pregnancy during and after medical methods of abortion, due to the similarity of symptoms. Additionally, neither mifepristone nor misoprostol are treatments for ectopic pregnancy, which, if present, will continue to grow. Therefore, health-care staff must be particularly alert to clinical signs of ectopic pregnancy.”

But health-care staff can’t be alert to these clinical signs — or even to the gestational age of an unborn child — if the pregnant mother never enters a clinic. These risks are impossible to manage without an in-person medical examination, which the FDA has already eliminated as a requirement.

Now, the Biden administration has taken an even more aggressive step by recruiting pharmaceutical companies to dispense chemical-abortion drugs and assuring them that they can ignore relevant federal law. The battle over this policy change isn’t over, as state officials will oppose this expansion, courts might well strike it down, and future administrations can roll it back entirely. But for now, the damage has been done — and once again, it will be American women and their unborn children who pay the price.

EPPC Fellow Alexandra DeSanctis writes on culture and family issues, with a particular focus on abortion policy and pro-life advocacy, as a member of the Life and Family Initiative.

EPPC Fellow Alexandra DeSanctis writes on culture and family issues, with a particular focus on abortion policy and pro-life advocacy, as a member of the Life and Family Initiative.

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