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Lawmakers should follow science on abortion drug

Protesters who favor a woman’s right to choose rally outside the U.S. Supreme Court last month as justices heard a case involving a Texas law that regulates abortion clinics.
Protesters who favor a woman’s right to choose rally outside the U.S. Supreme Court last month as justices heard a case involving a Texas law that regulates abortion clinics. The Associated Press

Last week, the Food and Drug Administration updated its 16-year-old guidelines for mifepristone, the drug used in medication abortions, to reflect the latest scientific evidence and reduce potential side effects.

Medication abortions make up about a quarter of all abortions, and in most states, the new guidelines will have little impact on doctors. They already follow the best science by using the pill off-label – a common and legal practice, given that science often advances faster than the FDA.

However, six anti-abortion Republican legislatures, including those in Ohio and Texas, have prohibited off-label use of mifepristone. The new FDA guidelines will bring immediate relief to women seeking abortions in these states, though lawmakers will no doubt find new and creative ways to restrict abortion. One state, Arizona, has already passed legislation, now awaiting the governor’s signature, to require doctors to follow the FDA guidelines from 2000.

This issue underscores the willingness of anti-abortion legislators to force doctors to use outdated, harmful and unscientific methods. They may influence the U.S. Supreme Court, which is considering a challenge to abortion restrictions in Texas. Legislators claim that those restrictions protect women’s health, but they are actually a blatant attempt to violate women’s constitutional rights. Recently, Justice Anthony Kennedy, the court’s swing voter on abortion, expressed concern about women’s access to medication abortions in Texas.

The new guidelines suggest that medication abortions be provided through the ninth week of pregnancy rather than the seventh week, in two office visits rather than three and at lower dosages to reduce side effects. They also suggest that nurse practitioners and midwives, not just physicians, can provide medication abortions. Now, 37 states require that physicians perform these abortions, but women’s health advocates and the World Health Organization agree that other providers are qualified to do so.

State regulation of medication abortion is part of a three-decade strategy of the anti-abortion movement, feigning concern for women’s health to create burdens and barriers to women’s constitutional right to abortion. Anti-abortion activists have made discredited claims that abortion causes breast cancer and psychiatric disorders, and Republican lawmakers have required doctors to inform their patients of these imaginary risks.

Most recently, Republican legislatures, using a template provided by Americans United for Life, have enacted a slew of abortion clinic regulations, such as making them follow costly and unnecessary rules that apply to surgical centers. Many clinics would have to make expensive renovations, and they would have to obtain admitting privileges from local hospitals that often refuse to provide them. As a result, many clinics are closing. Since 2010, the number of abortion clinics in Texas has gone from 36 to 10. For many women, especially poor women who cannot afford to miss work and travel hundreds of miles, this puts abortion out of reach.

As the Supreme Court rules on the constitutionality of the Texas facility restrictions, it will hopefully follow the FDA’s example and follow the science. It will recognize that anti-abortion restrictions that supposedly protect women’s health actually harm it.

Drew Halfmann is an associate professor of sociology at UC Davis and a member of the Scholars Strategy Network. He can be contacted at dhalfmann@ucdavis.edu.

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