FDA clears way for wider access to abortion pills

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• Geoff Bennett:

  For the first time, retail pharmacies will be allowed to offer prescribed abortion pills in the U.S. The FDA announced the regulatory change on Tuesday, which could significantly expand abortion access through medication.

  Earlier today, John Yang spoke with an obstetrician about the news.

• John Yang:

  Until now, the Food and Drug Administration had required that patients by mifepristone, the first of two pills used in medicated abortions, through a mail-order pharmacy or from certified clinics or doctors. Patients would still need a prescription under the new rules.

  Abortion rights groups hailed the move. NARAL called it "a science-based decision that will empower folks to get the care they need in the way that best works for them."

  Anti-abortion groups condemned it. Susan B. Anthony Pro-life America said the FDA was helping "abortion activists turn every post office and pharmacy into an abortion business."

  Dr. Jennifer Villavicencio is an obstetrician. She heads equity transformation for the American College of Obstetricians and Gynecologists, or ACOG, as it's known.

  Dr. Villavicencio, what — from your perspective, what is the significance of these new FDA rules?

  Dr. Jennifer Villavicencio, American College of Obstetricians and Gynecologists: These FDA rules are a response to the enormous amount of evidence that we have that mifepristone and medication abortion are extraordinarily safe and that these restrictions, these REMS, rules, are not necessary to keep people safe, and only create barriers to accessing essential health care like abortion.

• John Yang:

  Already, more than half of the pregnancy terminations in America are a result of medication abortions.

  Do you expect that to change now with these new rules?

• Dr. Jennifer Villavicencio:

  We have seen a steady increase in individuals who need abortion care choosing medication abortion. And individuals may choose medication abortion, in lieu of in-clinic or procedural abortion, for many different reasons.

  And so having more access to the medication, being able to pick it up at a pharmacy, is definitely something that helps remove those barriers. And we may see an ongoing increase in the usage and uptake of medication abortion.

• John Yang:

  What do you say to the critics and we heard the statement from Susan B. Anthony, anti-abortion America.

  What do you say to the critics who say this is making abortion, making terminating pregnancies too easy?

• Dr. Jennifer Villavicencio:

  I understand that perspective. I actually used to be an anti-abortion activist. And so I understand that abortion can be really hard for individuals to understand.

  As someone, as a physician, an expert in science and in medicine who takes care of patients every day and who provides abortion care now, I understand that, while this is a complex issue, it's a decision that should be made in between a doctor and the person seeking the abortion.

  Medication abortion and mifepristone are extraordinarily safe. They're just as safe as ibuprofen, the Advil that you get out of your cabinet or off the shelf in the local pharmacy. It's just as safe as those things. And so needed essential health care can never be too easy to access.

  And I want to reassure everybody who's watching this, as someone — take it from someone who takes care of patients every single day, that these decisions about ending a pregnancy are thoughtful and are done in the context and with the expertise that these women have in their own life.

• John Yang:

  There are still local and state restrictions, although the — just this week, the Justice Department told the Postal Service that, in light of the Supreme Court action, it could still deliver these medications.

  But there are state laws banning medication abortions. And that takes precedence over these FDA regulations. How serious or how significant is that limitation?

• Dr. Jennifer Villavicencio:

  So, while we are ACOG are happy to see the FDA respond to the enormous evidence that says that mifepristone is safe and does not require these additional restrictions, we also acknowledge that this is only one step in removing the unnecessary barriers to medication abortion.

  We know that there are still other aspects to these REMS, these rules, on mifepristone that will still add barriers to accessing medication abortion. And, of course, we know that there are nearly half of the states in the country who are banning or severely restricting abortion, and which this FDA change in rules will not impact.

• John Yang:

  The — we reached out to two of the biggest pharmacy chains in America, CVS and Walgreens, and both said — each said that they're studying these new regulations and will make decisions later.

  There are some administrative restrictions on drugstores, pharmacies, like not putting the prescribing doctor's name in a nationwide database. Could that keep national — big national chains from carrying this drug?

• Dr. Jennifer Villavicencio:

  I think that there is a lot of information that we still need to understand about how this rule is going to actually play out.

  We know that, on paper, it says that pharmacies can now dispense this medication with a prescription from a certified provider. But we — that's what it says on paper. But the way that that actually plays out at your pharmacy is going to really vary based on the chain, as you mentioned, as well as your region.

  And there's still a lot for us to understand and learn about what this is going to look like.

• John Yang:

  And, also, with abortion remaining a hot-button issue and a politicized issue, could nationwide chains be leery of carrying the medication and sort of broadcasting it, for fear of how their business might be affected in various parts of the country?

• Dr. Jennifer Villavicencio:

  I think that that's possible, although I'm — I don't work for one of those chains.

  What I can say is that abortion is essential health care. And we have seen that it is extraordinarily common and extraordinarily safe. One in four women will have an abortion by the time that they are 45. And mifepristone, this medication that we're talking about, is also used for other things, like miscarriage management.

  And so I — we at ACOG and I would urge these chains and people who are making these decisions to think about not only access to abortion, which is incredibly important, but access to evidence-based care for miscarriage management, which would include being able to dispense and receive mifepristone from a pharmacy.

• John Yang:

  So you say you were once in the anti-abortion movement.

  How did your viewpoint change? What was the process?

• Dr. Jennifer Villavicencio:

  So I grew up very religious and very conservative.

  And all of the values that drive me now, those of justice and compassion and fairness, I actually learned from my religion and from my family life. And I was, as you mentioned, an anti-abortion activist well into my early 20s.

  But when I started practicing medicine and being involved in the day-to-day care of people who were living complex lives in complex situations, I realized that the black and white of the false dichotomy of pro-life and pro-choice weren't real, that there were real people sitting in front of me who needed help, who were making challenging decisions, but with thought and with the inclusion of their family, and that I could better serve my values of — and my duty to my patients as a physician by showing up for them and taking care of them no matter what it is that they need.

  And that's why I practice the full scope of OB-GYN. I deliver babies. I provide abortion care. I prescribe birth control. And I do cancer screenings.

  When a patient comes to me and asks for my help and my expertise in medicine, I'm really proud to say that I'm able to be there for them, whatever — whatever it is that they say that they need, because I trust them to be able to make that decision in the context of their own lives.

• John Yang:

  Dr. Jennifer Villavicencio of the American College of Obstetricians and Gynecologists, thank you very much.

• Dr. Jennifer Villavicencio:

  Thank you.

• Geoff Bennett:

  And a quick follow-up to John's interview.

  Late today, Walgreens became the first national pharmacy chain to confirm it plans to dispense the abortion medication in its stores, but it did not provide a time frame. As John reported, other major chains, including CVS and Rite Aid, say they are still reviewing the new FDA rules.