Retail pharmacies may now dispense abortion pills but not in Arizona

Arizonans will not be affected by a federal rule change that's increasing access to abortion pills by allowing brick-and-mortar retail pharmacies to dispense them.

A U.S. Food and Drug Administration rule change, announced via its website and first reported by the New York Times on Jan. 3, was welcomed by abortion rights advocates as a step forward in creating more access to abortion care. The rule change was immediately criticized by anti-abortion groups, who are organizing protests outside of CVS and Walgreens stores in eight cities next month, Politico reported Jan. 11. But it won't matter in Arizona.

"Unfortunately for us, it's not going to help us anytime soon," said Eloisa Lopez, executive director of the Abortion Fund of Arizona and Pro-Choice Arizona.

The rule change will allow some Americans to obtain medication abortions from a retail pharmacy in person or by mail without needing to go into an abortion clinic, as long as they have a prescription from a health care provider.

Arizonans won't be able to take advantage of the rule change because of the state's restrictive abortion access laws.

Those laws include mandatory in-person counseling, followed by a 24-hour waiting period and then another office visit to obtain either a surgical or a medication abortion, providers here say. Arizona also prohibits the use of telemedicine for medication abortions.

"I do think it's important to acknowledge that this is a big deal and that this a step in the right direction, with the FDA lifting some of the really burdensome requirements," said Brittany Fonteno, president and CEO of Planned Parenthood Arizona, of the federal rule change.

The FDA rule change won't be of any benefit "in a hostile state to abortion rights like Arizona," Fonteno said.

Officials with the conservative-leaning Center for Arizona Policy, supporters of Arizona's restrictive abortion laws, on Friday said that it's "reckless and dangerous" for retail pharmacies to dispense abortion pills.

Group spokesperson Cindy Dahlgren wrote in an email to The Arizona Republic that abortion pills leave women to face the physical and emotional risks of a medication abortion alone, "and there are a host of financial reasons the abortion industry doesn't care if they do."

The Center for Arizona Policy is a political advocacy group that says its mission is "to promote and defend the foundational values of life, marriage and family, and religious freedom." The group has long held that abortion is not health care because "it ends a life."

More than half of U.S. abortions are 'medication abortions' that require only pills

More than half of abortions in both the U.S. and Arizona are what are known as medication abortions, sometimes referred to as abortion pills ― a two-drug combination recommended for use up to 10 weeks of pregnancy.

"Medication abortion is really safe, it's really effective and it's actually the choice of abortion that most people in Arizona and across the country decide to go with," Fonteno said. "However, in Arizona, we have several laws on the books that are designed to create barriers to abortion, whether it's surgical abortion or the abortion pill. This FDA guidance doesn't supersede state laws."

The two drugs used in a medication abortion are mifepristone and misoprostol. Arizona law requires that mifepristone be administered in person by a physician, said Dr. DeShawn Taylor, an obstetrician/gynecologist who is owner and founder of Desert Star Family Planning in Phoenix, which provides abortion care.

Advanced practice clinicians at one time were allowed to administer mifepristone in Arizona, but the laws here have become increasingly restrictive, she added.

"Unfortunately because of that law, Arizonans have not been able to benefit from all these lifting of restrictions of how people can get access to mifepristone," Taylor said. "All the regulation around the abortion pill is related to the mifepristone."

Fonteno said the FDA rule change ultimately could be positive for Arizona by helping to destigmatize abortion care.

"A potential impact this could have in Arizona is we are moving in a direction where we are seeing that people are supportive of abortion rights and access," Fonteno said. "Hopefully when they see this (increased access) happening in neighboring states, they would want to push their representatives to put forth legislation that would be supportive of a more open environment for abortion access."

Planned Parenthood Arizona on Friday said it will be requesting that Gov. Katie Hobbs take several actions on abortion and reproductive care in the state, including providing a multilingual education website and hotline that offer “know your rights” guidance and referrals for Arizonans seeking abortions and providing civil and criminal protections for patients seeking abortion care and people who assist with the provision of abortion care.

Reproductive rights advocates like Planned Parenthood say that abortion is better for overall population health and an essential part of comprehensive health care. The people who suffer most from abortion restrictions are underserved communities, including minorities and people with low incomes, abortion rights advocates say.

'A positive development at the end of a crushing year for abortion care'

The American College of Obstetricians and Gynecologists says medication abortions are a "safe and effective method" of providing an abortion. The group has long advocated that mifepristone be made available in retail pharmacies "just like other prescription drugs, to allow more patients access to abortion care without clinically unnecessary hurdles."

Codifying the FDA rule change on mifepristone is "a positive development at the end of a crushing year for abortion care," a Jan. 3 statement from the organization says.

After the U.S. Supreme Court on June 24 reversed Roe v. Wade, the landmark 1973 opinion that protected an individual's right to obtain an abortion, there was increased interest in abortion pills and how to obtain them.

"We know the risk is not medical. It's legal," Lopez said. "The more bans we see, the more restrictions, the tighter the reins get on abortions, the more likely people are turning to order pills by mail."

Arizona has a law that says a "manufacturer, supplier or physician or any other person is prohibited from providing an abortion-inducing drug via courier, delivery or mail service," though the law doesn't say anything about whether it's legal for a person to receive the drugs in the mail.

Plan C, a U.S.-based information campaign about medication abortions, says that while abortion pills are prescription medications in the U.S., it is possible to get them from some places without a prescription. Plan C is referring patients to a free, confidential Repro Legal Helpline at 844-868-2812.

Providers from outside the U.S. will ship abortion pills to U.S. residents. Those include Aid Access, operated by a Dutch physician, and Women on Web, which is based in the U.K.

Reach health care reporter Stephanie Innes at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes.