Gather 'round. Let's talk abortion pills.

Mifepristone is pretty awesome, and its approval by the FDA in 2000 changed the way people
obtain abortions in the US. In 2020, 53% of people having abortions in facilities had a medication
abortion with mifepristone and misoprostol. But with mifepristone under attack in the courts, we need to figure out how we will provide abortion
care without this medication.

Fortunately, there is a good alternative: misoprostol-only medication abortion. cdn.who.int/media/docs/def…

I am really proud of our Care Post Roe study and heartbroken over the stories that we're hearing coming from providers who are concerned about the legalities of treating their patients and patients who are scared to seek treatment for fear of criminalization.

https://twitter.com/SofiaResnick/status/1628838981570813953

In some cases, patients traveled long distances to another state to be evaluated. And sometimes it turned out they weren’t even pregnant. Sometimes it turned out they had had a miscarriage that had actually already been completed and they didn’t need any treatment.

Hi @MikeKellyPA, I’m a professor of Ob/Gyn at @UCSF, an abortion provider, and researcher at @ANSIRH.

Unsurprisingly, you got a few things wrong in this tweet that I’d like to clarify. Do you mind if I outline them for you? Facts are critical when discussing medical treatments.

https://twitter.com/MikeKellyPA/status/1621240316568260609

First, let’s address the issue of the safety of medication abortion with mifepristone. We have over 22 years of experience with this treatment, and all the data indicate that it is very safe.

You can read the science for yourself here: ansirh.org/research/brief…

For @thenation @RBraceySherman, @TracyWeitz, and I wrote about the FDA's decision to allow retail pharmacies to dispense medication abortion. While it is historic news, the fine print contains significant red tape that will continue to serve as a barrier.
thenation.com/article/societ… "Despite years of peer-reviewed, evidence-based research, the FDA chose to alter rather than eliminate the REMS for medication abortion."
thenation.com/article/societ…

This morning has been painful, upsetting, and full of despair. I am so proud of all of my colleagues who are working around the clock to make sure patients have care.

Please donate, if you can: secure.actblue.com/donate/txfunds

Let's also talk about what is possible to rebuild.⤵️ I see some folks are asking "what else we can do" and worrying about returning to the time before Roe. I have some thoughts. It's important to remember that the practice of abortion care has changed significantly in 50 years, particularly with the invention of abortion pills.

Good morning! We have a new study in @greenjrnl which shows that medication abortion—with the pills dispensed by a pharmacist instead of by a clinician in an office or clinic—is safe, effective, and well-liked by patients.

(But, you already knew that!)
journals.lww.com/greenjournal/p… I know this kind of sounds like common sense, but we hope these data will be useful to lead FDA to remove or modify the mifepristone REMS, which currently requires that the pill be dispensed only in a clinic, medical office, or hospital. youtube.com/embed/Tp8hZLMy…

Hey Senator Cruz!

It's me again, Dr. Grossman the ob/gyn and abortion provider. We've gone over this a few times before, but I'm happy to explain pregnancy and abortion to you. It's complicated, I know.

Here's my last fact check on your article:

https://twitter.com/DrDGrossman/status/1293159568680263680?s=20

https://twitter.com/SenTedCruz/status/1301203239140954112

Pregnancy is a medical condition and no two patients or their pregnancies are the same. Pregnancies can change as they progress, and some can become life-threatening. This is evidenced by pregnancy complications, ectopic pregnancies, and our nation's maternal mortality rate.

For any reporters covering later abortion, here's a quick explainer of the facts:

There are many reasons why patients need abortions later in pregnancy; sometimes because of the financial and logistical restrictions enacted across the country and others because of their health. Many patients are unable to obtain care as soon as they decide to have an abortion. Inconsistent healthcare, income inequity, and systemic racism create barriers.

We must make sure patients have access to abortions when they need them.

Everyone deserves abortion access.

I want to elevate—and add to—this thread by @RHAVote's experience having a later abortion in Colorado and why Colorado voters should vote #NoOn115 which would create more barriers to patients who need later abortions and doctors who provide them.

https://twitter.com/RHAVote/status/1291750373498277888

The text of this ballot measure is very clear: abortion would only be allowed after 22 weeks if it were “immediately required” to save the life of the pregnant person.

That is not the same as a health exception. Medicine is rarely black & white—there’s a lot of grey.

#NoOn115

Hi @tedcruz & @LilaGraceRose. I saw your latest op-ed on the court's decision to make medication abortions more accessible in a few states during the coronavirus pandemic.

I hope you won't mind if I offer a few edits and fact check the piece. 📝 First, 11 of the 24 deaths were not even associated with abortion—these women died from things like drug overdose or homicide. It's unfortunate, however not related.

All medical procedures have some risk, but medication abortion's risk is extremely low, especially over 20 years.

Hi! I’m Dr. Jamila Perritt @reprorightsdoc and I’m taking over Dr. Grossman’s Twitter account today! I'll be tweeting about my work as an Ob/Gyn, and how reproductive justice, Black feminism, and decriminalization inform my medical practice. My tweets will be signed -JP A little about me: I'm a fellowship-trained Ob/Gyn. I received my undergraduate degree from Brown University, my medical degree from Howard University College of Medicine, and did my fellowship training and MPH at Johns Hopkins University. -JP jamilaperrittmd.com

This morning I was going to #RunWithMaud, but I was reminded that as a white person this action is just another example of white privilege: something I have the privilege of doing daily without fear. It's a hollow promise without real action to save lives like Ahmaud Arbery's. In Indianapolis, my hometown, several police officers shot and killed Sean Reed, which was streamed on his Facebook, then cracked "jokes" over his dead body and focused on protecting their identities from the livestream rather than trying to save his life.
nytimes.com/2020/05/07/us/…

This week, Texas clarified an abortion ban under the guise that it's not an essential health care service and stopping abortions will help free up the demand for personal protective equipment (PPE) like gloves, masks, and gowns. But this is a baseless argument. I'll explain: First, of course abortion is essential health care—it's a time bound procedure that cannot be delayed, particularly in states with medically unnecessary restrictions like state-mandated waiting periods, ultrasound requirements, and gestational limits.

Now, let's talk about PPE!

This is such an absurd piece—it’s embarrassing that @WSJopinion published it. @ACOG is not a fringe organization: it represents 90% of Ob/Gyns. Ob/Gyns know that medically unnecessary restrictions on access to safe abortion are not good for healthcare. wsj.com/articles/the-o… The author packed this piece with lies—did you even bother to fact-check this @WSJ? For example, she incorrectly says that 14% of Ob/Gyns provide abortion care. Fact: The most recent national survey found that 24% of Ob/Gyns provide abortion. Basic facts.
journals.lww.com/greenjournal/F…

If you don't mind, @AOC, I'd like to respond to this one on your behalf. I definitely know the science on this one!

Senator @tedcruz, currently the best evidence-based research indicates a fetus cannot perceive pain until the third trimester, 26 weeks. I'll walk you through it.

https://twitter.com/tedcruz/status/1233131075184078851

As you know, the anti-abortion movement has pushed the idea of "fetal pain" and misnomer "late-term abortion" in order to ban abortion care before the current precedent set by Roe v. Wade which is viability, around 24-28 weeks. It's actually not based on science, just stigma.

Good morning! I'm feeling a bit nerdy today and would like to explain what "REMS" is and why it's making medication abortion pills less accessible as they could be. First, what is "REMS"?

Well, it stands for Risk Evaluation and Mitigation Strategy. It's a restriction the Food and Drug Administration (FDA) puts on medications that have high safety concerns to ensure it is used safely.
fda.gov/drugs/drug-saf….

Since legislators are once again trying to write non-existent medical procedures into state law, let's again review why you cannot reimplant an ectopic pregnancy into the uterus.
time.com/5742053/ectopi… As @Rewire_News wrote, this bill is based on a case report (lowest level of medical evidence in terms of the quality) from 1917 and a 1990 letter to the editor. rewire.news/article/2019/0…

I wrote about this back in May when the bill was first introduced: cincinnati.com/story/opinion/…

Apropos of nothing, patients will always need access to abortion care. They always have. As all public health professionals know, access to healthcare is dependent on race, class, region, immigration status, etc. As all medical professionals know, contraception fails sometimes. Research from @Guttmacher shows about half of abortion patients used contraception the month they became pregnant.

“Contraceptive methods are highly effective at preventing unintended pregnancies, but no method—and no user—is perfect,” @rachelj5
guttmacher.org/news-release/2…

@acog has released new recommendations for birth control, calling for all forms of hormonal birth control to be over-the-counter. As vice chair of ACOG's Committee on Health Care for Underserved Women, I spoke to @NBCNews about what this means.
nbcnews.com/health/womens-… In 2012 @acog issued a committee opinion supporting over-the-counter birth control pills. Now there are at least 2 companies doing research to support an OTC pill and may submit applications to the FDA in the next 2 years. The new recommendation is for all forms of birth control.

With the changes to #TitleX, access to contraception dramatically shifted for many low-income patients across this country this week and it's a complete shame. Access to healthcare is a human right, not a political game. Patients are not pawns.
nytimes.com/2019/08/19/opi… Providers should not be gagged when it comes to sharing information and offering care to patients. We must be able to refer them to services they need based on their individual situations. This interferes with the provider-patient relationship.
nytimes.com/2019/08/19/opi…

Hi @BeckerGOP. I read your op-ed in @Enquirer and it seems despite our email exchange, you still aren't comprehending how ectopic pregnancies, the practice of gynecology, or medical research work. I'll try to explain again.
cincinnati.com/story/opinion/… Your bill is not "forward thinking," @BeckerGOP. It's regressive, anachronistic, and archaic. It uses century- and decades-old reports and ignores the thousands of studies we have on ectopic pregnancies, maternal mortality, and abortion. It patronizes providers & patients.