Missouri’s attorney general restricts access to the abortion drug mifepristone, arguing in a lawsuit filed this month that its availability harms the state by reducing teen pregnancies. I asked again.
The amended lawsuit was filed by Missouri Attorney General Andrew Bailey, along with the Republican attorneys general of Kansas and Idaho. They are asking a Texas judge to order the Federal Drug Administration to reinstate restrictions on mifepristone, one of two drugs prescribed to induce chemical abortions.
The three attorneys general were then forced to refile the case. The U.S. Supreme Court dismissed the original lawsuit It concluded that the original plaintiffs, anti-abortion doctors and medical organizations, lacked standing to sue because they could not prove they had been harmed.
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This time, in arguing that the states’ position is correct, the attorneys general argue that access to mifepristone has reduced “birth rates among teenage mothers,” and that mifepristone has “decreased political representation.” He argued that this was a contributing factor to the decline in the population of each state, along with the loss of citizens. It’s federal funding. ”
“Young women are more likely to use online abortion search sites and drug ordering websites to self-manage their abortions,” the application claims.
Missouri’s teen pregnancy birth rate is 16.9 births per 1,000 girls ages 15 to 19, but it has been steadily declining over the past few years. Centers for Disease Control and Prevention; However, it is still among the highest in the country. According to the CDC, the teen pregnancy birth rate in Idaho is 10.9 births per 1,000 girls ages 15 to 19.
The lawsuit calls on the federal government to require three in-person doctor visits, shorten the gestational period during which the drug can be taken from 10 weeks to seven weeks, and to allow mifepristone to be delivered by mail. It calls for reinstating previous restrictions on mifepristone, including reversing the policy. You are allowed to fill a prescription online or through a pharmacy.
In a statement to the Missouri Independent, Bailey called the lawsuit an attempt to ensure that “long-standing safety requirements” for the use of mifepristone are reinstated. .
“We are unflinchingly moving forward for the safety of women across the country,” Bailey said.
American College of Obstetricians and Gynecologists says mifepristone lawsuit is not based on science
Molly Megan, chief legal officer and general counsel for the American College of Obstetricians and Gynecologists, said the latest legal attempt to curtail access to mifepristone is based on “outdated and unscientific federal regulations.” He said that
“Science shows that mifepristone is safe and effective, including when used as directed through telemedicine, and that patients of all ages who become pregnant and need a medical abortion can benefit from mifepristone and misoprostol. We have conclusively demonstrated that the combination therapy can be used safely.” she said in a statement. “Imposing unnecessary barriers to mifepristone will make it harder for people to access this necessary care, which is of course the point, and will exacerbate existing health disparities. ”
According to the FDA, mifepristone is safe to use when taken as directed. Cramps and bleeding are common side effects of the drug. People prescribed mifepristone are advised to call their doctor If you experience heavy bleeding, abdominal pain, or fever. The same guidance also applies to people who have recently had an abortion, experienced a miscarriage, or given birth.
According to the FDA, only 32 deaths related to mifepristone have been reported since the drug was approved for use 28 years ago.
But Mr. Bailey and his fellow Republican attorneys general maintain that the drug is dangerous.
“The FDA has allowed online abortion providers to mail FDA-approved abortion pills to women in states that regulate abortion. Abortion pills can be dispensed without a doctor’s visit, testing, or in-person follow-up care.” ” said the Attorney General. Amended lawsuit. “These dangerous drugs are now flooding states like Missouri and Idaho, and women in those states are being sent to emergency rooms.”
The application also claims that current regulations surrounding mifepristone make it impossible to track and prevent medication abortions.
“All of this makes it difficult for state law enforcement to detect and prevent violations of state law and to give effect to state abortion laws,” the attorneys general wrote.
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Lower incomes and fewer teenage mothers
When the constitutional right to abortion was overturned in June 2022, Missouri became the first state to enact a trigger law banning the procedure in all cases except medical emergencies.
Ten years ago, there were more than 5,000 abortions in Missouri, according to data from the Missouri Department of Health and Senior Services. By 2020, that number had dropped to 167, thanks to a series of “targeted abortion provider regulations” laws enacted by Congress. These include requiring a 72-hour waiting period between the initial appointment and surgical abortion, and requiring a pelvic exam for medication abortions.
From June 2022 to March 2024, just 64 abortions were performed under the state’s emergency exemption in Missouri, according to health department data.
Despite these laws, thousands of Missourians have still received abortions over the past two years. Driving to clinics in Illinois and Kansas Or you can order abortion pills by mail.
In the six months since the Supreme Court’s abortion decision, Self-administered medical abortions on the rise According to the study Published in JAMA, the journal of the American Medical Association.
In its filing, the attorney general seeks to estimate how many people in each state may have received medical abortions and how many may have received Medicaid.
According to the lawsuit, 438 abortion complication reports were submitted to the Missouri Department of Health between April 2018 and August 2023, including 186 for medication abortions.
Bailey’s office estimates that just under 400,000 women and girls of reproductive age are eligible for Medicaid in Missouri, and about 13% of them are enrolled in Medicaid.
Bailey took these data points to estimate how much abortion pills cost in the state, and said that under the Emergency Care and Affirmative Labor Act, public hospitals are not allowed to pay for emergency care, regardless of ability to pay. He pointed out that everyone who comes to the hospital must be treated.
“If a public hospital provides medical services for complications resulting from chemical abortion, and the state’s Medicaid program does not cover the full amount of the bill, the outstanding balance is a loss to the public hospital, and a loss to the public hospital itself. ” the filing says. It is an instrument of the state. ”
The attorney general’s office also cited the “potential population loss” of increased access to medication abortion among Missourians.
“After Dobbs, only 2.4 women considering abortion were prevented from obtaining an abortion in Missouri, reflecting the ease of driving to another state to receive abortion pills. %,” the attorney general wrote in the filing.
If the FDA’s previous requirements were still in place, there would have been fewer abortions, the attorney general argues.
Mr. Bailey made a similar argument last year when he tried to inflate the estimated cost of an abortion rights ballot measure, saying: States suffered $6.9 trillion in revenue losses. The judge denied his request.
The filing also pointed to a November 2023 study that found abortion bans did not lead to an increase in teenage pregnancies resulting in birth between the ages of 15 and 19.
The study attributes this in part to young people’s ability to find abortion pill providers online.
“Thus, this study shows that remote dispensing of abortion pills by mail, carrier, and interactive computer services lowers expected birth rates for teenage mothers in plaintiff states, even if other overall birth rates are lower than expected. “This suggests that there is,” he said. the attorney general wrote.
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