The prescription abortion pill we could have, but don’t
Mifeprestone is offered directly to patients in places like Canada and Australia, but not in the U.S.
When a patient asks Dr. Graham Chelius for an early-term abortion, all he can do is tell them to buy a plane ticket.
Chelius is a family medicine doctor at a hospital on the Hawaiian island of Kaua’i, where there are no surgical abortion providers. His best option is to instead write patients a prescription for what is called a medication abortion: using two drugs – mifepristone and misoprostol – over the course of two or three days, the patient would end their pregnancy themselves. Save for a routine follow-up two weeks later, they wouldn’t need to see Chelius again.
But if he wrote that prescription, his patients wouldn’t be able to fill it. Mifeprex, the American brand name for mifepristone, is one of a handful of drugs that the FDA says is too dangerous for retail pharmacies. It can only be dispensed at pre-approved clinics, hospitals, and private practices, and the hospital where Chelius works doesn’t stock it. The process for approval is so onerous that nowhere on Kaua’i does.