Emergency contraception pill could be an alternative to mifepristone for abortions, study suggests
IN AMERICA HAD A FEDERALLY PROTECTED RIGHT TO ABORTION. WELL, NOW, TWO YEARS AFTER THE DOBBS DECISION, MORE THAN HALF OF ALL WOMEN ABOUT 33 MILLION LIVE IN STATES WHERE ABORTION IS EITHER BANNED OR LIMITED. REPRODUCTIVE RIGHTS AND LAW WILL CONTINUE TO EVOLVE, INCLUDING UNDER THE INCOMING TRUMP ADMINISTRATION. KIMBERLY MUTCHERSON IS A PROFESSOR AT RUTGERS LAW SCHOOL, VISITING AT TEMPLE LAW SCHOOL, AND IS AN EXPERT IN REPRODUCTIVE JUSTICE AND LAW. IT’S SO NICE TO HAVE YOU IN STUDIO. THANK YOU FOR TALKING WITH ME. THANK YOU. SENTIMENT AROUND PUBLIC SUPPORT FOR ABORTION RIGHTS HAS INCREASED YEAR AFTER YEAR, INCREASING EVEN AS THOSE RIGHTS HAVE FALLEN DROPPED. I FIND THAT VERY CONTRADICTORY. I’M NOT SURE THAT IT’S TOTALLY CONTRADICTORY. IT’S TRUE THAT PEOPLE WILL PROTECT ABORTION RIGHTS, BUT OFTEN ONLY TO A PARTICULAR DEGREE. AND I THINK THAT’S A LOT OF WHAT WE’RE SEEING NOW. SO EVEN IN STATES WHERE THERE WERE THESE BALLOT INITIATIVES THAT SAID WE’RE GOING TO PROTECT ABORTION RIGHTS IN OUR STATE, THOSE STILL HAD LIMITATIONS TO THEM. SOME OF THOSE STATES THEN VOTED FOR DONALD TRUMP, WHO’S BEEN PRETTY EXPLICIT ABOUT WHAT HE’S THINKING ABOUT DOING AN ABORTION. RIGHT? THAT’S RIGHT. WHAT THEY’RE NOT RECOGNIZING IS THAT IF THE FEDERAL GOVERNMENT STEPS IN, OR IF CONGRESS STEPS IN AND DECIDES TO BAN ABORTION ACROSS THE COUNTRY, IT’S NOT GOING TO MATTER THAT YOU HAVE A CONSTITUTIONAL AMENDMENT IN YOUR STATE CONSTITUTION THAT PROTECTS ABORTION RIGHTS. FEDERAL LAW WILL TRUMP THAT. WHAT DO YOU EXPECT WILL BE THE CHANGES UNDER A NEW ADMINISTRATION DURING THE PRESIDENTIAL CAMPAIGN, PRESIDENT ELECT TRUMP SAID MANY TIMES, YOU KNOW, I’M NOT AN ARCHITECT OF PROJECT 2025, AND YET WE’RE WATCHING HIM START TO SORT OF FILL HIS LEADERSHIP ROLES WITH PEOPLE WHO WERE ARCHITECTS OF PROJECT 2025 AND PROJECT 2025 HAS A LOT TO SAY ABOUT ABORTION, SO IT HAS A LOT TO SAY ABOUT PEOPLE WHO ARE LOW INCOME, HAVING ACCESS TO MEDICAID FUNDS FOR ABORTION. I IMAGINE THAT THEY’RE GOING TO DO AS MUCH AS THEY CAN TO KEEP STATES FROM USING MEDICAID DOLLARS, WHICH OF COURSE IMPACTS LOW INCOME WOMEN AND THEIR ACCESS TO ABORTION CARE. THEY’RE GOING TO RE-IMPLEMENT WHAT WE CALL THE DOMESTIC GAG RULE, WHICH BASICALLY SAYS, IF YOU RECEIVE TITLE TEN FUNDING, WHICH IS FEDERAL FUNDING FOR FOR PURPOSES OF FAMILY PLANNING, YOU CAN NO LONGER REFER PEOPLE TO ABORTIONS. WE’RE GOING TO SEE CHANGES IN SEX EDUCATION. HOW THE FEDERAL GOVERNMENT DOES OR DOES NOT PROTECT ABORTION IN COURTS. SO, FOR INSTANCE, WE HAVE THE EMTALA CASE, AND THAT BASICALLY SAYS THE FEDS CAN OVERRIDE WHAT’S HAPPENING STATE WISE IF THE MOTHER’S LIFE IS IN DANGER, THEN DOCTORS CAN PERFORM AN ABORTION TO SAVE THE MOTHER’S LIFE. EXACTLY. AND THE FEDERAL GOVERNMENT TOOK THE POSITION THAT IF AN ABORTION IS WHAT SOMEBODY NEEDS TO BE STABILIZED IN AN EMERGENCY, THEN STATE LAWS THAT SAY ABORTION ISN’T ALLOWED, THOSE ARE GOING TO CANNOT BE ENFORCED IN THOSE CIRCUMSTANCES. NOW, THE TRUMP ADMINISTRATION IS NO LONGER GOING TO TAKE THE POSITION THAT EMTALA SHOULD OVERRIDE STATE LAW. SO WE’RE NOT GOING TO SEE THAT ANYMORE AS WELL. AND LOTS AND LOTS OF CHANGES AROUND ACCESS TO MEDICATION, ABORTION. WELL, LET’S TALK A LITTLE BIT ABOUT THAT. THE NUMBER OF PEOPLE WHO GET A MEDICATION ABORTION IS ACTUALLY MUCH HIGHER THAN I WOULD HAVE GUESSED. IT’S SOMETHING LIKE 63%. THAT’S RIGHT. AND MEDICATION ABORTION IS ONLY AVAILABLE REALLY IN THIS COUNTRY. IT’S ONLY AVAILABLE IN THE FIRST TRIMESTER. AND IT’S ACTUALLY TWO MEDICATIONS. IT’S ONE CALLED MIFEPRISTONE AND A SECOND ONE CALLED MISOPROSTOL. AND THERE WAS AN ATTEMPT TO GET MIFEPRISTONE, THAT FIRST DRUG TAKEN OFF OF THE MARKET THROUGH A LAWSUIT. AND THE PEOPLE WHO FILED THAT LAWSUIT WERE NOT ABLE TO BE SUCCESSFUL. NOW, YOU DON’T NEED A LAWSUIT. RIGHT NOW. YOU HAVE THE FDA, AND YOU CAN JUST SAY, EITHER WE NEVER SHOULD HAVE APPROVED THIS, AND WE’RE GOING TO PULL IT OFF THE MARKET, OR YOU CAN REINSTATE SOME REALLY ONEROUS REQUIREMENTS THAT USED TO EXIST FOR ACCESS TO MEDICATION AND ABORTION. DO YOU THINK THE NEXT STEP IS MOVING INTO BIRTH CONTROL? ABSOLUTELY. THERE ARE A NUMBER OF PEOPLE, WHETHER BECAUSE OF THEIR FAITH OR JUST THEIR BELIEFS ABOUT ABORTION, WHO BELIEVE THAT CERTAIN TYPES OF CONTRACEPTION, IUDS OR PLAN B ARE IN FACT CREATING ABORTIONS. IF YOU HAVE THE POWER TO DEFINE WHAT AN ABORTION IS, THEN YOU ALSO HAVE THE POWER TO KEEP PEOPLE FROM ACCESSING THOSE THINGS AS WELL. KIMBERLY MUTCHERSON IS A PROFESSOR AT TEMPLE UNIVERSITY SCHOOL OF LAW AND ALSO AT RUTGERS SCHOOL OF LAW. THANK YOU SO MU
Emergency contraception pill could be an alternative to mifepristone for abortions, study suggests
A new study suggests that a pill used for emergency contraception could be repurposed at a higher dose as an abortion drug, providing a possible alternative to mifepristone, one of the two drugs used in the most common type of abortion in the United States.Related video above: What’s Next for Abortion Law?Mifepristone has been under attack by abortion opponents, with several states seeking in federal court to restrict its use. Now used in two-thirds of U.S. abortions, mifepristone blocks a hormone needed to sustain a pregnancy. It's typically used with misoprostol, which causes contractions and bleeding.In the study, 133 women who were up to nine weeks pregnant took a 60-milligram dose of ulipristal acetate, the active ingredient in the prescription contraceptive Ella, followed by misoprostol 24 hours later.For 97% of them, that drug combo was effective at inducing an abortion, an effectiveness equal to the mifepristone-misoprostol combination. Four women needed a procedure or an additional medication to complete the abortion.The 60-milligram dose of ulipristal used in the study is twice the dose of Ella, a prescription drug used for emergency contraception. The company that makes Ella says on its website that it won't end an existing pregnancy. It can be taken up to five days after unprotected sex to prevent pregnancy.The findings, published Thursday in the journal NEJM Evidence, may make emergency contraception a target of abortion opponents."I'm really worried that these results could be misapplied by anti-abortion activists to try to further their assault on contraception," said Dr. Daniel Grossman of the University of California, San Francisco, who wrote an accompanying editorial in the journal. Grossman praised the study but said more research is needed on ulipristal as an abortion drug before doctors would prescribe it routinely for that use.Lead author Dr. Beverly Winikoff, president of Gynuity Health Projects, a not-for-profit research group, said women need information about ulipristal, especially with mifepristone challenged in court. "At least now we would have an alternative," Winikoff said. "I think it's better to have more things that you could use."
A new study suggests that a pill used for emergency contraception could be repurposed at a higher dose as an abortion drug, providing a possible alternative to mifepristone, one of the two drugs used in the most common type of abortion in the United States.
Related video above: What’s Next for Abortion Law?
Mifepristone has been under attack by abortion opponents, with several states seeking in federal court to restrict its use.
Now used in two-thirds of U.S. abortions, mifepristone blocks a hormone needed to sustain a pregnancy. It's typically used with misoprostol, which causes contractions and bleeding.
In the study, 133 women who were up to nine weeks pregnant took a 60-milligram dose of ulipristal acetate, the active ingredient in the prescription contraceptive Ella, followed by misoprostol 24 hours later.
For 97% of them, that drug combo was effective at inducing an abortion, an effectiveness equal to the mifepristone-misoprostol combination. Four women needed a procedure or an additional medication to complete the abortion.
The 60-milligram dose of ulipristal used in the study is twice the dose of Ella, a prescription drug used for emergency contraception.
The company that makes Ella says on its website that it won't end an existing pregnancy. It can be taken up to five days after unprotected sex to prevent pregnancy.
The findings, published Thursday in the journal NEJM Evidence, may make emergency contraception a target of abortion opponents.
"I'm really worried that these results could be misapplied by anti-abortion activists to try to further their assault on contraception," said Dr. Daniel Grossman of the University of California, San Francisco, who wrote an accompanying editorial in the journal. Grossman praised the study but said more research is needed on ulipristal as an abortion drug before doctors would prescribe it routinely for that use.
Lead author Dr. Beverly Winikoff, president of Gynuity Health Projects, a not-for-profit research group, said women need information about ulipristal, especially with mifepristone challenged in court.
"At least now we would have an alternative," Winikoff said. "I think it's better to have more things that you could use."