Medical Technology

South Dakota makes it harder for women to obtain abortion drugs

SIOUX FALLS S.D. (AP) — South Dakota lawmakers on Thursday approved Governor. Kristi Noem’s new rules for medical abortions, making South Dakota one of the most difficult locations in the U.S. for abortion pills.

Women are required to return to their physician to receive the second medication used in a medication abortion. The majority of women receive both drugs in one visit while taking the second drug at home.

Doctors and advocates for abortion rights decried the rule as a threatening intrusion into the relationship between doctors and patients.

In September, the Republican governor announced the rules changes through an executive order. This was prior to the Food and Drug Administration decision to eliminate permanently the requirement that women who are seeking abortion pills be picked up in person. The new rules, inspired by the governor’s directive was been unable to pass through a committee of the legislature last month after Republican Sen. Timothy Johns, said he did not see any evidence that the requirement was necessary for the abortion-seeker’s safety as Noem claimed.

Johns voted with three other Republicans in the committee to accept the rule change on Thursday. It is expected that it will be in effect later this month.

South Dakota currently requires that women seeking medical abortions must first see a doctor. After waiting for 72 hours, they return to the clinic to receive the first medication, mifepristone. Also, they receive misoprostol which is a hormone blocker at the time of their appointment. This is usually taken the next day to stop their pregnancy.

The new rules will require women to wait at most one day after they have received their first medication before they return to receive the second one.

The U.S. Supreme Court is currently considering a case that could significantly reduce the rights of abortion that have been in place for over 50 years.

Noem’s administration claimed that the additional visit was needed to ensure that women don’t suffer complications from the drug.

However, doctors cautioned that making it harder for women to access the second drug is dangerous. By avoiding the second drug, women run the risk of hemorrhaging more, according to the South Dakota Section of the American College of Obstetricians and Gynecologists.

“How many women will not be able to adhere with the rules, and will not be able to come back for the third time in less than one week, and then decide that they’ll have to gamble and not try the second drug?” Nancy Turbak Berry, a Planned Parenthood lawyer, asked the question at last month’s meeting. “How many emergency rooms and clinics in the outlying areas of our state are likely to be confronted with unneeded medical emergencies?”

One medical trial that published its findings in the journal Obstetrics and Gynecology, tried to study the effects of women not taking the second drug or taking the hormone progesterone which pro-abortion activists claim can stop medical abortion. However, the trial was stopped at just 12 participants after three were taken to the hospital for bleeding. Two of the women were not given any medication during the second round. One had received progesterone.

Dr. Erica Schipper is a Sioux Falls obstetrician/gynecologist. She noted that there have been very few studies to stop medical abortions, but that the safety of the medications that cause abortions has been proven for a long time.

Since 2000, the year that medication for abortion was made available in the United States, the FDA has tracked 26 deaths associated with the medication, however not all of them can be directly linked to the medication due to underlying health conditions and other factors. Schipper declared that this is a low-risk scenario given that Tylenol and acetaminophen account to 150 deaths every year.

“(The rule) will unfortunately increase the government’s involvement in the physician-patient relationship and create more problems than it is likely to solve,” Schipper said, saying that it could hinder treatment for patients who get abortions for medically necessary reasons. It also sets a precedent for the state government regulating prescription drugs.

A number of doctors who are against abortions testified to the committee on Thursday, stating that medical abortions carry risks and requiring extra visits helped mitigate it. Glenn Ridder is the medical director of the Alpha Center in Sioux Falls. He said that the third visit was a chance to determine if the woman actually needed the second drug.

Two Democrats argued that Noem’s rule was more like an ordinance that ought to have been discussed in the full Legislature, and they stopped it last month. Noem said she would vote for legislation to put the rule into law.

However, lawmakers on Thursday washed their hands of the debate on the merits of the rule and instead focused on whether the Department of Health made the necessary steps to make it effective.

Johns said, “I’m troubled; I really am worried.” Johns voted to approve the rule.

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