Global Evidence on Medical Abortion Shows How the United States Can Protect Reproductive Rights
As the U.S. Supreme Court debates whether to overturn Roe v. Wade, the next reproductive rights battle is already heating up: access to abortion pills.
Republican-controlled state legislatures backed by the court’s leaked draft opinion, are rushing to pass a series of new laws aimed at criminalizing what would otherwise be a lifeline – the distribution of abortion pills. There is already several states that have proposed or enacted laws banning “pills in the mail”. In Texas, a recent law came into effect that also makes the providing abortion pills after seven weeks of pregnancy is a crime.
The options for women in a post-Roe world will be radically different from those available before 1973, thanks to medicated abortion pills.
It all started in the context of restrictive abortion policies in Latin America in the 1980s, when women in brazil started publicizing a pill invented to treat gastric ulcers that could also be used to terminate a pregnancy. Women who wanted an abortion began converging en masse at their local pharmacies to access the new drug, misoprostol. Today, misoprostol is taken as part of a two-step method to safely end an early pregnancy. The other pill mifepristone, did not become available in the United States until 2000, because, as with so many other advances in abortion care, misinformation has created unfounded concerns about its safety.
Early pioneers in Brazil paved the way for women around the world, helping them access abortion in the comfort, privacy and safety of their homes. In the decades since, medical abortion has proven to be one of the safest and most effective ways to end a pregnancy, accounting for more than half of all abortions in the United States.
It is this data on the successful use of abortion pills along with worldwide medical consensus, including the World Health Organization (WHO) recommendation for the use of abortion pills at home, that has led the Food and Drug Administration (FDA) of the United States. decision to definitively authorize abortion pills in the mail.
Despite the FDA ruling and growing evidence in favor of medical abortion since the 1980s, 19 states will seek to further restrict American women’s access to abortion by introducing legislation to prevent these safe and necessary drugs from being shipped through the mail.
Medical abortion is not new. And during the pandemic, the evidence supporting safe self-management of medical abortion has only grown stronger. With women’s access to reproductive health care affected by lockdowns and travel restrictions, several countries have decided to support telemedicine and home abortion to enable women to continue to access abortion care. This included the UK, which changed its abortion regulations in March 2020 to allow early medical abortion at home via telemedicine.
In Nepal, the government has introduced interim guidelines allowing women to access medical abortion at home. Nepal is a country that knows all too well the tragedy of maternal deaths. Before abortion was legalized in Nepal in 2002, more than half of her maternal deaths were attributable to unsafe abortions – a number that has now plummeted 72 percent thanks to the steps it has taken to expand access to abortion and contraception.
Evidence shows that with the right support and information, self-managed abortion is not only safe, more convenient and affordable for women, but often the preferred form of care when offered. A peer-reviewed study by MSI UK Program revealed that home abortion care was the preferred care choice during the pandemic for 83 percent of its clientele. Additionally, two-thirds said they would choose medical abortion at home again, even if COVID-19 was no longer an issue.
Abortion has come a long way in the four decades since activists in Brazil changed the face of abortion access. The availability of medical abortion drugs has played a central role in the expansion of reproductive rights around the world. We urge U.S. lawmakers to listen to the global evidence on medical abortion and ensure women can access this vital service.
Amanda Seller is President of MSI United States, a Washington, D.C.-based nonprofit organization that supports MSI Reproductive Choices family planning services in 37 countries, providing reproductive health care, including birth control, birth control, and birth control. safe abortion and post-abortion care.