The COVID-19 pandemic laid bare and deepened existing health care inequities – including, and in some places, especially, reproductive health care. In a new commentary in Contraception, the authors, including CPHLR Program Manager Adrienne Ghorashi, Esq., argue that permanently lifting the FDA’s Risk Evaluation and Mitigation Strategy (REMS) for mifepristone in its entirety would expand access to early abortion and miscarriage care.

The REMS requirements restrict access to mifepristone, one of two drugs used to end early pregnancy and manage a miscarriage, by requiring people to obtain the medication in person from clinics, medical offices, and hospitals – not in retail pharmacies or by mail like most other medications. REMS also requires patients to obtain mifepristone only from a “certified” medical provider.

“Research has shown that barriers to abortion particularly exacerbate health care inequities among populations already experiencing significant burdens and limited access to health care because of their race, socio-economic status, housing circumstances, and residency status, among other factors,” Ghorashi said.

Ghorashi joins authors Alexandra Thompson, Dipti Singh, Megan Donovan, Jenny Ma and Julie Rikelman in a discussion of existing legal barriers to abortion access at the state and federal levels, compounding the effects of these inequities.

In the article, the authors explain that permanently removing the REMS for mifepristone should be part of an intentional effort to reduce health care inequalities during and after the COVID-19 pandemic. Removing the REMS would likely also reduce the disproportionate harms of abortion restrictions on communities of color by advancing equity in and access to timely and essential reproductive health care.