Medication Abortion: A 20-year Anniversary and an Opportunity

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Medication abortion care is a safe and effective method of abortion care that has been studied extensively since it was approved by the FDA 20 years ago this month.

Still, many Americans are unfamiliar with medication abortion care -- what it is, how it can increase access to care during a pandemic and beyond, and the state and federal level policy barriers that stand in the way.

To assist state legislators' work in this area SiX Reproductive Rights teamed up with Dr. Ushma Upadhyay, an expert in medication abortion care from the University of California San Francisco, and Innovating Education in Reproductive Health to make this short instructive video.

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Click here to read video transcript.

Some topline takeaways to keep in mind:

Medication abortion care is an FDA-approved option for ending an early pregnancy.
Medication abortion care has been shown to be safe and effective over the last 20 years with a more than 99% safety rate.
Despite its 20-year safety record, FDA restrictions (called REMS) still limit the number of providers that can stock and dispense the medication used in medication abortion care, reducing the options for patients to access it.
Unnecessary state level restrictions on the use of telemedicine for medication abortion care — which have been passed in 18 states — add to the burden by requiring people to travel for an in-person visit, even though it is just as safe and effective to consult with a provider over video or phone.
- In July a Federal Court blocked the enforcement of the FDA restriction that requires people to pick up the medication in-person from their provider for the duration of the COVID public health emergency.
- The Trump administration has appealed to the Supreme Court to re-instate that requirement.
Restrictions on medication abortion care, and abortion care in general, fall hardest on those who have low incomes, live in rural areas, are women of color, undocumented, or are young.
It doesn’t have to be this hard to get medication abortion care. Pregnant people should be able to have medication abortion prescribed by their health care provider and receive their medications in the way that makes the most sense for them, whether that is having it delivered to their home or picking up at a local pharmacy or at a health center.

Medication abortion care has been researched extensively.

This list contains a selection of issue briefs and fact sheets summarizing the research and the state-level policy implications:

Abortion is Safe in All Forms (fact sheet highlighting the findings of the National Academies of Science, Engineering, and Medicine report on quality of abortion care in the United States)
The Safety of Medication Abortion Care (The EMAA Project)
Expanding Telemedicine Can Ensure Abortion Access During COVID-19 Pandemic (Center for Reproductive Rights and Columbia University Mailman School of Public Health)
Medication Abortion: State Laws and Policies (Guttmacher Institute)

For additional resources, messaging guidance, or to be connected with a research expert on reproductive health topics, please reach out to fran@stateinnovation.org.

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SiX Repro Book Club: Michele Goodwin's Policing the Womb

Policing the Womb brings to life the chilling ways in which women have become the targets of secretive state surveillance of their pregnancies. Dr. Michele Goodwin expands the reproductive health and rights debate beyond abortion to include how legislators increasingly turn to criminalizing women for miscarriages, stillbirths, and threatening the health of their pregnancies.

Legislators can protect workers’ rights by partnering with AGs

The fight for worker’s rights rages on through the pandemic. Everyone deserves a safe workplace, yet the average American worker currently finds themselves in a troubling situation: risk their health or go to work. Millions of Americans are relying on elected officials to enact policies that will protect their rights and ensure their safety. Fortunately, workers are not the only ones calling for strong reforms such as paid sick leave, recovering stolen wages, and fighting misclassification of workers, amongst many others.

A new EPI report documents the dramatic increase in the involvement of state attorneys general (AGs) in protecting workers’ rights in the past two years. The report recommends that state legislatures grant attorney general offices jurisdiction to enforce workplace rights laws. It also urges state AGs to expand their involvement in this area using a range of their existing powers and authority.

“Many workers held precarious jobs and experienced high rates of wage theft and retaliation... In response to the dire challenges facing workers today, a number of state AGs have emerged as leaders in enforcing and protecting workers’ rights,” said Terri Gerstein, director of the State and Local Enforcement Project at the Harvard Labor and Worklife Program, and a senior fellow at EPI.

Unfortunately, several states have already taken steps to grant business liability protections from workers’ lawsuits during the COVID-19 crisis. These liability laws have dire consequences such as unsafe conditions for both workers and daily consumers.

The State Innovation Exchange commissioned a recent poll surveying Americans in ten states and it revealed that voters strongly support policies that would provide immediate pocketbook relief for families and workers. Even more, results show that a majority of voters side with workplace safety requirements over liability protections for corporations (55% to 26%).

There are a number of common sense measures state and local officials should be considering to put worker and public health front and center. To see what else you can do to help keep workers safe, visit SiX’s Coronavirus Response Resources page.

For more on the Economic Policy Institute, see their report and press release.

Defending Against Harmful Policies

State legislatures are on the frontlines of the coronavirus pandemic, trying to do their best to protect and provide vital social services to their constituents. While some states are passing inclusive policies to stabilize our local economies, others are using the pandemic as an opportunity to pass harmful policies that will have devastating impacts on our communities. Additionally, some policies are intended to support struggling families but are having unintended consequences.

Resources:

Stay at home orders are putting sexual assault survivors at risk.
- A Double Pandemic: Domestic Violence in the Age of COVID-19: Around the globe, governments have implored residents to stay home to protect themselves and others from the new coronavirus disease, COVID-19. But for domestic violence victims—the vast majority of whom are women, children, and LGBTQ+ individuals—home is a dangerous place.
- COVID-19 Resources for Communities: A brief summary of what the American Bar Association has learned from victims’ attorneys across the country during the ongoing,
- Domestic Violence Is on the Rise With Coronavirus Lockdown. The Responses Are Missing the Point.
- The international response to violence against women and girls during COVID-10: Five ways governments are responding to violence against women and children during COVID-19
- Futures Without Violence: Information and resources for survivors

A growing group of anti-maskers are trying to avoid it by misusing disability laws.
- With the spread of the coronavirus, many states and localities require wearing masks to protect communities from the virus, as a result, some are attempting to misuse the Americans with Disability Act (ADA).
- Flyers urging anti-maskers to specifically rely on the right to not disclose a disability as the response for denial of access to public spaces have gained traction across the U.S.
- The ADA has a clause that says disabilities must be accommodated except when there is "a significant risk to the health or safety of others." The refusal to wear a mask endangers the very communities protected by the ADA.
- Actions that aim to contort the purpose of the ADA actively harm people living with disabilities. Messaging and proactive measures from state legislators about the importance of social distancing and the importance of wearing a mask is critical to stopping the abuse of the ADA.