Dutch Doctor Provides Abortion Pills to U.S. Women, Sues FDA

Fortune (Sept. 19, 2019): "A Doctor Who Prescribes Abortion Pills to U.S. Women Online is Suing the FDA. Is She Breaking the Law?", by Erin Corbett:

Dr. Rebecca Gomperts, a physician licensed to practice medicine in Europe, launched the website Aid Access in 2018 in order to meet the growing need for accessible abortion care in the U.S.

Patients seeking to end a pregnancy in its early stages through the use of the medications misoprostol and mifepristone can complete an online consultation form on Aid Access about their pregnancy and general health. Dr. Gomperts prescribes the medication to patients so long as they are "healthy, less than 10 weeks pregnant, and live within an hour's distance of a hospital in case of emergency."

Medical abortion is an FDA-approved method to end a pregnancy, and studies have found that independently managing an abortion using misoprostol and mifepristone pills is both safe and effective.

"There is no evidence that home-based medical abortion is less effective, safe or acceptable than clinic-based medical abortion,” reads one study from the World Health Organization (WHO).

The two pills work in combination to terminate a pregnancy in the first 12 weeks. Together, they are over 96% effective, and using misoprostol on its own is more than 80% effective in the first trimester. 

Dr. Gomperts emphasizes that the science supports the safety of medication abortions, including those done entirely by the women seeking the abortion themselves (in some cases, women may go to a clinic to physically receive the medication; in others, like here, women are prescribed the medications remotely, which are then mailed to them). "All medical abortions are self-managed," though, Dr. Gomperts says. "Women that go to a clinic and get the pill and have their miscarriage at home—it’s exactly the same procedure if they get the pills online.”

In the wake of the confirmation of right-wing, anti-choice Supreme Court Justice Brett Kavanaugh, along with the slew of extreme state-level restrictions on abortion access in recent years, Dr. Gomperts found that patients reaching out to her were seeking her help not only because they wanted an abortion but because they didn't know where else to get help or even information on any local health services available to them.

Dr. Gomperts received inquiries from over 40,000 women between March 2018 and August 2019. She prescribed the two abortion medications to just over 7,000 of those persons. The majority of the requests came from women living in abortion-hostile states with strict laws, like Alabama, Georgia, and Mississippi. Dr. Gomperts has consulted with women in all 50 states.

While several states have laws that criminalize any self-managed abortions, all of these statutes "pre-date Roe, likely making them unconstitutional," Erin Corbett, author of the Fortune article, says. They've been applied against pregnant persons nonetheless. 

On September 9th, Dr. Gomperts and her attorneys filed a lawsuit in federal court in Idaho against the FDA and other federal officials, claiming that they illegally confiscated "between three and 10 'individual doses of misoprostol and mifepristone' that Dr. Gomperts had prescribed to patients since March." 

The FDA claims that her practice "'poses an inherent risk to consumers who purchase'" these medications.

Dr. Gomperts asserts several claims for relief under both the Constitution and the Administrative Procedure Act. Prosecuting Dr. Gomperts or her patients would violate their rights to liberty, privacy, and equal protection under the Fifth Amendment, the lawsuit claims.