London — A European doctor who runs a telemedicine abortion service says she will continue to prescribe abortion pills to women in Texas who are more than six weeks pregnant, despite a new law that makes doing so a crime.
"I don't care about six weeks," Dr. Rebecca Gomperts, a physician from the Netherlands who also works in Austria, told CBS News. "It's another law that is not based on any scientific evidence, human rights, common sense," she said. "I will provide [prescriptions for abortion pills] until 10 weeks of pregnancy like I've always done."
On September 1, a Texas law banning abortions after embryonic cardiac activity can be detected, at about six weeks, went into effect. Last week, Texas governor Greg Abbott signed another bill into law, criminalizing the distribution of abortion pills by mail. That law is slated to take effect in December, and violations could result in thousands of dollars in fines and jail time of up to two years.
Gomperts founded an organization called Aid Access in 2018 to provide abortion pills to women in the U.S. after more than a decade running similar nonprofit groups in countries where abortion is illegal.
In 2000, the FDA approved a combination of two medicines — mifepristone and misoprostol — to terminate pregnancies up to 10 weeks. Taken as pills, they effectively trigger a miscarriage, and are now a common option for women seeking an abortion. This method accounted for nearly 40% of abortions in the U.S. in 2018, according to the Centers for Disease Control.
In the U.S., states have varying rules about when and where the pills can be taken, and who can prescribe them for a medication abortion.
The World Health Organization has deemed that the pills can be safely prescribed for women to self-administer, without the direct supervision of a health care professional, until the end of the 11th week of pregnancy.
How it works
People who contact Aid Access seeking abortions fill out an online consultation form in which they outline where they are located, when their last missed period was, and if they have any other medical conditions.
Aid Access may then connect them with a U.S.- based health care provider who can prescribe pills. If they are further along than six weeks pregnant and in a place like Texas — where in-state providers are not permitted to work with them — Aid Access may connect them with Gomperts herself, who operates out of Europe.
Gomperts can issue a prescription over the internet and recommend an online pharmacy outside of the United States to fill it. The pills take on average 10 to 20 days to arrive.
A medication abortion in Texas costs around $500, but Aid Access charges around $100 for the pills, and says the price can be discounted based on need.
Is it legal?
Gomperts says her service is legal in all the jurisdictions in which it operates.
"Where I work from, it's legal to prescribe the medications. And so I'll do that. And the pharmacy that I refer to is allowed to mail the medicines, on a prescription of a doctor, to the women. So (the new Texas law) has no impact on what we do," Gomperts said.
Operating out of Europe may shield Gomperts from legal liability, but whether the operation is legal in the U.S. — and Texas, in particular — is a complicated question.
While one new Texas law bans helping people getting abortions after embryonic cardiac activity is detected at around six weeks of pregnancy and another bans using telemedicine for abortion services, they do not outlaw terminating one's own pregnancy.
Gomperts' recommended pharmacy has received a "Good Manufacturing Practices" certificate from the World Health Organization, but the mifepristone and misoprostol that it sends to women in the United States are generic versions of the drugs, which have not been approved by the FDA.
Importing drugs from abroad is against the law in the U.S., but the FDA doesn't tend to go after individuals who are bringing medicines into the country for personal use, according to Farah Diaz-Tello, senior counsel and legal director of the reproductive rights group If/When/How.
In 2019, the FDA sent Aid Access a cease and desist letter, arguing that "new drugs may not be legally introduced or delivered for introduction into interstate commerce without prior approval from FDA." It also noted that mifepristone is currently marketed in the United States under the brand name Mifeprex, which is subject to special regulations.
The "prescriber must have the ability to: assess the duration of the pregnancy accurately, diagnose ectopic pregnancies, and provide surgical intervention in cases of incomplete abortion or severe bleeding, or to have made arrangements for others to provide such care," the FDA said.
"Failure to correct these violations may result in FDA regulatory action, including seizure or injunction, without further notice," it continued.
In response to the letter, Aid Access sued the FDA for impeding women's constitutional rights to access abortions under Roe v. Wade, but a judge dismissed Aid Access' claim, in part because the FDA hadn't done anything to follow through on its threat, Aid Access said.
"(The FDA) sent that threatening letter, but it took no action based upon that letter," Richard Hearn, the attorney who represented Aid Access in the suit, told CBS News.
"All of our drugs were going through. The FDA and the Postal Service wasn't stopping any. They weren't arresting women. They weren't doing anything like that," Hearn said. "Women still have an option in Texas, just like they do in Idaho and other very red states."
Christie Pitney, a U.S.-based abortion provider for Aid Access who prescribes pills for women in California and Massachusetts, says if a patient has any medical concerns after she takes the pills, she can go to the emergency room, even if she doesn't want anyone to know she's had an abortion.
"If there's ever a legal concern or just, you know, a concern of stigma, or they don't want their family to know, then patients can always just say that they think that they're having a miscarriage," Pitney said. "There's no way that [the hospital] will ever be able to tell the difference between a miscarriage and abortion."
Gomperts, meanwhile, says she hopes the Department of Justice will win its suit against Texas over the first of the restrictive abortion laws.
"I think that women living in Texas deserve to have access in their own state, near where they live," Gomperts told CBS News. "The U.S. should take better care of its pregnant women."
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