South Dakota further restricts medical abortion

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Current state law allows medical abortion procedures to begin 72 hours after the doctor has met in person with the pregnant mother, except in medical emergencies, and usually requires only one more visit to a licensed facility to obtain the necessary medication. process.

According to Elizabeth Nash, a state policy analyst at the Guttmacher Institute, the rule means South Dakota will be the first state to require a visit to get misoprostol.

Medical abortion, also known as medical abortion, is a non-surgical procedure that is effective during about 10 weeks of pregnancy. It involves taking mifepristone and misoprostol a day or two apart.

Often, women take both medications at the same doctor or clinic visit. They took mifepristone pills at the clinic and were instructed to take misoprostol pills at home a day or two later.

Under the new rules, women in South Dakota will now effectively be required to go to a licensed abortion facility for four medical abortions.

The rule comes after the Biden administration temporarily eased federal regulations on medical abortion in April, removing the requirement to dispense mifepristone in person during the Covid-19 pandemic.

The move prompted South Dakota and other conservative states to take steps against the federal government.

South Dakota Gov. Kristi Noem, a Republican, signed an executive order in September directing the state Department of Health to draft rules to ensure that drugs distributed in the state cannot be delivered by mail, among other restrictions.
South Dakota Governor Kristi Noem pauses while speaking at the Conservative Political Action Conference (CPAC) in Dallas, Texas, U.S., Sunday, July 11, 2021. The three-day conference is titled
In December, the FDA permanently removed the requirement that the first drug must be dispensed in person, instead allowing pills to be delivered by mail. The agency also began requiring pharmacies that dispense drugs to be certified.

The Republican-majority Interim Rules Review Committee in the South Dakota legislature voted to pass rules requiring in-person distribution of both drugs, following public hearings last month and committee hearings that resumed Thursday.

Current South Dakota law requires doctors to obtain the “voluntary and informed written consent” of a pregnant woman to perform an abortion, except in medical emergencies.

Under the new rules, pregnant women can return to the clinic to receive their first drug, mifepristone, three days after giving informed consent to a medical abortion. She can only take the medication for nine weeks after conception.

But under the new rules, doctors must inform a pregnant woman before dispensing the medicine that the effects of mifepristone could be reversed if she changes her mind and decides to put the baby to term.

If she did take the drug, she would have to wait 24 to 72 hours before returning to the clinic a third time for the second drug, misoprostol, to be dispensed in person.

The abortion facility staff then needs to schedule a follow-up appointment with the woman 14 days after taking the medication.

Abortion facilities must also monitor patients and report to the Ministry of Health any complications requiring medical follow-up, follow-up care needed, the facility where follow-up appointments are made, and whether pregnant women are sexting.

Ali Tornow, a staff attorney for the Department of Health, argued at Thursday’s hearing that “the purpose of this rule is to protect the health and safety of women in South Dakota by requiring in-person distribution of these two drugs.”

Other supporters of the rule, including several South Dakota doctors, testified that eliminating in-person visits could lead to life-threatening health complications for pregnant women.

The American Civil Liberties Union of Planned Parenthood’s north-central states and South Dakota slammed the new rule, saying it required another “unnecessary” visit to the clinic.

Dr. Sarah Traxler, chief medical officer of Planned Parenthood in the North Central, testified at Thursday’s hearing that the rule is “medically unnecessary” and could instead prevent women from “taking a second drug, thereby making the They are at greater risk.”

Traxler believes the extra travel is an “insurmountable barrier to care” for patients who spend hours driving to the clinic, while for some women “the unpredictability of daily life may ultimately prevent patients from returning to the clinic for acceptance.” Misoprostol.”

South Dakota’s request “represents a dangerous political interference that compromises patient care and safety,” ACLU Jett Jonellis, South Dakota’s advocacy manager, said in a statement provided to CNN.

“These restrictions violate patients’ rights to liberty, privacy, and equal protection guaranteed by the U.S. Constitution, and impose a significant burden on the use of abortion without valid medically proven evidence,” Jonellis said.

The American College of Obstetricians and Gynecologists (ACOG) and several other medical societies advocate for the removal of federal restrictions on how drugs are administered.

The restrictions “do not make care safer, are not based on medical evidence or need, and prevent clinicians and patients from accessing medical abortion,” ACOG said on its website.

But “the limited available evidence suggests that the use of mifepristone alone without subsequent use of misoprostol may be associated with an increased risk of bleeding,” the team said.

According to data collected by the FDA since the drug was approved in 2000, 26 of the 4.9 million women who took mifepristone for medical abortions died — a mortality rate of less than 0.0001 percent.

Governor moves to make new rules permanent

Nome “plans to work with the South Dakota Legislature to make these and other agreements permanent,” her office said in a release. The upcoming meeting will begin on Tuesday.

“I look forward to the day when the life of every unborn child in South Dakota is protected,” the governor said in a statement.

South Dakota has many restrictions on abortion, including a ban on abortion after 22 weeks of pregnancy, with some exceptions.

It is also one of 19 states that require doctors providing medical abortions to be present, effectively banning telemedicine prescribing abortion drugs, according to the Guttmacher Institute.

CNN’s Jen Christensen and Tierney Sneed contributed to this report.

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