Medication abortion remains legal and available in Illinois, despite a recent U.S. appellate court decision that put tighter rules on the drug.
Abortion providers across the state — a haven for abortion services — say they will continue to offer the two-pill combination of mifepristone and misoprostol, which are typically taken up to 48 hours apart to end a pregnancy.
“PPIL will continue to offer all abortion-care options available because everyone should have the ability to make a decision that is best for their bodies, their lives and their futures,” Jennifer Welch, CEO of Planned Parenthood of Illinois, said in a statement.
Reproductive Health Services of Planned Parenthood of the St. Louis region, which has a clinic in Illinois across the border in Fairview Heights, echoed the sentiment.
“As has been true throughout the history of this affiliate, in the face of attacks, we will do all we can to ensure patients get the care they want, need, and are entitled to,” the organization’s chief medical officer, Dr. Colleen McNicholas, said in a statement.
She added that Planned Parenthood has secured additional long-term supply of mifepristone.
The whiplash of the last week has been the latest legal quandary since Roe v. Wade was overturned last year in June. A federal judge in Texas issued a ruling that would invalidate the Food and Drug Administration’s longtime approval of mifepristone.
Then late Wednesday, a federal appeals court set up new restrictions for the drug but allowed it to remain approved. Now the drug can’t be sent through the mail and can only be used in abortions up to seven weeks, instead of previously through 10 weeks.
In a statement, Eric Scheidler, executive director of the anti-abortion group Pro-Life Action League, applauded the appellate court’s decision.
In a separate lawsuit in Washington, a judge ruled the FDA could not change its approval of mifepristone. The FDA approved the drug more than 20 years ago. Illinois was one of more than a dozen states to sue to preserve access to the drug. This is the guidance that many abortion providers across Illinois are using to keep using mifepristone.
Katie Watson, an attorney and a bioethicist at Northwestern University’s Feinberg School of Medicine, said the judges in Texas and Washington have equal authority.
For the FDA, “… their hands are tied,” Watson said. “It’s not at all unreasonable to try to follow both (judges’ decisions).”
She added that Illinois providers are likely confident in still offering the mifepristone-misoprostol combination because state law shields providers from getting served subpoenas from other states or from getting extradited for providing reproductive health care.
Planned Parenthood of Illinois also will continue to offer the two-pill medication through the mail, said Kristen Schultz, chief strategy and operations officer. Currently the organization offers medication abortion in all 16 clinics that are open (one in Peoria was firebombed and is currently closed).
How Illinois abortion providers are preparing for more restrictions
Medication abortions are the most common type of the procedure in Illinois, state public health data shows, and they account for the majority of abortions across the U.S., according to the Guttmacher Institute, which supports abortion rights.
The confusion over the latest legal actions might send even more patients to Illinois, which has become more significant for providing abortion services since the U.S. Supreme Court struck down Roe.
Illinois clinics are making backup plans should mifepristone eventually be restricted. This includes preparing to treat more patients who want a procedure in a clinic, or to take misoprostol only. The latter means patients who are traveling from out of state would need to stay longer, perhaps needing a hotel room or child care covered.
That’s because in the mifepristone-misoprostol combination, the first pill is considered the abortion pill. It causes the pregnancy to end, while misoprostol helps pass the pregnancy. The medication can be taken in a doctor’s office or at home in a state where abortion is legal.
But if patients take misoprostol only, this pill is considered the abortion pill, and the regimen involves taking pills every three to four hours. That means patients would need to stay in Illinois, or leave and travel to a state where abortion is legal, to complete the procedure.
Schultz said Planned Parenthood of Illinois is looking to add appointment times for procedural abortions inside clinics to increase access, and to ensure there is enough staff to do so. At the same time, while the organization is not stockpiling misoprostol, it is keeping an eye on supply.
Dr. Allison Cowett, medical director of Family Planning Associates, a reproductive health clinic that provides abortions in Chicago’s West Loop neighborhood, said she’s offering the two-drug combination as long as she can. She points out that taking only misoprostol is less effective at ending pregnancies — at least 80% effective compared to the high 90s for the two-drug combo — and has significantly stronger side effects, such as nausea, vomiting and diarrhea, than giving mifepristone and misoprostol together.
She said her clinic has enough space and staff should more patients opt for in-person procedures, especially for patients who travel from other states and don’t want to risk a medication abortion not working. With the appellate court restricting mifepristone for use up to seven weeks from 10 weeks, Cowett said this three-week window is critical for getting an appointment and then making plans to get the abortion, from transportation to child care.
“The difference between seven and 10 weeks is often the difference between whether someone is going to have a baby or have an abortion,” Cowett said.
Megan Jeyifo, executive director of the Chicago Abortion Fund, is preparing to need to provide more hotel stays, plane tickets, gas and child care, among other things needed for patients traveling to Illinois for the procedure. The fund has already pledged to spend more than $1 million this year.
“If we assume 50% of the people we support are potentially going to move to this miso-only protocol, it not only means not only more dollars, it means more actual counseling support, logistical support,” Jeyifo said.
Jeyifo said her organization is supporting more than 200 people a week.
“How can we continue to make sure that we have not only the financial resources to actually pay for those items, but also the people power to continue to be able to support people through what comes next?” Jeyifo said. “And we don’t know how long this could potentially last either.”
She adds that more people who call the fund asking for financial help are traveling to Illinois for procedural abortions, not wanting to risk that ending a pregnancy through medication doesn’t always work.
Kristen Schorsch covers public health and Cook County government for WBEZ. Follow her @kschorsch.