Finally, a small glimmer of good news for women: The ACLU is working to make the abortion pill more accessible across the country. On Tuesday, the organization filed a federal lawsuit to make Mifeprex available by prescription in retail pharmacies, arguing that the FDA’s current restrictions against offering it there mean that women are delayed—or prevented altogether—from obtaining their legal right to abortion.
It’s an important case, but I’d like to see pro-choice advocates go even further: Make the abortion pill available over the counter. In the same way you can go buy condoms or emergency contraception at your local pharmacy, you should be able to purchase medication to end an early pregnancy.
The abortion pill can be used up to 10 weeks and has been proven safe and effective; there’s no scientific or medical reason to keep it out of women’s hands—just political ones. Abortion is legal and safe. It’s high time that women were able to access it without ideological hurdles.
We all know that it’s not a good time for women’s reproductive rights in general. The Trump administration is throwing its weight behind the GOP’s 20 week abortion-ban, they support employers who don’t want their insurance to cover birth control, and the state-level attacks on reproductive health care are worse than ever before: Nearly 30 percent of all post-Roe v. Wade abortion restrictions have been proposed just since 2010.
It’s easy to fall back into a defensive crouch. And it’s true that American women need to hold onto the ground we already have. But to fight back the anti-women climate and the policies that legitimize it, we also need to think big about what comes next for abortion rights.
Having over-the-counter abortion medication would be revolutionary for American women.
Millions of women in the U.S. have used the abortion pill to end their early pregnancies, and the American College of Obstetricians and Gynecologists already supports making the pill available at pharmacies with a prescription. That’s part of why the ACLU filed suit—their case is on behalf of a Hawaiian doctor who says he can’t give his patients the care they need because of onerous FDA restrictions that require women to fill the prescription for the medication at a healthcare facility instead of a pharmacy. That means women who don’t live close to an approved facility have to travel long distances—in this doctor’s case his patients need to make a 300 mile round trip flight—to access the drug.
Some experts say that the abortion pill actually meets the FDA’s criteria not just for availability by prescription, but for over-the-counter sale. In an article that Daniel Grossman, M.D. wrote for The Guardian on his research, he says, “From a purely medical perspective, it no longer makes sense to demonize women’s safe use of abortion medications at home.” Another study this year found that using the medication at home is just as safe as getting the pill from a clinic.
Women want this. In response to increasing abortion restrictions—and because some women would simply prefer to end their pregnancies at home without medical intervention—a large number of people are obtaining abortion pills illegally. In the same way women are increasingly eager to look for non-invasive ways to give birth or treat themselves without the help of doctors, it makes sense that women would prefer to have safe abortions at home.
Over-the-counter access to the abortion pill might be a pipe dream—or at the very least, years away. But if we want to help women access the care they need in the easiest and most comfortable way possible, this has to be something that pro-choice groups and advocates start to think seriously about. Fighting for reproductive justice and health needs to be a forward-thinking project. Our mission can’t just be playing defense—that's not how to win.