May 30, 2023

In Light of New Threats to Medication Abortion, Duckworth Joins Warren, Hirono and Smith in Expanding Investigation into Effects of State Abortion Bans

 

[WASHINGTON, D.C.] – U.S. Senator Tammy Duckworth (D-IL) joined U.S. Senators Elizabeth Warren (D-MA), Mazie Hirono (D-HI) and Tina Smith (D-MN) to expand their investigation on the effects of state abortion bans on women. As the country nears the first anniversary of the Supreme Court’s decision to overturn Roe v. Wade, the Senators sent letters to five leading healthcare organizations representing physicians, nurses, pharmacists and hospitals asking for updates since the organizations’ responses to the Senators’ questions about threats to abortion sent in August and September 2022. The Senators are also requesting information about the effects of attacks on medication abortion amidst ongoing legal challenges. 

“Since the Supreme Court’s devastating decision in Dobbs v. Jackson Women’s Health Organization to overturn Roe v. Wade, Republican politicians across the country have enacted draconian laws banning or severely limiting abortions, with Republicans in Congress even introducing a 15-week national abortion ban. In particular, medication abortion, which accounts for over half of all abortions in the United States, is increasingly under attack,” wrote the Senators. 

In the letter, the Senators call on the American Medical Association, Physicians for Reproductive Health, National Nurses United, the American Pharmacists Association and the American Hospital Association, noting the importance of access to medication abortion, which accounts for more than half of abortions nationwide. In states that restrict access to mifepristone, a medication used in conjunction with misoprostol to induce abortion, women are more likely to seek procedural abortions later in their pregnancies, resulting in higher costs and elevated health risks. Beyond abortion care, mifepristone is also used to treat miscarriages, allowing mothers to safely manage a painful loss in private.

“Since the Supreme Court’s decision to overturn Roe v. Wade, online misinformation about the safety and efficacy of mifepristone… has exploded despite extensive evidence proving the drug’s safety. Anti-abortion organizations, including crisis pregnancy centers, have also promoted erroneous claims that medication abortion can be reversed, commonly referred to as ‘abortion pill reversals,’ resulting in confusion and fear… A federal district court’s ruling challenging the U.S. Food and Drug Administration’s (FDA) 23-year-old approval of mifepristone has further fueled this surge in misinformation, which has left women across the country unsure whether they can legally access the medication – even in states without restrictions,” wrote the Senators. 

Given these serious concerns, the Senators are asking each organization to answer a set of questions by June 8, 2023 to better assess how challenges related to accessing medication abortion, including misinformation, affect patients and providers across the nation and to better understand the effects of a potential judicial decision staying the FDA’s approval of mifepristone. 

Duckworth is a fierce advocate in protecting Americans’ right to access the reproductive healthcare they need. Recently, Duckworth joined more than 250 members of Congress in submitting an amicus brief to the U.S. Supreme Court in Alliance for Hippocratic Medicine v. FDA, in support of the Biden Administration’s appeal of a federal district court ruling that suspends the Food and Drug Administration’s (FDA) more than 20-year-old approval of mifepristone as well as the decision by the U.S. Court of Appeals for the Fifth Circuit—which does not revoke FDA approval of mifepristone in its entirety but does significantly restrict access to the drug nationwide and ultimately overrides FDA’s scientific judgment. Duckworth and also helped introduce the Women’s Health Protection Act of 2023, federal legislation to guarantee access to abortion everywhere across the country and restore the right to comprehensive reproductive healthcare for millions of Americans.

Duckworth hosted Dr. Erin King of Illinois’s Hope Clinic as her 2023 State of the Union guest, as part of the Senator’s continuing efforts to defend Americans’ right to full, comprehensive reproductive healthcare—no matter their zip code, income, ability status or skin color. In 2021, she introduced the Equal Access to Abortion Coverage in Health Insurance (EACH) Act, as well as previously supported the Women’s Health Protection Act, which she vocally criticized Republicans for blocking. After she urged Secretary of Defense Lloyd Austin to proactively protect servicemembers’ abortion rights, the Department of Defense announced several new protections and services to ensure our female troops can access the healthcare they need. Duckworth also pushed back against Republican attacks against the Biden Administration’s efforts to protect female Veterans’ access to care.

A copy of this letter can be found here and below:

Dear Dr. Resneck:

Since the Supreme Court’s devastating decision in Dobbs v. Jackson Women’s Health Organization to overturn Roe v. Wade, Republican politicians across the country have enacted draconian laws banning or severely limiting abortion,1 with Republicans in Congress even introducing a 15-week national abortion ban.2 In particular, medication abortion, which accounts for over half of all abortions in the United States,3 is increasingly under attack. As we approach the first anniversary of the Dobbs decision, I’m writing to you to request an update to the responses you shared in September and October 20224 to understand how conditions have changed. I am also deeply concerned about the escalating attacks on medication abortion and write to seek the American Medical Association’s perspective on the impacts of state laws and court proceedings related to medication abortion on women’s health.

Last year, I asked you to share how state-imposed abortion restrictions5 and the proposed 15-week nationwide abortion ban have affected and would affect women’s health.6 I deeply appreciate your response to those requests, which underscored the dangerous consequences of these policies on women’s health. Given the escalating assault on medication abortion, I write today to seek updated information on the impact of these restrictions.

Since the Supreme Court’s decision to overturn Roe v. Wade, online misinformation about the safety and efficacy of mifepristone, a drug commonly used in conjunction with misoprostol for medication abortion,7 has exploded despite extensive evidence demonstrating the drug’s safety.8 Anti-abortion organizations, including crisis pregnancy centers, have also promoted erroneous claims that medication abortion can be reversed, commonly referred to as “abortion pill reversals,”9 resulting in confusion and fear. These claims “that exaggerate the harms of medication abortion, that use very shoddy and in many cases, non-rigorous science…do a lot of fear mongering and stigmatizing.”10 Such tactics can have devastating consequences for women seeking abortion care, including creating unnecessary delays that could jeopardize a woman’s ability to access this care entirely.

A federal district court’s ruling challenging the U.S. Food and Drug Administration’s (FDA) 23-year-old approval of mifepristone11 has further fueled this surge in misinformation, which has left women across the country unsure whether they can legally access the medication – even in states without restrictions.12 And while the Supreme Court has temporarily blocked the ruling from Judge Matthew Kacsmaryk to stay the FDA’s approval of mifepristone from going into effect while the litigation proceeds, the district court decision and ensuing legal fights will only add to the widespread confusion about the medication’s legal status and safety.13

Medication abortion accounts for more than half of abortions nationwide.14 In states that restrict access to mifepristone, women are more likely to seek surgical abortions later in their pregnancies, resulting in higher costs and elevated health risks.15 But even beyond abortion care, mifepristone is used to treat miscarriages and stillbirths, allowing mothers to safely and effectively manage a painful loss in private.16 As such, a reckless decision to stay the approval of mifepristone, a drug that has been safely administered for over two decades, would only endanger the health and safety of women across the country.

Given these alarming events, I am writing to the American Medical Association — and other leading organizations representing physicians, nurses, pharmacists, and other health care providers — to better understand how challenges related to accessing medication abortion, including misinformation, affect patients and providers across the nation, and to better understand the effects of a potential Supreme Court decision staying the FDA’s approval of mifepristone. Accordingly, I request that you answer the following questions by June 8, 2023:

  1. How has access to medication abortion changed since the Supreme Court issued its decision in Dobbs v. Jackson Women’s Health Organization and since the District Court’s ruling in Alliance for Hippocratic Medicine v. FDA?
  2. Have your providers seen an increase in confusion from patients and/or providers regarding the safety, efficacy, and legality of medication abortion?
    1. Please describe how this relates to both mifepristone and misoprostol.
  3. How have state-imposed restrictions on medication abortion affected patients?
  4. Are your members experiencing challenges related to pharmacist refusals of prescriptions for misoprostol? Please describe.
  5. What guidance have you provided to your members, if any, about how to administer medication abortion in light of increased misinformation and the ongoing litigation in Alliance for Hippocratic Medicine v. FDA and Washington v. FDA?
  6. What effect would a stay of the FDA’s approval of mifepristone have on patients and providers?
  7. How would a stay of the FDA’s approval of mifepristone affect providers’ ability to treat miscarriages?
  8. Is there additional information you would like to share regarding women’s health care, including access to abortion and medication abortion, the impacts of the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization and the District Court’s ruling in Alliance for Hippocratic Medicine v. FDA, and how providers are navigating the criminalization of abortion and increased surveillance in a number of states?

Thank you for your attention to this matter.

Sincerely,