By Carrie Baker for Ms. Magazine.
Broadcast version by Roz Brown for Texas News Service reporting for the Ms. Magazine-Public News Service Collaboration

Earlier this month, the pharmaceutical company GenBioPro announced the names of 18 brick-and-mortar pharmacies that are now dispensing the abortion pill mifepristone. They are the first pharmacies to publicly acknowledge doing so after the FDA in late 2021 finally loosened medically unnecessary restrictions on mifepristone that blocked pharmacy distribution for decades.

"At GenBioPro, we firmly believe everyone has a right to access evidence-based health care and safe and effective medicines, and that includes medical abortion," said Evan Masingill, CEO of GenBioPro, which successfully obtained FDA approval in 2019 for the first generic mifepristone tablet.

The pharmacies listed on their website include independent community drugstores, university-affiliated outlets and compounders located in nine states, including in Arizona, California, Maryland, New York, Pennsylvania, South Carolina, Washington, Wisconsin and Texas. There are no chain pharmacies on the list, although CVS and Walgreens say they plan to dispense the medication soon.

"While it's hopeful to see some brick-and-mortar pharmacies on this list, the large pharmacy chains are notably absent," said Amy Merrill, co-director of Plan C, which provides information on at-home abortion with pills. "Chain pharmacies could play a major part in expanding access, both because of their numerous locations and because they're the only ones with the resources to stand up to bullying by extremist politicians and their supporters."

When the FDA approved mifepristone in 2000, the agency blocked pharmacies from dispensing the medication, instead requiring doctors to give the medication directly to patients. In December of 2021, the FDA announced they would for the first time allow brick-and-mortar pharmacies to dispense mifepristone-if they were certified with the FDA. In the ensuing months, the FDA negotiated with pharmacy representatives, GenBioPro and Danco, maker of the brand name mifepristone, to develop a certification process.

Finally, in January of 2023, the FDA announced the new certification process for pharmacies to dispense mifepristone. CVS and Walgreens immediately announced they would apply for certification to dispense mifepristone.

In response, anti-abortion advocates staged boycotts at CVS and Walgreen pharmacies and 20 conservative state attorneys general threatened legal action against these companies if they dispensed mifepristone in their states. Then 23 attorneys general issued a statement supporting medication abortion at CVS and Walgreens stores.

CVS acknowledged their pharmacies were not currently dispensing mifepristone, but said they were working through the steps required for certification.

"Once certified, we plan to dispense mifepristone in states where legally permissible in the near future," Amy Thibault of CVS Pharmacy told Ms.

Walgreens will also soon dispense the medication. "We are in the last stages of finalizing certification, and once certified, we will dispense this medication consistent with federal and state laws," said Fraser Engerman, senior director of external relations at Walgreens.

In addition to listing pharmacies dispensing mifepristone, GenBioPro has updated their website to help prescribers, pharmacies and patients understand the new FDA rules on mifepristone and learn how to access abortion pills. The website has up-to-date information about how pharmacies can become certified to dispense mifepristone, and how medical professionals can become certified to prescribe mifepristone and dispense the medication directly to patients or through certified pharmacies. They also offer patient education and support resources in English and Spanish, with some resources available in additional languages, including Portuguese, Arabic, Chinese, Vietnamese, French, Haitian and Russian.

"We will continue to do everything in our power to ensure that these ... changes benefit as many people as possible and work toward truly universal access," said GenBioPro, noting that not everyone will have equal access because some states restrict abortion.

In addition to brick-and-mortar pharmacies, there are several mail-order companies dispensing mifepristone, including Honeybee Health and American Mail Order Pharmacy.

While many people prefer to receive abortion pills privately by mail, others may want to pick up the medications in person either because:

• they do not have a reliable or confidential mailing address,


• they cannot wait for the medication to arrive by mail because they are experiencing a miscarriage or health-threatening pregnancy, or


• they live in a state with an early gestational ban.

Advocates expressed frustration at how long it's taken for pharmacies to begin dispensing mifepristone.


"Mifepristone is the only medication that's seemingly regulated in a cultural manner: Can you imagine any other safe, common and essential medication being withheld from people who need it, even when they live right down the street from a pharmacy, and even after it's received long-overdue approval to be there?" said Merrill.


While pharmacy access to abortion pills slowly expands, the anti-abortion movement is trying to remove mifepristone from the market.


In November of 2021, anti-abortion doctors and a dentist filed a lawsuit, Alliance for Hippocratic Medicine v. FDA, asking an anti-abortion federal judge in Amarillo, Texas, to reverse the FDA's approval of mifepristone.


In April, the judge ruled the FDA improperly approved mifepristone in 2000 and stayed the approval-a ruling put on hold by the Supreme Court until it issues a final ruling in the case. On appeal, the Fifth Circuit Court of Appeals reversed in part, but still sharply restricted access to mifepristone nationwide. The Justice Department has appealed the decision to the Supreme Court.


"This is why Plan C is dedicated to researching and listing alternate routes of access on our website, so people know about their full range of options to get safe abortion pills in the US," said Merrill. The Plan C Guide to Pills provides information about how to obtain abortion pills in all 50 states, including through telemedicine, community support networks, and vetted websites selling abortion pills.


Meanwhile, if restrictions are put in place, clinicians are prepared to continue offering telehealth abortion with misoprostol alone.


"We all deserve better. And until our government, policymakers and industries can protect full rights and access, people will continue to need activist providers and community networks, and Plan C will continue to spread the word that these options exist," said Merrill.



Carrie Baker wrote this article for Ms. Magazine.



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In an unusual set of circumstances, the Nebraska Supreme Court will hear arguments in three lawsuits about the two abortion-related ballot initiatives, each of which had successful petition drives for the November ballot.

The first two lawsuits ask the Nebraska Supreme Court to rule to keep "Protect our Rights," which would legalize abortions until fetal viability, off the ballot. They claim it violates the state's "single subject" rule.

The third suit was filed in response to these on behalf of 29 Nebraska physicians who support Protect Our Rights.

Joshua Livingston, an attorney at the Koenig Dunne law firm in Omaha, which filed the lawsuit, said there are two types of access at stake.

"These physicians spend their days working with Nebraska patients, and they understand what Nebraskans need and what Nebraskans are asking for," Livingston explained. "Over 200,000 Nebraskans signed this petition asking for their voices to be heard. So the goal is access to health care and access to the ballot."

Livingston maintained the only fair outcome would require both initiatives to remain on the ballot or both to be removed. The "Protect Women and Children" initiative would prohibit abortions after the first trimester. The Nebraska legislature passed a 12-week abortion ban in 2023.

Livingston noted their position is that the "single-subject" rule would allow both initiatives to remain on the ballot.

"What we're really seeing is that the opponents to Protect Our Rights, the activist opponents, are scared of what the outcome is going to be," Livingston contended. "They're scared that if Nebraskans have the opportunity to expand abortion health care, they're going to vote in favor of that."

Livingston stressed Nebraska voters' right to be heard is really what is at stake here. He added they hope the Nebraska Supreme Court will rule before the Sept. 13 deadline for Nebraska ballots to be finalized.

Since the U.S. Supreme Court overturned Roe v. Wade in 2022, voters in six states have passed constitutional amendments to protect abortion rights.


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The Commonwealth has the second-highest maternal mortality rate in the nation, and within the state maternal deaths are twice as high among Black women.

Tamara Wieder, Kentucky state director for Planned Parenthood Alliance Advocates, said the lack of OBGYN's in the state is part of the problem. Wieder is one of the recipients of this year's Healthy Kentucky Champions Award, given by the Foundation for a Healthy Kentucky, and says legislative efforts such as the Momnibus Bill passed earlier this year will make a huge difference in improving women's outcomes.

"These are nonpartisan bills that we can find common ground on in a state that lacks equitable access to care. We can really have a dialog that brings everybody to the table, and that is something that's really important to me," she said.

The Momnibus Bill adds pregnancy to the list of qualifying life events for health coverage, increasing the odds of women receiving prenatal care; and expands programs that provide free lactation counseling, telehealth assistance, and mental health support for new moms. According to the CDC, more than 80% of maternal deaths are preventable.

Dr. Elizabeth Ottman, an obstetrician-gynecologist with Ohio County Healthcare, said perinatal mental health disorders are the most common complication of pregnancy. Several years ago she launched an innovative program to treat women suffering from postpartum depression with the first FDA-approved drug for the condition. She said the state's efforts to expand broadband access have helped more rural women get help.

"It's allowed us to do more and more telehealth and do meetings with patients to make access easier for them, because it's very difficult when you're depressed to pick up the phone and make an appointment and drive to the doctor. It is super difficult when you're a rural community and you have to drive miles to the doctor with a new baby," she continued.

According to federal data, 76 of Kentucky's 120 counties lack an OBGYN doctor.

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Legal disputes still surround North Dakota's abortion ban.

Underneath the court activity is the influence of "crisis pregnancy centers" and debate over the state's role in supporting them. The facilities have become controversial in recent years. Opponents said they pose as a non-biased resource with services such as peer counseling and infant supplies but instead have a mission to steer women toward keeping their pregnancy. North Dakota is one of several states with abortion restrictions to set aside funding for these centers.

Kali Bauer, executive coordinator of the Minot Women's Network, said it is troubling.

"This state funding is allowing them to continue a lot of these practices that are not evidence based and do not adhere to the same medical standards that traditional clinics have to abide by," Bauer pointed out.

Bauer added the centers are often staffed by untrained and unlicensed individuals. North Dakota is currently providing $1 million to fund its "Alternative to Abortions" program. Opponents want lawmakers to revisit the issue next session and establish accountability measures. A Republican sponsor has vowed to block such efforts, arguing the initiative is not harmful to clients.

After the U.S. Supreme Court overturned federal abortion protections, North Dakota joined the wave of conservative-led states to enact bans. In response, other states, such as neighboring Minnesota, have expanded access to assist patients living under restrictions elsewhere.

Sen. Janne Myrdal, R-Edinburg, contended North Dakota's program is trying to help women with an unwanted pregnancy succeed.

"Women that find themselves in crisis pregnancy need the support from volunteerism, from the local communities," Myrdal contended. "But also we stepped in as a state and said, 'We're going to fund these places because they affirm life, like our law said.'"

Because of other budget priorities, Myrdal does not anticipate pushing for increased funding for the centers, but she feels they are transparent and no additional oversight is needed.

Bauer suggested the descriptions of crisis centers leave out practices she feels are dangerous.

"Even providing medically inaccurate information, such as information on how to reverse a medical abortion," Bauer noted.

Meanwhile, a judge recently announced he would decide whether to dismiss a legal challenge to North Dakota's abortion ban. The request blocked a trial in the case from getting underway last month.


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