After one of the nation’s largest pharmacies said will stop dispensing abortion pills in 20 states, including several where medication abortion remains legal, a progressive New Jersey Democrat reiterated her call on the Biden administration to make those drugs available to women nationwide by designating them as over-the-counter (OTC) medications.
Lisa McCormick said Mifepristone and Misoprostol —two of the most common abortion pills—should be made over-the-counter (OTC) medications by the Biden administration.
McCormick said OTC medicines can be sold directly to people without a prescription. The manufacture and sale of OTC substances are regulated by the Food and Drug Administration.
“It’s time to put birth control pills and medical abortion kits where they belong: on the shelf next to condoms, spermicide, and emergency contraception,” said McCormick, who noted that HRA Pharma, a French drugmaker, has submitted an application to the U.S. Food and Drug Administration (FDA) for the first over-the-counter birth control pill in the U.S.
“Access to contraception is a human right, as is an individual’s ability to control her own life and reproduction,” said McCormick. “Taking the next step to put oral contraception where it belongs—on the shelf in the family planning aisle—is absolutely essential to expanding birth control access for all and our federal government must ensure the availability of safe, effective medication abortion to allow women to prevent unwanted births.”
Human rights bodies and courts worldwide recognize that abortion care is essential health care and a critical aspect of women and girls’ fundamental human rights, according to McCormick.
Everyone has the right to accessible, high-quality abortion care and no one should be criminalized for seeking or accessing abortion services, recognizing the importance of reproductive autonomy in women’s lives, she said.
McCormick initially declared pills used to terminate early pregnancies should become available without a prescription almost a year before the conservative-slanted U.S. Supreme Court dramatically curbed abortion rights in a far-reaching and historic decision that reversed the landmark 1973 Roe v. Wade verdict, a ruling that for nearly a half century upheld the constitutional right to abortion.
A group of 20 Republican attorneys general warned CVS and Walgreens in a letter last month that they could face legal consequences if they sell abortion pills by mail in their states.
The letter, from Missouri Attorney General Andrew Bailey, was cosigned by attorneys general in Alabama, Alaska, Arkansas, Florida, Georgia, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Montana, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Texas, Utah, and West Virginia.
In 2019, The American College of Obstetricians and Gynecologists issued a committee opinion supporting over-the-counter access to hormonal contraception without age restrictions, yet some states do only provide over-the-counter hormonal birth control to adults.
Other organizations like ACOG support legislation that allows people to receive hormonal contraception from a pharmacist at any age.
“Access to the full spectrum of medical care, including abortion, is essential for people’s health, safety, and well-being. Physicians must be able to provide medical care to people without outside interference,” said McCormick. “However, if states are going to erect barriers that stop obstetrician–gynecologists from giving their patients unimpeded access to the full spectrum of medical care, including abortion, then the Biden administration should ensure access to medication that will stop unwanted pregnancies.”
The pill, mifepristone, in combination with a second drug called misoprostol, induces an abortion up to 10 weeks into a pregnancy and is only available through a certified doctor’s prescription.
Medication abortion involves two drugs, taken over a day or two. The first, mifepristone, blocks the pregnancy-sustaining hormone progesterone. The second, misoprostol, induces uterine contractions.
Abortion rights activists have stepped up calls to make it available at pharmacies without a prescription but companies that make the pills have shown little interest in ORC sales. A spokesperson for Danco Laboratories, a manufacturer of mifepristone, said it does not plan to seek over-the-counter approval. GenBioPro, the second maker of mifepristone for the U.S. market, did not respond to requests for comment.
As states move to severely limit or outright ban abortions, the matter is becoming urgent.
Abortion rights activists say the pill has a long track record of being safe and effective, with no risk of overdose or addiction. In several countries, including India and Mexico, women can buy them without a prescription to induce abortion.
“Being able to access your prescribed medication abortion through the mail or to pick it up in person from a pharmacy like any other prescription is a game changer for people trying to access basic health care,” said Planned Parenthood President Alexis McGill Johnson.
“Medication abortion really does meet all the FDA criteria for an over-the-counter switch,” said Antonia Biggs, associate professor at the University of California, San Francisco’s Obstetrics, Gynecology and Reproductive Sciences department.
A study by Biggs and colleagues found that the majority of participants would understand a medication abortion over-the-counter label. Biggs said she was not in talks with drugmakers over her research.
Others point to the decade-long legal fight for over-the-counter Plan B, a form of emergency contraception taken within days of sexual intercourse. The FDA approved its use for women 18 and over in 2006 and for all women in 2013.