With Roe v. Wade at risk, Planned Parenthood of Illinois makes abortion pills available by mail for state residents

With the U.S. Supreme Court poised to overturn Roe v. Wade, Planned Parenthood of Illinoissaid Monday it has begun offering abortion pills by mail for state residents who qualify.

The agency said the relatively new means of abortion access will break down “unnecessary barriers to health care” and also expand access to underserved parts of the state.

“Now more than ever it’s crucial that our patients can access the care they need, when and where they need it,” Dr. Amy Whitaker, chief medical officer for the agency, said in a news release.

The U.S. Food and Drug Administration in December eased long-standing medication abortion regulations, allowing abortion pills to be to be distributed through the mail in certain states, including Illinois.

Planned Parenthood of Illinois providers have been prescribing medication abortions through telehealth visits since 2021, according to the news release, but the patient still had to visit a clinic to pick up the prescription, per FDA rules.

Now that the regulations have been rolled back, Illinois patients who qualify for a medication abortion have since April been able to have the pills mailed to their in-state address, in many cases eliminating the need to ever visit a brick-and-mortar facility, Planned Parenthood of Illinois said Monday.

Patients still need a prescription for the pills, which can be provided through a telehealth visit. Medication abortion is generally used in early pregnancy, typically up until 11 weeks gestation.

Planned Parenthood of Illinois said the new program will help “expand capacity for patients who still require in-person services and for those who are forced to travel here from other states.”

Patients from other states can still access abortion pills, but they must travel to Illinois to have the telehealth or in-person visit, and then pick up the medication at a clinic in Illinois, according to Planned Parenthood of Illinois.

Medication abortions now comprise more than half of all terminated pregnancies in the United States, according to the Guttmacher Institute, a research group that supports reproductive rights. But the majority of states have restrictions on abortion pills.

In 19 states, the provider has to be physically present when the medication is administered, barring the use of telehealth services. Some states have introduced legislation this year that would ban the use of medication abortions or the mailing of pills, according to the Guttmacher Institute.

Illinois has none of these restrictions.

In an interview late last year, Eric Scheidler, executive director of the Chicago-based Pro-Life Action League, lamented the FDA’s policy reversal, saying the “policy change is tragic, because it leads to more abortion.”

“Illinois has embraced a new identity as the abortion capital of the Midwest, especially as the landscape is changing in other states,” he said. “I expect to see Illinois become a major source for abortion pills for the entire region, both legally and clandestinely. Unfortunately, neither the public nor policymakers will be able to say with any confidence where those abortion pills really wind up.”

Earlier this month, a leaked draft opinion indicated the Supreme Court planned to overturn federal abortion rights. For nearly a half-century, the landmark Supreme Court case Roe v. Wade has established the right to terminate a pregnancy nationwide.

Without Roe, the matter of abortion rights would be left to individual states; reproductive rights experts predict roughly half of the nation would severely restrict or ban abortion, including almost the entire Midwest.

Illinois has long been considered a haven for abortion access, with strong reproductive rights protections. The number of patients traveling from other states to Illinois has increased every year since 2014, with nearly 10,000 out-of-state patients in 2020, according to the most recent available data from the Illinois Department of Public Health.

If federal abortion rights are overturned, Planned Parenthood of Illinois has estimated that an additional 20,000 to 30,000 out-of-state patients will be traveling here to terminate a pregnancy each year.

Medication abortions have been available in the United States since 2000.

The process includes taking two medications: First the patient takes mifepristone, which blocks the hormone progesterone and stops the pregnancy.

The FDA had long mandated that the first pill had to be dispensed at a hospital, clinic or medical office.

About a day or two later, the patient takes the second medication, misoprostol, which spurs cramping and bleeding to empty the uterus. This pill is typically taken by the patient at home.

But in May 2020, at the height of COVID-19 pandemic restrictions, the American College of Obstetricians and Gynecologists and other organizations filed a federal lawsuit challenging the FDA’s requirements for mifepristone, partly due to an urgent need to avoid unnecessary travel and exposure to the virus.

The FDA was court-ordered to ease the regulations over the following summer, but the administration of President Donald Trump challenged the reversal and the Supreme Court reinstated the regulations.

In April 2021, the FDA announced that it temporarily would not enforce the restrictions and allow abortion pills to be mailed during the pandemic, citing the unprecedented need for abortion access.

The federal agency permanently lifted those restrictions in December, paving the way for programs like the one Planned Parenthood of Illinois has launched.

“There are over 20 years of data demonstrating the safety and effectiveness of medication abortion using mifepristone,” Whitaker said in the news release. “Not only is this a safe method, but it also increases access to care, especially for people of color, people living in rural areas and people with low incomes who already face barriers to care.”

In southern Illinois, another Planned Parenthood affiliate began offering mail-order medication abortion and telehealth services in July 2020.

“We really strongly feel folks should have the abortion experience that they want, and that can mean a number of different things,” Dr. Colleen McNicholas, chief medical officer for reproductive health services of Planned Parenthood of the St. Louis Region, told the Tribune at the time.

A clinician verifies that the patient is in Illinois during the telehealth visit and the medication is shipped to an Illinois address, she said. A health screening checks for any medical issues the patient might have as well as how far along the pregnancy is at that point, to ensure the patient qualifies for a medication abortion, she added.

“People really like getting their health care through telehealth,” she told the Tribune in December. “Whether it’s a visit with their cardiologist or their abortion visit, if they can take it from their couch, many folks just really prefer the comfort and the ease of that visit in their own space.”

eleventis@chicagotribune.com