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Uncertainty over mifepristone is a concern — even in states where abortion is legal

A MARTÍNEZ, HOST:

The Supreme Court could decide before midnight tonight whether to allow an abortion pill to remain widely available.

MICHEL MARTIN, HOST:

So far, the justices have temporarily paused lower court rulings that would block or partially restrict access to mifepristone. That's a drug now being used in more than half of abortions in the U.S.

MARTÍNEZ: Kate Wells at Michigan Radio is here to tell us about what's at stake in one state where abortion is still legal. Kate, you're in Michigan. What are clinics saying there?

KATE WELLS, BYLINE: It's chaos. I mean, doctors here have not experienced this much confusion or uncertainty really since last summer, since Roe was overturned, especially since, you know, residents here in Michigan in November voted to put abortion rights in the state constitution. And yet, you know, even here, this method is still under threat. One of the doctors that I talked with is Dr. Audrey Lance. She's an OB-GYN with Northland Family Planning outside Detroit. And she told me that every time in the last few weeks that one of these legal deadlines approaches, it is disruptive.

AUDREY LANCE: It's hard, you know, when I know that I'm going to walk in to work tomorrow to provide care to patients with these medications. Am I allowed to do that? I don't know yet. I don't know what's going to happen.

WELLS: And, of course, what she wants to do is keep using mifepristone, because when you combine it with misoprostol, that two-drug combination is the gold standard of medication abortions. It is the most effective method. But if the court bans mifepristone entirely, it might also just restrict its use by not allowing it to be sent through the mail. And that especially is a big fear for doctors here.

MARTÍNEZ: But what's the biggest fear about losing the ability to send these pills directly to patients?

WELLS: Well, I mean, Michigan is a large state. You know, most brick-and-mortar clinics right now that provide abortion are concentrated in the southern part of the state, which means if you live farther north, if you're in the Upper Peninsula, you've got to drive for hours just to get to a clinic. But, of course, right now, these patients can get the pills remotely. Dr. Sarah Wallett is with Planned Parenthood of Michigan, and she can do a virtual appointment with these patients and then send the pills directly to them through the mail.

SARAH WALLETT: We see patients who are in their car on break from their job. We see patients at home with their small children who don't have the ability to take time off work, to get child care, to get gas money.

MARTÍNEZ: OK, so, Kate, the option to mail mifepristone could disappear depending on the Supreme Court's decision. But could misoprostol still be mailed?

WELLS: Yes, they could definitely still use that medication rather than the two-drug combination. And misoprostol alone is effective at ending pregnancies. But the doctors I spoke with say, you know, they're slightly worried about this because it is slightly less effective than when you use both pills, and they worry that this would mean more patients would need to come back in for surgical procedures afterwards. And - bigger picture - they also just worry that if mifepristone isn't available, some patients just won't want to take the risk. They won't want to have a medication abortion. They will just opt for surgical procedures instead.

MARTÍNEZ: And can they handle the capacity for more of those?

WELLS: Not at first. You know, it would be a big change. A lot of people right now use medication abortions. If a lot of them instead want to do an actual procedure, that could mean longer wait times and delays in care.

MARTÍNEZ: Michigan Radio's Kate Wells. Kate, thanks a lot.

WELLS: You're welcome. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

A Martínez is one of the hosts of Morning Edition and Up First. He came to NPR in 2021 and is based out of NPR West.
Kate Wells is a Peabody Award-winning journalist and co-host of the Michigan Radio and NPR podcast Believed. The series was widely ranked among the best of the year, drawing millions of downloads and numerous awards. She and co-host Lindsey Smith received the prestigious Livingston Award for Young Journalists. Judges described their work as "a haunting and multifaceted account of U.S.A. Gymnastics doctor Larry Nassar’s belated arrest and an intimate look at how an army of women – a detective, a prosecutor and survivors – brought down the serial sex offender."