FDA restriction on abortion pill poses barrier to Guam women, senator says

By Pacific Island Times News Staff 

The Federal Drug Administration’s restrictions on access to the abortion pill pose an impediment for Guam women seeking to end pregnancy, Sen. William Parkinson said, noting that no physician on the island performs the procedure or offers pre-abortion consultation.

“Medication abortion is instead available through telemedicine from off-island physicians who are registered to practice medicine on Guam,” Parkinson said.

Joining 437 other state legislators in the U.S., the Democratic senator has signed on to an amicus curiae brief filed with the U.S Court of Appeals for the Fifth Circuit, seeking to preserve access to mifepristone, a medication used for abortion and miscarriage care.

The case stemmed from FDA’s policy that blocks mail-order mifepristone and limits pharmacy prescriptions by requiring a special certification. The policy also requires that patients and their doctor sign a form acknowledging the treatment and its risks.

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“For many women on Guam, telehealth medication abortion is one of the only practical options that exists,” Parkinson said.

“Taking away telehealth prescribing and delivery by mail would not simply make care more difficult. It could make lawful healthcare functionally inaccessible," he added.

The sole physician who performed abortion on Guam retired in 2018.

“For patients on Guam, the case carries particularly severe consequences. No physicians physically practicing on Guam publicly provide either medication abortion or surgical abortion,” Parkinson said.

The amicus curiae filed in the appeals court on July 22 was related to a Louisiana lawsuit.

A federal trial court declined to impose the restriction while the litigation proceeds. The Fifth Circuit subsequently granted Louisiana relief, but the U.S. Supreme Court paused that ruling, temporarily preserving access through pharmacies and mail while the case continues.

The Fifth Circuit is expected to hear oral arguments in September.

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A similar case was decided today in Virginia, where Federal Judge Robert S Ballou ordered the FDA to reconsider mifepristone restrictions, describing the policy as “arbitrary and capricious.”

“The new Virginia ruling found that the FDA inadequately justified the restrictions it kept, suggesting fewer barriers may be warranted, Parkinson said.

“It does not bind the Fifth Circuit or decide Louisiana’s case, but it supports my argument that unnecessary restrictions would severely harm patients, especially on Guam,” he added.

In 2023, Parkinson introduced a bill that would eliminate the requirement for in-person consultation before receiving an abortion, following a Ninth Circuit Court's ruling that reinstated abortion restrictions on Guam.

The appeals court’s ruling was based on a lawsuit filed by the American Civil Liberties Union and Guam-based attorney Vanessa L. Williams, who sued the government on behalf of two Hawaii-based physicians Shandhini Raidoo and Bliss Kaneshiro, who provide abortion care by telemedicine to patients in Guam, where they are both licensed.

The Ninth Circuit panel nullified Chief Judge Frances Tydingco-Gatewood's 2021 preliminary injunction that subsequently allowed the two OB-GYNs to remotely prescribe medication abortion to their Guam patients through telemedicine and without first conducting an in-person consultation.

In voiding the federal judge's ruling, the appeals court cited the U.S. Supreme Court's decision that overturned the 1973 Roe v. Wade.

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