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Judge Blocks Rule for In-Person Doctor Visits to Get Abortion Pill in Pandemic

A federal judge in Maryland Monday ruled that women seeking an abortion pill do not need to visit a clinic, hospital or medical office in person to obtain the medication during the Covid-19 pandemic.

SILVER SPRING, Md. (CN) — A federal judge in Maryland ruled Monday that women seeking an abortion pill do not need to visit a clinic, hospital or medical office in person to obtain the medication during the Covid-19 pandemic.

U.S. District Judge Theodore Chuang’s 80-page opinion granted a preliminary injunction allowing mifepristone and the accompanying drug misoprostol — oral medications that allow women to manage a miscarriage or end an early pregnancy — to be mailed to patients during the global outbreak of novel coronavirus. 

Currently, patients are required to receive a consultation on the drug’s effects at a medical facility and must sign a form noting risks and other information before receiving a single pill.

Chuang wrote the in-person requirements alone constitute irreparable harm to a myriad of challengers, including the American College of Obstetricians and Gynecologists, the New York State Academy of Family Physicians and the Council of University Chairs of Obstetrics and Gynecology. The groups challenged the Food and Drug Administration and Department of Health and Human Services requirement in May.

“Specifically … In-Person requirements, combined with the Covid-19 pandemic, place a substantial obstacle in the path of women seeking a medication abortion and that may delay or preclude a medication abortion and thus may necessitate a more invasive procedure,” Chuang wrote. “Particularly in light of the limited timeframe during which a medication abortion or any abortion must occur, such infringement on the right to an abortion would constitute irreparable harm.”

The federal government has already issued waivers dealing with other drug-dispensing requirements, Chuang wrote, acknowledging, “during the pandemic, medical visits present substantial challenges to any patient.”

Additionally, HHS has advanced the use of telemedicine during the pandemic, with Secretary Alex Azar announcing a “historic expansion of telehealth access” to combat Covid-19 in March, Chuang wrote. The Centers for Disease Control and Prevention also issued guidance outlining that telemedicine was the best way to protect patients and staff from the virus.

A disproportionate number of abortion patients are from demographic groups that have been hit especially hard by Covid-19. They face additional barriers in childcare, transportation and an economic downturn during the global pandemic. Sixty percent of woman seeking abortion care are minorities and 75% are poor or low-income. 

“Although the need to counsel patients is an important interest, the evidence in the record supports the conclusion that with personal counseling now occurring through telemedicine, the requirement is not actually necessary to meet this interest,” Chuang wrote.

Dr. Heather Paladine, a practicing physician at a community health center in New York City and assistant professor of medicine at Columbia University Medical Center, testified many medical offices and clinics have reduced staff so greatly that in-person appointments have ceased or been delayed.

“For example, her own clinic closed entirely to in-person visits, then reopened operating at only 10 percent capacity. She estimates that it will operate at 25 percent capacity through Spring 2021,” Chuang wrote.

Indiana, Louisiana, Alabama, Arkansas and six other states argued a decision in the case could affect how they enforce state laws related to mifepristone and misoprostol, but Chuang denied their attempt to intervene in the suit last month. 

The judge did not apply a geographical limitation to the injunction. 

More than 4 million people in the U.S. have used the drugs to end an early pregnancy and the method made up 39% of all the nation’s abortions in 2017.

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