Why is miscarriage medication hard to access?

Article Summary –

Miscarriages are a significant complication of pregnancy, with 1 million out of 5 million pregnancies in the U.S. resulting in miscarriage, and the most effective drug for managing miscarriages, mifepristone, is heavily regulated due to its dual use in abortions. Despite its proven safety and efficacy when combined with misoprostol for treating miscarriages, access to mifepristone is restricted, as only certified healthcare providers can prescribe it, which can lead to substandard care and increased trauma for women like Megan Kling, who needed the drug for delivering a stillborn baby. The legal and regulatory status of mifepristone remains uncertain due to ongoing lawsuits and political intervention, highlighting the tensions between medical needs and political influences affecting healthcare access.

Miscarriage is a frequent pregnancy complication. Yale School of Medicine reports that in the U.S., 1 million of 5 million pregnancies end in miscarriage before 20 weeks. Since 2000, the FDA has heavily regulated mifepristone, a key drug for miscarriage treatment, also used in abortions.

Mifepristone, branded as Mifeprex, halts pregnancy by blocking progesterone, leading to uterine lining shedding. It pairs with misoprostol, which induces cramping and tissue expulsion. Although misoprostol alone can manage miscarriages, a 2018 study shows higher success with mifepristone.

Megan Kling from Taylor was surprised her doctor couldn’t prescribe mifepristone when her fetus lacked a heartbeat. The medication was essential to deliver her stillborn baby. Despite its safety record, only certified providers can prescribe mifepristone due to REMS regulations.

Certified prescribers or pharmacies must supervise dispensing. Kling’s doctor wasn’t certified, forcing her to use only misoprostol, increasing complication risks like incomplete expulsion, infection, or requiring surgical intervention. Kling avoided complications but criticizes the care standard as politically influenced and substandard.

A U.S. Supreme Court decision maintained mifepristone access, but its status is unclear. In January, U.S. District Court Judge Matthew Kacsmaryk allowed a lawsuit by Idaho, Missouri, and Kansas against the FDA to proceed, seeking approval rescission or access restrictions.

During a February Senate Committee hearing, Robert F. Kennedy Jr. said Trump tasked him to study mifepristone’s safety and pledged to implement Trump’s policies, whatever they may be.