By Carrie Baker for Ms. Magazine.
Broadcast version by Roz Brown for Texas News Service reporting for the Ms. Magazine-Public News Service Collaboration

Earlier this month, the pharmaceutical company GenBioPro announced the names of 18 brick-and-mortar pharmacies that are now dispensing the abortion pill mifepristone. They are the first pharmacies to publicly acknowledge doing so after the FDA in late 2021 finally loosened medically unnecessary restrictions on mifepristone that blocked pharmacy distribution for decades.

"At GenBioPro, we firmly believe everyone has a right to access evidence-based health care and safe and effective medicines, and that includes medical abortion," said Evan Masingill, CEO of GenBioPro, which successfully obtained FDA approval in 2019 for the first generic mifepristone tablet.

The pharmacies listed on their website include independent community drugstores, university-affiliated outlets and compounders located in nine states, including in Arizona, California, Maryland, New York, Pennsylvania, South Carolina, Washington, Wisconsin and Texas. There are no chain pharmacies on the list, although CVS and Walgreens say they plan to dispense the medication soon.

"While it's hopeful to see some brick-and-mortar pharmacies on this list, the large pharmacy chains are notably absent," said Amy Merrill, co-director of Plan C, which provides information on at-home abortion with pills. "Chain pharmacies could play a major part in expanding access, both because of their numerous locations and because they're the only ones with the resources to stand up to bullying by extremist politicians and their supporters."

When the FDA approved mifepristone in 2000, the agency blocked pharmacies from dispensing the medication, instead requiring doctors to give the medication directly to patients. In December of 2021, the FDA announced they would for the first time allow brick-and-mortar pharmacies to dispense mifepristone-if they were certified with the FDA. In the ensuing months, the FDA negotiated with pharmacy representatives, GenBioPro and Danco, maker of the brand name mifepristone, to develop a certification process.

Finally, in January of 2023, the FDA announced the new certification process for pharmacies to dispense mifepristone. CVS and Walgreens immediately announced they would apply for certification to dispense mifepristone.

In response, anti-abortion advocates staged boycotts at CVS and Walgreen pharmacies and 20 conservative state attorneys general threatened legal action against these companies if they dispensed mifepristone in their states. Then 23 attorneys general issued a statement supporting medication abortion at CVS and Walgreens stores.

CVS acknowledged their pharmacies were not currently dispensing mifepristone, but said they were working through the steps required for certification.

"Once certified, we plan to dispense mifepristone in states where legally permissible in the near future," Amy Thibault of CVS Pharmacy told Ms.

Walgreens will also soon dispense the medication. "We are in the last stages of finalizing certification, and once certified, we will dispense this medication consistent with federal and state laws," said Fraser Engerman, senior director of external relations at Walgreens.

In addition to listing pharmacies dispensing mifepristone, GenBioPro has updated their website to help prescribers, pharmacies and patients understand the new FDA rules on mifepristone and learn how to access abortion pills. The website has up-to-date information about how pharmacies can become certified to dispense mifepristone, and how medical professionals can become certified to prescribe mifepristone and dispense the medication directly to patients or through certified pharmacies. They also offer patient education and support resources in English and Spanish, with some resources available in additional languages, including Portuguese, Arabic, Chinese, Vietnamese, French, Haitian and Russian.

"We will continue to do everything in our power to ensure that these ... changes benefit as many people as possible and work toward truly universal access," said GenBioPro, noting that not everyone will have equal access because some states restrict abortion.

In addition to brick-and-mortar pharmacies, there are several mail-order companies dispensing mifepristone, including Honeybee Health and American Mail Order Pharmacy.

While many people prefer to receive abortion pills privately by mail, others may want to pick up the medications in person either because:

• they do not have a reliable or confidential mailing address,


• they cannot wait for the medication to arrive by mail because they are experiencing a miscarriage or health-threatening pregnancy, or


• they live in a state with an early gestational ban.

Advocates expressed frustration at how long it's taken for pharmacies to begin dispensing mifepristone.


"Mifepristone is the only medication that's seemingly regulated in a cultural manner: Can you imagine any other safe, common and essential medication being withheld from people who need it, even when they live right down the street from a pharmacy, and even after it's received long-overdue approval to be there?" said Merrill.


While pharmacy access to abortion pills slowly expands, the anti-abortion movement is trying to remove mifepristone from the market.


In November of 2021, anti-abortion doctors and a dentist filed a lawsuit, Alliance for Hippocratic Medicine v. FDA, asking an anti-abortion federal judge in Amarillo, Texas, to reverse the FDA's approval of mifepristone.


In April, the judge ruled the FDA improperly approved mifepristone in 2000 and stayed the approval-a ruling put on hold by the Supreme Court until it issues a final ruling in the case. On appeal, the Fifth Circuit Court of Appeals reversed in part, but still sharply restricted access to mifepristone nationwide. The Justice Department has appealed the decision to the Supreme Court.


"This is why Plan C is dedicated to researching and listing alternate routes of access on our website, so people know about their full range of options to get safe abortion pills in the US," said Merrill. The Plan C Guide to Pills provides information about how to obtain abortion pills in all 50 states, including through telemedicine, community support networks, and vetted websites selling abortion pills.


Meanwhile, if restrictions are put in place, clinicians are prepared to continue offering telehealth abortion with misoprostol alone.


"We all deserve better. And until our government, policymakers and industries can protect full rights and access, people will continue to need activist providers and community networks, and Plan C will continue to spread the word that these options exist," said Merrill.



Carrie Baker wrote this article for Ms. Magazine.



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The Missouri Legislature has approved a law to stop its Medicaid program, known as MO HealthNet, from paying Planned Parenthood for medical services for Medicaid patients.

The decision follows a court ruling which found not reimbursing Planned Parenthood through Medicaid goes against Missouri's constitution.

Emily Wales, president and CEO of Planned Parenthood Great Plains, said they have joined forces with Planned Parenthood St. Louis Region and Southwest Missouri and stand behind providing health care to those who need it. She argued the Legislature is causing confusion despite a clear decision from the highest court.

"Despite the court's repeatedly ruling that 'defunding' Planned Parenthood health centers is unconstitutional, lawmakers continue to deny critical care like birth control, cancer screenings, wellness exams and STI testing and treatment from the patients who need it," Wales stressed.

According to the Missouri Family Health Council, Planned Parenthood health centers serve nearly half of patients who rely on family planning safety net providers in the state. Planned Parenthood Great Plains and St. Louis Region Southwest Missouri will continue serving patients and is looking for alternative solutions for funding.

The new law also blocks Planned Parenthood from being a recognized provider in the state's Medicaid program. Wales pointed out it could hurt health care for people who rely on the safety net.

"There are not enough other providers in the health care safety-net system to absorb Planned Parenthood's patients," Wales pointed out. "At Planned Parenthood, we'll continue to do everything we can to serve our patients, no matter what."

Planned Parenthood Great Plains provides health care to more than 30,000 people in 13 health centers across Missouri, Arkansas, Kansas and Oklahoma. The St. Louis Region and Southwest Missouri chapter has been serving for more than 90 years.

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The U.S. Supreme Court is set to hear oral arguments today in a case about whether patients have access to emergency room abortions in states banning the procedure.

Idaho v. United States could determine if providers can perform medically necessary abortions for women experiencing complications under decades-old rules known as the Emergency Medical Treatment and Labor Act.

Dr. Polly Wiltz, a second-year emergency medicine resident at University Hospitals in Cleveland, said she is worried about her ability to care for patients who need abortions, if protections end.

"We are putting ourselves at risk for allowing legislators -- allowing people who do not have medical training -- to pick and choose which procedures, which life-stabilizing treatments and medications can and cannot be applied in the emergency department," Wiltz pointed out. "It's infringing on patient rights."

The Center for American Progress said pregnant patients with severe complications who are denied abortions could develop severe sepsis requiring limb amputation, uncontrollable uterine hemorrhage requiring hysterectomy, kidney failure requiring lifelong dialysis, hypoxic brain injury and other severe conditions.

Wiltz added most of the patients with pregnancy complications coming into the hospital lack access to routine OBGYN-related care.

"Regarding pregnancy related complaints, I see first trimester pregnant patients every single day," Wiltz noted. "In my shift, I have caught ectopic pregnancies that have ruptured."

Hospitals made up 33% of the facilities providing abortions in 2020, according to data from the Pew Research Center. Last fall, a majority of Ohio voters chose to approve a constitutional amendment, "Issue 1," establishing a statewide right to abortion and reproductive care in the aftermath of the Roe versus Wade decision.


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By Mary Anne Franks for Ms. Magazine.
Broadcast version by Alex Gonzalez for Northern Rockies News Service reporting for the Ms. Magazine-Public News Service Collaboration

People end up in emergency rooms for a variety of reasons. They’re having trouble breathing. They’ve suddenly developed chest pains. They’re bleeding uncontrollably. They’ve fallen off a roof, they’ve crashed their car, they’ve overdosed, they’re suicidal, they got stabbed in a fight, they got shot by police.

Some people who need emergency services are poor, or have no insurance, or are in the country illegally, or have committed a crime. Under the federal Emergency Medical Treatment and Labor Act (EMTALA), they are all entitled to receive emergency care. This law is based on a simple principle: Hospitals shouldn’t be allowed to let people die based on who they are, how much they can pay, or what they have done.

On April 24, the Supreme Court will hear oral arguments in Moyle v. U.S., a case that will determine whether individual states are allowed to exclude a single group from this basic protection: pregnant women. The state of Idaho claims that it has the right to forbid pregnant women and girls—and only pregnant women and girls—from receiving emergency care that could save their lives.

How, and why, would a state want to do this?

First, the how: In 2022, the Supreme Court ruled in Dobbs that forced childbirth does not violate the Constitution. This allowed Idaho’s 2020 “Defense of Life Act,” a draconian anti-abortion law, to go into effect. According to the law, anyone who performs an abortion faces imprisonment of up to five years in prison. Healthcare professionals who perform abortions will also have their professional licenses suspended or revoked permanently.

This puts the state law directly in conflict with federal emergency care law. EMTALA requires Medicare-funded hospitals (which most hospitals are) to provide medically necessary stabilizing treatment to any patient with an “emergency medical condition.” An emergency medical condition is one that, in the absence of immediate medical attention, is likely to cause “serious impairment to bodily functions,” “serious dysfunction of any bodily organ,” or otherwise puts the health of the patient “in serious jeopardy.”

Pregnancy complications are a common reason for emergency care visits, and the medically necessary stabilizing treatment necessary to prevent serious injury or death to women and girls experiencing those complications sometimes includes the termination of the pregnancy.

Given that an abortion is sometimes the only medical treatment that will prevent death or serious bodily injury to women, a more accurate title for Idaho’s abortion law would be the “Let Women Die Act.” But as seen in the majority decision in Dobbs and the arguments propounded recently by the Alliance Defending Freedom in the mifepristone access case, forced birth proponents are rarely candid about their necropolitical agenda. Defenders of Idaho’s law instead feign outrage at the suggestion that the law will kill women, pointing to the law’s exception for abortions performed by a physician who “determined, in his good faith medical judgment and based on the facts known to the physician at the time, that the abortion was necessary to prevent the death of the pregnant woman.”

Idaho insists that the law’s exception for abortions necessary to save the life of the mother means that there is no conflict between it and federal law. But as the Department of Justice pointed out when it sued to stop the Idaho law from being enforced with regard to EMTALA’s requirements, federal law requires emergency medical care necessary to prevent serious injury, not just death. The federal law does not authorize the withholding of essential medical treatment to patients who are only close to, but have not yet arrived, at death’s door.

What is more, as countless medical professionals have attested, the line between serious bodily injury or death is rarely precise. It is often difficult, if not impossible, to predict the exact moment that a serious medical condition becomes a life-threatening one.

As the National Women’s Law Center detailed in its amicus brief in the case, “No clinical bright line defines when a patient’s condition crosses the lines of this continuum. At what point does the condition of a pregnant woman with a uterine hemorrhage deteriorate from health-threatening to the point that an abortion is ‘necessary’ to prevent death? When is it certain she will die but for medical intervention? How many blood units does she have to lose? One? Two? Five? How fast does she have to be bleeding?”

The recognition that serious bodily injury and death are so closely related as to be nearly indistinguishable has long been reflected in U.S. law. At common law, a person could be convicted of murder not only if he intended to kill but also if he intended to inflict “grievous bodily injury.” The law of self-defense generally allows a person to use deadly force when facing an imminent threat of death or serious bodily harm, not only to herself but to others.

Significantly, Idaho’s self-defense law specifies that a person is not required to wait for the danger to become fully apparent before acting: “The defense of self or of another does not require a person to wait until he or she ascertains whether the danger is apparent or real. A person confronted with such danger has a clear right to act upon appearances such as would influence the action of a reasonable person.”

Unless, of course, the person in danger is a pregnant woman.


Mary Anne Franks wrote this article for Ms. Magazine.

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