2022 State Legislative Sessions: An Overview on Chemical Abortion

2022 State Legislative Sessions: An Overview on Chemical Abortion

As pro-life laws continue to advance in many states, the abortion industry is searching for ways to circumvent them. One of their preferred methods of doing this is by promoting risky, do-it-yourself chemical abortions. Efforts to make chemical abortions widely available to women via telemedicine and the mail have been ramping up, even as the U.S. Supreme Court’s consequential decision in Dobbs v. Jackson Women’s Health Organization, which could overturn Roe v. Wade and return jurisdiction over abortion legislation to the states, draws closer. These circumstances make state-level safety regulations for chemical abortion especially urgent. Thankfully, state legislators across the country are responding to this need introducing legislation to protect women and unborn children from chemical abortion or at least minimize the dangers for women.

Chemical abortion (often referred to by the euphemistic names “self-managed” and “medical” abortion), is a two-pill regimen consisting of abortion-inducing drug mifepristone (Mifeprex®; also known as RU-486 or simply “the abortion pill”) and misoprostol (Cytotec®). Chemical abortion is favored by the abortion industry because of its low overhead compared to surgical abortion and its ability to be performed anywhere. However, this abortion method is particularly hazardous to women, often leaving them to endure the trauma of abortion alone in their bathrooms, with little to no support or medical follow-up. Between 2000 and 2021, 4,471 adverse events related to chemical abortions were voluntarily reported to the U.S. Food and Drug Administration (FDA), including 26 maternal deaths.

Despite the danger, the number of chemical abortions has rapidly increased, even as the total number of abortions occurring in the United Sates has steadily declined. According to the Centers for Disease Control (CDC), 42 percent of U.S. abortions in 2019 were chemical.

By extolling the supposed virtues of abortion pills and seeking to expand their availability at all costs—despite chemical abortion’s far higher rate of risk for serious complications compared to surgical abortion—pro-abortion activists are putting women’s health and safety in jeopardy. In 2021, the pro-abortion Biden administration further compromised women’s safety by removing the FDA’s in-person dispensing requirement, allowing women to obtain abortion pills without ever undergoing a physical examination by a doctor.

Thankfully, state legislators are taking the initiative to protect women and their unborn children with commonsense safety regulations. Since 2011, 31 states have introduced protections against chemical abortion. Of these, 16 states have enacted such legislation, each establishing various safeguards for women. Legislation seeking to establish complete protections against chemical abortion for women and their unborn children started becoming prevalent in 2021, but none of these bills have been enacted yet. Bills that regulate chemical abortion typically include some combination of the following key provisions:

  • Require that the pre-abortion exam be performed and the abortion pills be administered in person by a licensed physician. (These laws are often referred to as “Skype abortion bans” since, without them, abortionists can abuse telehealth to dispense chemical abortion drugs without ever physically examining the mother.)
  • Require that physicians meet certain certification and qualification standards, including:
    • Being certified by an “Abortion Inducing Drug Certification Program” at the state board of pharmacy.
    • Being capable of performing an in-person exam to confirm the pregnancy and the absence of an ectopic pregnancy, determine the gestational age and intrauterine location of the unborn child, and document said information in the patient’s medical chart.
  • Require at least two follow-up appointments.
  • Require patients to be informed of the “final printed label” (FPL) of each drug (“FPL” or "final printed labeling" means the FDA-approved informational document for an abortion-inducing drug, which outlines the protocol authorized by the FDA and agreed upon by the drug company and delineates how the drug is to be used).
  • Require informed consent for mothers.
  • Require reporting Adverse Event Complications to the state board of pharmacy.
  • Provide a penalty for noncompliance (criminal, civil, and/or professional).
  • Create a civil cause of action (e., abortion providers who violate the law can be sued).

In 2022 so far, a record-high 18 states (including carryover) introduced legislation to protect women and their unborn children from chemical abortion or at least reduce its health-damaging effects for women. So far, three have been enacted, and there’s still time for others to follow. Here is a rundown of the three bills already enacted:

  • Kentucky H.B. 3 requires that abortion-inducing drugs be dispensed and administered in person by a licensed physician, requires an in-person exam and a follow-up appointment, prohibits providing abortion-inducing drugs by mail, provides informed consent requirements, provides a professional penalty, and creates a cause of action.
  • South Dakota H.B. 1318 requires that abortion-inducing drugs be administered in person by a licensed physician, requires at least one follow-up appointment, and provides informed consent and reporting requirements.
  • Tennessee H.B. 2416 requires that abortion-inducing drugs be administered in person by a qualified physician, requires at least one follow-up appointment, provides informed consent requirements and reporting requirements, imposes criminal and professional penalties for noncompliance, and creates a cause of action for the woman given the drugs, members of her close family, her healthcare provider, a prosecuting attorney, and the attorney general and reporter.

More states must follow suit. Abortion businesses must not be allowed to reduce their overhead at the expense of women’s health and safety. Given the abortion industry’s relentless efforts to expand access to abortion-inducing drugs and the possibility of the U.S. Supreme Court overturning Roe, protections against chemical abortion have never been more needed. All states, including those that will have laws in effect protecting unborn life at conception, must find ways to prevent Planned Parenthood and other abortion businesses from circumventing the law and flooding their states with dangerous, unregulated abortion-inducing drugs.