What does possible overturn of Roe v. Wade mean for abortion pills in NC?

Fifty-nine percent of North Carolina abortions in 2020 were so-called medication abortions, which use a combination of the medications Mifepristone and Misoprostol. The procedure is legal at clinics across the country, including in North Carolina. But alternative sources, such as mail-order abortion drugs, are not legal in this state.

The Federal Drug Administration has approved the procedure. But many abortion opponents say medication abortions aren’t safe.

“People are really looking for information, preparing for what we anticipate will be really horrible access and looking for alternate sources of supply of the pills,” said Elisa Wells, co-founder of Plan C, a nonprofit that advocates for over-the-counter access to abortion pills. “And we know that's already something people are looking for right now in a lot of the states that don't allow telemedicine abortion, so we already have restrictions on access to care, both through clinics and especially through telemedicine.”

Plan C provides information about where people can buy abortion drugs online. It typically has about 2,300 visitors to its website per day, Wells said. The site had 56,000 visitors on Tuesday, a day after the leak of the draft opinion.

In North Carolina, women need to undergo a 72-hour consent phone call, followed by an appointment for pre-abortion blood and ultrasound testing, according to Dr. Katherine Farris, chief medical officer of Planned Parenthood South Atlantic. A doctor then administers the first medication, Mifepristone. The patient is then given the second medication, Misoprostol, with instructions on how to take the medication at home to complete the abortion.

The method works best in the first 10 weeks of pregnancy, which is when the vast majority of abortions happen.

Mifepristone blocks the activity of progesterone in the uterus and softens the cervix, so progression of the pregnancy stops and the embryo comes out more easily. Misoprostol makes the uterus contract to push out the embryo.

Family doctors can prescribe the drugs, but most can’t do it in their home clinics due to strict rules requiring that clinics have specific width requirements for hallways and doorways, Farris said. They also require that a nurse be on site.

“Most clinics, most private practices don’t meet those criteria,” she said.

Abortion Pills Stand to Become the Next Battleground in a Post-Roe America

Many of the rules, known as TRAP (Targeted Regulation of Abortion Providers) laws, are medically unnecessary, implemented many years ago to make it more difficult for abortion operators to operate, Farris said.

She said there are also requirements around ultrasound and requirements around blood testing for hemoglobin, which is for iron level and blood type.

The regulations mean that most family physicians in North Carolina cannot legally prescribe Mifepristone. The drug is not available in regular pharmacies.

Also, North Carolina doesn’t allow telehealth consultations for abortion.

“People should be aware that in half of the country, people are able to go online, have a consultation with a doctor or nurse practitioner or nurse midwife, and within about two or three days, get the pills, [U.S. Food and Drug Administration]-approved medications, mailed to them at their home so they can manage their abortion in the privacy and comfort of their own home,” Wells said. “And that modern medical care is not available to people in North Carolina right now. And it's because of politics. So people need to know that and be outraged by that.”

Farris said that if the ruling becomes law, she anticipates an influx of patients from states around the country planning abortion to several other states where abortion is still legal, including North Carolina and Virginia.

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