Elections do still have consequences even in the last year of a president's term, and President Obama's Federal Drug Administration is proving it. It has approved a change that makes access to the abortion pill less difficult.
The change was an unequivocal victory for abortion rights advocates who had been fighting laws in Texas, North Dakota and Ohio, among other states, that require doctors prescribing the pill to follow the directions on the F.D.A. label for using it, which had been more stringent.
The change brings the directions for taking the drug, mifepristone, in line with what has become standard medical practice in most states: reducing the dosage to 200 milligrams from 600 milligrams, decreasing the number of visits a woman must make to a doctor to two from three, and extending the period when she can take the pill to 10 weeks of pregnancy from seven weeks.
The debate over the drug, formerly known as RU-486, has raged for decades, with abortion rights groups demanding access to it in the United States in the 1990s. Medication-induced abortions have increasingly been used to terminate pregnancies in recent years, and limiting access to them has become an important front in the anti-abortion movement. They made up as much as a quarter of all abortions in 2011, according to the most recent figures from the Guttmacher Institute, which tracks women’s reproductive health issues. Planned Parenthood said as many as half of eligible women in its clinics requested medication-induced abortions.
The move, guided by three decades of clinical experience in this country with the drug, updates the protocols for it to be in line with how it actually works as a safe alternative to surgical abortions. The abortion fights in the 1980s and the staunch opposition of the George H.W. Bush administration, which went so far as to put it on the "import alert" list of foreign drugs too dangerous or useless to be allowed into the country, stigmatized the drug. While President Clinton lifted the import alert on the drug immediately after coming into office, it wasn't until the last year of his presidency that it finally gained approval by the FDA.
Over the years, doctors have discovered that lower doses worked as well as the dose the FDA approved, with fewer side effects, and that women could safely take the drug further into their pregnancy. Many have been following this better medical protocol, even though the FDA labeling advised otherwise. This is what happens, by the way, with a lot of medicine—many drugs are prescribed "off-label," even used for ailments other than the one a drug is labeled for by the FDA. The drug's manufacturer, Danco Laboratories, requested the label review from the FDA in light of this actual, clinical experience. It's this medical science anti-abortion legislators have been fighting, trying to force the medical community to ignore best practices when it comes to this one procedure.
This change is good news for the medical community, for women, and particularly for Texas.
“This will allow us to do two things immediately: Expand medical abortions up to 10 weeks of pregnancy, and cut out the unnecessary additional visit for the second dose of medication,” said Amy Hagstrom Miller, the president of Whole Woman’s Health, which has abortion facilities in five states including Texas and is the lead plaintiff in an abortion case before the Supreme Court.
Does it mean the long awaited goal of the pro-choice community—the ability of a woman to go to her family doctor and get the abortion pill in complete privacy, without having to run a gauntlet of screaming protestors—is here? The forced birthers are going to do their damnedest to make sure it isn’t, but we’re closer.