Making the case for advance provision of mifepristone and misoprostol for abortion in the United States

Introduction

In the United States (US), mifepristone used together with misoprostol is registered by the Food and Drug Administration (FDA) for termination of intrauterine pregnancy up to 70 days’ gestation.1 While medication abortion is safe and effective,1 current FDA requirements delineated in the Risk Evaluation and Mitigation Strategy (REMS) for mifepristone mandate that it be dispensed in a clinic, medical office or hospital.2 Patients then complete the medication regimen outside of the facility. Post-treatment assessment is recommended to ensure the pregnancy is not ongoing, which can take place in person or remotely.3 While there is little evidence demonstrating that the mandated dispensing requirement improves patient safety, it may pose an insurmountable barrier for people unable to travel to an abortion facility.4 In addition, hostile policy environments have made abortion nearly unattainable in some US states, a situation that may worsen…

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