Graphic by Gabby Gagnon ‘24
By Shira Sadeh ’25
Staff Writer
Medicated abortions now account for over half of all abortions in the United States, according to a Feb. 24 policy analysis by the Guttmacher Institute. Preliminary findings indicate that the combination of the pills mifepristone and misoprostol, which work together to induce an abortion, accounted for 54 percent of abortions in the United States in 2020, a significant jump from 39 percent in 2017. Although data collection for 2022 has not been completed, usage is predicted to remain above the 50 percent mark. Various factors contribute to the increase of use, including the COVID-19 pandemic which encouraged remote access to healthcare and increased access to medication instead of in-clinic abortions.
As explained by Planned Parenthood, medicated abortion works in two steps. The first dose of mifepristone is taken in pill form. According to the FDA, the patient must take 800 micrograms of misoprostol immediately or within 48 hours of this dosage. Patients are encouraged to follow up with the medical professional who issued the prescription between 7 and 14 days later to ensure no serious side effects occur. Planned Parenthood maintains that the pill used for medicated abortions is considered extremely safe and has been in circulation for 20 years with few negative results.
According to the FDA, mifepristone was first approved in 2000. The two pills used together are currently approved for up to 70 days after gestation — 70 days or less since the first day of the last menstrual cycle. In 2019, the FDA approved the current generic form of mifepristone in the 200 milligrams form along with a Risk Evaluation and Mitigation Strategy. This means that the pills must be “ordered, prescribed and dispensed by or under the supervision of a healthcare provider who prescribes and who meets certain qualifications,” according to the FDA. Before issuing the pills, this provider must complete a Prescriber Agreement Form, which must be dispensed in clinics, medical offices and hospitals supervised by a certified provider. In 2021 the FDA added that mifepristone must be prescribed only after counseling in addition to the Patient Agreement Form and that pharmacies dispensing mifepristone must be certified to do so.
The New York Times reported in Dec. 2021 that the FDA approved medicated abortions to be available through mail in all 50 states. This announcement came at a critical turning point for abortion accessibility. As the Supreme Court moves to possibly overturn Roe v. Wade through a Mississippi law banning abortions at 15 weeks of pregnancy, abortion by mail could provide a solution. Anti-abortion advocates recognize that medicated abortion presents a more accessible way of recieving an abortion and have worked to place restrictions on it, especially since the FDA’s policy change in 2021. For example, according to the Guttmacher Institute, 32 states require that the individual administering the abortion be a physician, disregarding FDA approval of medical professionals with other titles.
The Guttmacher Institute went on to report that as of Feb. 22, 2022, 16 states moved to introduce restrictions on medicated abortion, including complete bans in seven states — Alabama, Arizona, Illinois, Iowa, South Dakota, Washington and Wyoming.
Assistant Professor of Politics Cora Fernández Anderson summarized this anti-choice legislation. “Anti-choice activists are always ready to deploy new strategies to deny access to abortion and criminalize the practice,” Anderson said.
Anderson went on to raise an additional concern regarding restrictions on medicated abortions.
“In a restrictive context where the pill is not legally available and is thus sold in the black market, there will always be those that will take advantage of this and sell either expired, ineffective or dangerous medications instead of the actual drug. And correct information might not always be available to everybody,” Anderson said. “Feminist networks will always monitor and suggest the safe places to get them and the correct way of doing it, but we cannot ensure everybody will be able to get this information and people can order anything in the internet when desperate.”
The cost of accessing abortion medication is a challenge many people face. Planned Parenthood reported that because 60 percent of their patients are covered by programs like Medicaid, the Hyde Amendment prohibits them from accessing federal funds to help cover the costs. KFF reported that due to the Hyde Amendment passed in 1977, Medicaid does not currently cover any abortion expenses, except in the case of incest, rape or endangerment to the pregnant person’s life. In 2014 the average cost for a medicated abortion up to 10 weeks was $535. While the manufacturers of the mifepristone do not report the cost of the pill publicly, providers stated that it cost them approximately $90 per Mifeprex pill, according to KFF.
On a local level, the University of Massachusetts Amherst recently announced that the university health center would begin offering medicated abortions on campus starting in Fall ’22, according to WWLP. While in the past, the institution has offered referral services to connect students with regional abortion providers, student demand has pushed the university to simplify the process.
Anderson stated that although she has not heard of any similar policy on the Mount Holyoke campus, she feels that the momentum created by UMass Amherst students could help Mount Holyoke students push the school in new directions.
This was seconded by JoJo Zeitlin ’22, co-chair of the Mount Holyoke chapter Planned Parenthood Generation Action group. She spoke to her experiences talking with other students and indicated that medicated abortions are becoming more popular among young people. “I believe this is because it is less invasive, more accessible, and can be taken in the comfort of your own home where you can receive support from friends and family,” Zeitlin said.
Regarding UMass Amherst’s decision to provide on-campus abortions, Zeitlin stated that she believes the Mount Holyoke Health Center should follow suit.