There are caveats, chief among them being that the pills can only be mailed to states that allow telemedicine for medication abortions—which 19 states prohibit, while some states prohibit the mailing of the pills or require that they be obtained in person. Prosecutors in those states are likely to look for ways to charge women with crimes related to medication abortion, as already happened in one Mississippi case.
The FDA also left in place other restrictions, including that mifepristone must be prescribed by a specially certified health provider.
But in states that allow it, being able to get a prescription through a remote appointment and have the medication mailed will be a major advance—especially for people in rural areas where accessing in-person abortion can mean a long drive. And it seems like a reasonable bet that a new incarnation of the Jane Collective will be necessary, and that medication abortions will be one of its most important tools (which would be true whatever the FDA did or didn’t do about allowing the pills to be mailed).
Anti-choice groups are screaming about the FDA’s move, but the science shows it’s safe, including a new study in The New England Journal of Medicine drawing on 84,000 abortions in Canada and concluding that mifepristone availability didn’t increase the rate of complications. That’s just the most recent study, though. Others have had similar findings.
“We’ve really seen that this is completely safe and that these FDA regulations are based on politics — they’re not based on science or evidence,” Dr. Nisha Verma, a fellow with the American College of Obstetricians and Gynecologists, told NPR. “Medications with similar risk, similar safety profiles, are not regulated the same way.” But that’s reproductive rights policy in the U.S.: Everything about getting abortion care is more difficult than getting other forms of equivalently safe medical care.
The FDA’s decision is certainly not a panacea, but it’s progress.