FDA Allows Pharmacies To Dispense Abortion Pills—What Happens Next?

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Giulia Carbonaro is a Newsweek reporter based in London, U.K. Her focus is on the U.S. economy, housing market, property insurance market, local and national politics. She has previously extensively covered U.S. and European politics. Giulia joined Newsweek in 2022 from CGTN Europe and had previously worked at the European Central Bank. She is a graduate in Broadcast Journalism from Nottingham Trent University and holds a Bachelor's degree in Politics and International Relations from Università degli Studi di Cagliari, Italy. She speaks English, Italian, and a little French and Spanish. You can get in touch with Giulia by emailing: g.carbonaro@newsweek.com.

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The Food and Drug Administration (FDA) on Tuesday approved a rule change allowing retail pharmacies—from major chains to mail-order companies—across the country to offer abortion pills. Until now, abortion pills could only be dispensed by clinics, doctors and a few mail-order pharmacies.

The change is significant: with the new rule, those in need will be able to access mifepristone, the first of two drugs used in medication abortions, at any brick-and-mortar pharmacy willing to go through the special certification process necessary to stock and dispense the drug to pregnant people with a prescription.

The FDA had already extended access to abortion pills in 2021, when it permanently lifted the in-person requirement demanding that patients wishing to terminate their pregnancy obtain a prescription by a health professional in person.

With the requirement lifted due to the COVID-19 pandemic, patients became able to obtain a prescription via telehealth consultation, either through a video call, a phone call or an online consultation.

Tuesday's FDA decision allows patients who obtained a prescription to turn to retail pharmacies to pick up the abortion pill in-store or by mail order, instead of referring to a limited number of specially certified doctors, clinics and pharmacies.

Abortion pill
A person holds a carton of the "morning-after" pill purchased from the Plan-B vending machine that sits in the basement of the student union building on the Boston University Campus in Boston, Massachusetts on July... JOSEPH PREZIOSO/AFP via Getty Images

Mifepristone, approved for abortions in September 2000, works by blocking a hormone necessary for pregnancy development—progesterone—and can be taken in the first 10 weeks of pregnancy, as permitted by the FDA. It's part of a two-drug regimen which includes misoprostol, which can be taken one or two days after mifepristone and causes contractions that lead to the expulsion of pregnancy tissues. Not a restricted drug, misoprostol is widely available at pharmacies via prescription.

Together, the two drugs are known as the abortion pill. They can be taken safely and effectively in the comfort of one's home, instead of being administered in a clinic or doctor's office, and allow people who live in rural or remote areas to access the medication without traveling to a health provider.

Abortion pills, which are used in more than half of all abortions in the U.S. according to a report by abortion rights advocacy research group the Guttmacher Institute, have reportedly become even more sought after the Supreme Court overturned Roe v. Wade in June 2022, eliminating the constitutional right to abortion.

But while the FDA's rule change has the potential to massively expand access to abortion medication, state legislation is likely to influence whether retail pharmacies now allowed to offer mifepristone will be able to do that.

Several red states have moved to limit access to abortion pill in the wake of the end of Roe, with outright bans on the procedure also potentially halting medication abortions.

According to the Guttmacher Institute, 32 states require physicians only—and not other clinicians—to dispense abortion pills, while 19 require patients to get the medication in person at a doctor's office.

Doctors in states where abortion rights are protected by law are not allowed to prescribe the procedure to patients across state lines.

In late June of 2022, Montana's Planned Parenthood preemptively decided not to provide abortion pills at their clinics in Billings, Great Falls and Helena to out-of-state patients coming from states where trigger laws have already gone into effect, to protect them from criminal charges.

The same month, Louisiana Governor John Bel Edwards signed into law a bill making it illegal for anyone to mail abortion pills in the state. As per a May 2022 legislation, mailing abortion pills is also a felony in Tennessee.

In a Q&A page dedicated to mifepristone updated by the FDA on January 3, the agency addresses the question of what happens if a state refuses to allow the abortion drug to be prescribed for terminating a pregnancy.

"We are coordinating with the Department of Justice and others across the government on these legal issues," the FDA writes. "Any questions regarding preemption of state law should be directed to the Department of Justice."

Newsweek has contacted the Department of Justice for comment.

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About the writer

Giulia Carbonaro is a Newsweek reporter based in London, U.K. Her focus is on the U.S. economy, housing market, property insurance market, local and national politics. She has previously extensively covered U.S. and European politics. Giulia joined Newsweek in 2022 from CGTN Europe and had previously worked at the European Central Bank. She is a graduate in Broadcast Journalism from Nottingham Trent University and holds a Bachelor's degree in Politics and International Relations from Università degli Studi di Cagliari, Italy. She speaks English, Italian, and a little French and Spanish. You can get in touch with Giulia by emailing: g.carbonaro@newsweek.com.

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Giulia Carbonaro is a Newsweek reporter based in London, U.K. Her focus is on the U.S. economy, housing market, property ... Read more