Should medical abortion medication be available over the counter?

@Rarebear, I would defer to YOU for the answer. Is it safe? That should be the standard for the answer to your question.

No. And this is why.

I am wondering if the pills require follow up care, to make sure everything came out thoroughly, and that’s another reason why they’d need to be prescribed.

@Judi I have my opinion, but I do not want to color the arguments.

I’m generally in favor of everything being legalized – all drugs, including all prescription medications as well as “recreational” drugs (with the possible exception of antibiotics, because of the public health problems of lessening effectiveness because of misuse and overuse – but I might be changing my mind on that.

While I certainly understand the ramifications of what @Seek‘s post points out, people have had the capability of poisoning each other for millennia, and “making drugs harder to get” will have only a slightly deterring effect on that. In fact, had the “abortion medication” not been available to that poisoner, he may have used even more lethal means of poisoning his ex. So for that reason that post wouldn’t sway my opinion in this matter.

I realize that beyond the well-known problem with diminishing effectiveness of antibiotics because of overuse (with humans and perhaps even more importantly, with livestock, when antibiotics are introduced into their normal feed), I’m also aware of the growing problem with accumulation of high-potency and long-lived drugs in waterways now, too.

So I’m not sure what to think. In principle and in general I’m 100% in favor of legalization and more access. (Pharmacists often know better than many doctors who don’t keep up with advances in pharmacology the various problems, drug interactions and even “the latest and best” medications for various conditions. So it might sometimes be more helpful to take a complaint and a physician’s diagnosis of “this is the problem” to a pharmacist and let the pharmacist write the prescription.)

There’s probably a more convoluted reason as to why not, but drawing it back to basic understanding, i’d just think it to be too cold an act for such a heavyweight decision

I like the idea of more individual control, but the possibilities of physical problems happening if one hasn’t had appropriate medical prep (awkward phrasing, not sure how to improve it) are too high to have this stuff be OTC.
Just my opinion.

If not available off the shelf, right next to the pregnancy tests, then it should be available by just asking the pharmacist.

Assuming it is safe and easy to use, then yes. However, I’m not sure if it’s a medication that is best used under the supervision of a medical professional?

I worry that anything that can induce a miscarriage, with all the attendant problems that can ensue from that, should be medically supervised.

@CWOTUS Drugs are legal. You just need a physician’s prescription to use them. Let me give you a trivial example of why a physician is necessary for some medications: Let’s say you walked up some stairs and all of a sudden you were so short of breath you had to sit down. What drug do you get to treat that?

Back to the OP, I feel that it should be prescribed by a physician.

Yes, It should be available.

Totes avail.

What test does the doctor do when giving you a prescription?

The answer is none….

At least the pharmacists tells you that you should eat some toast while you slurp up that pill.

@johnpowell I don’t understand your post. Can you please rephrase?

@rojo I’m not saying that the medication should be available or not available. I’m asking if it should be available under the supervision of a physician (or FNP, or PA)?

@CWOTUS – He didn’t want to poison his girlfriend. He wanted his girlfriend to not be pregnant. He was able to acquire medical abortion pills twice in order to cause a miscarriage. That is obscene.

Don’t get me wrong: I want those abortion pills to be easy to acquire, I just want them to be limited in distribution to pregnant women who wish to take them only. The easiest way to do that is to limit them to prescription.

If I had my ‘druthers, the physician appointment and the drug itself would be free to the patient and subsidized by the government (which should be more than happy to get out of paying for a pregnancy, a birth, and three years of WIC).

question was modded because of a misunderstanding but now it is back.

I understand what his intent was, @Seek – the link that you posted was pretty clear. I used a deliberately provocative word (prosecutor’s language) to bluntly express what he did.

And your proposed restriction is sensible on its face, but how would that actually be controlled in the real world? The guy wanted to slip these to his ex, since she was unwilling to take them on her own. If a legitimate seller would be enjoined from selling them “to him”, then how difficult would it be for him to get a pregnant woman (or one who could be made to appear pregnant, or even a man – maybe even himself – skillfully disguised as a pregnant woman) to act as his straw buyer?

And the argument against “free after-pregnancy birth control” (which is what we’re essentially talking about) is that it all leads to a lessening of personal responsibility, which is construed as “a license for licentious behavior”. In other words, government condoning promiscuity.
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@Rarebear as to your hypothetical question, I don’t know the answer because that’s not a condition that I live with, but I have a good counter-example from real life for you. While traveling in Indonesia once, years ago, I developed an earache. I’ve had earaches before, and the American way to resolve that is to go to a doctor, get a scrip, get the ear drops from the pharmacy and be fixed up within a day or two. Since I wasn’t going to visit an unknown doctor in Indonesia I decided to tough it out for the week that I was in-country. My expatriate friend noticed my suffering after a day or two, and I told him my problem. “No worries,” he said. “We have a great pharmacy here, and you don’t need a scrip. The pharmacist also speaks very good English.” Within a half-hour I had exactly what I needed, and relief within the day.

Maybe I don’t want to buy medications for asthma, emphysema, COPD or some other “shortness-of-breath” condition without more input from a physician – but if I already have asthma, for example, and I’ve had it all my life and know exactly how it’s been controlled for years and years… then why should I need another prescription to buy exactly what I always buy to treat a chronic condition?

I’d love to see a man skillfully dressed as a pregnant woman go in for a gynaecological evaluation to confirm a pregnancy. Please, videotape that consultation, and damn the HIPAA regulations.

I thought we were talking about buying medications sans prescription.

Um, no, that’s what you are talking about. I am talking about keeping the abortion pill prescription-only, and making it easier to get it from a doctor.

Uh… yes, that has been something that I’ve been talking about. But how did the man in your link acquire the pills that he used? (I understand it was in Norway, so I don’t expect you to know personally. But it seemed like you were on board with the OTC nature of the acquisition, anyway. At least until the post I responded to a few minutes ago.)

Might want to adjust your reading comprehension.

Question: Should medical abortion medication be available over the counter?
My answer: “No.”

@cwotus did you have otitis externa or otitis media? (Don’t google it).

Seek is absolutely correct and I agree completely with her point of view.

«Sigh»

No, it’s not a comprehension issue, it’s a perception problem. I hadn’t seen the “No.” All I saw was the link. Thank you for the correction, if not for the tone.

I hate getting my prescriptions renewed. I often feel I’m made to jump through hoops to get things I’ve been on for years, and know I need. More than once I’ve decided to just stop taking a medication rather than going through the trouble it takes to get access to it (this has never worked out well for me).

But my GI just noticed a couple months ago that I’ve been, for years, on a combo of medications that interacts dangerously. I thought the heart palpitations I’d been having were from anxiety. They weren’t.

Nowadays I’m a lot gladder that I’ve got a professional managing my prescriptions.

@Mariah Out of professional curiosity, which combo of medications were causing you palpitations? I ask because I treat IBD. Don’t feel obligated to answer, and you can PM me.

Cipro and celexa. I switched to amoxy successfully.

@Mariah Did the pharmacist ever say anything to you?

Nope. It had slipped past other doctors too. I was kind of shocked.

@Rarebear Even given the outliers (and there will always be such) like the guy in in @Seek ‘s post, I still believe it should be available OTC with or without the consent of a physician. By forcing a woman to seek medical approval for the meds you are implementing another level of control over a persons reproductive rights. I see no benefits from doing such.

@rojo: I don’t see his question ad calling for “consent of a physician” or not but discussing the value of medical supervision for a potentially dangerous sequence of physical events the pill sequence induces a miscarriage, which in someone with certain conditions that might cause over-bleeding could prove dire.
At least the advice of a medical professional, not necessarily a physician, should be sought. That’s where groups like Planned Parenthood, a neighborhood free clinics come in.
The treatment should not be denied (barring medical issues) but should be monitored.

This is ridiculous.

We’re not talking about curing a headache or a bout of constipation. We’re talking about taking a hormone blocker that causes a miscarriage on purpose.

How many of you have ever read the insert packet that comes with a bottle of Excedrin? I know I have because I compulsively read everything, but most people never do.

How many women would end up in the hospital after trying three times to abort an undiagnosed ectopic pregnancy with an over-the-counter pill?

How many will end up septic after an incomplete abortion?

There’s literally no data on the safety of the abortion pill in women of advanced maternal age (over 35), or women with heart, renal, or liver disease, or diabetes, or women who smoke.

They’re not certain whether the abortion pill is secreted in breastmilk but it is known similar chemicals are, and it’s unknown how the medication would affect an infant should it be secreted.

TL;DR: The abortion pill is not safe enough to rely on the general public to doctor themselves with it.

That, @Seek is the more convoluted reasoning I referred to earlier, exactly what I meant but put beautifully, knew I was right :D

@canidmajor “Should medical abortion medication be available over the counter or should a woman be required to go to a physician?” I am looking at it as a pretty straightforward question about availability. I see no advantage to requiring a physicians permission. Lots of medications have potentially dire consequences. Many times these are dealt with after they occur. If a person wants to see a doc I am all for it, I just don’t think it is a necessity 100% of the time.

Literally no over the counter medication has “death due to bleeding haemorrhage” as a potential side effect for a single dose.

If used exactly as directed, though, @rojo, there could be catastrophic results. I doubt anyone here is a greater proponent of reproductive rights than I am, I have been an activist for same, with varying degrees of intensity for more than 40 years. You are approaching this as a moral and/or political issue. I am seeing this as a medical one.
Systemic antibiotics are prescription only drugs for good reason. Would you have them be OTC? How about opiates? Stuff like that?
Or do you perhaps think that a 14 year old girl simply deserves to bleed out because she might panic and do the protocol inappropriately because she’s frightened and maybe “wants to make sure” it works?

Can any of you, besides Seek, name the contraindications of the medication and other side effects? Can any of you tell me how long the bleeding lasts or how severe it is

Don’t look it up now.

@Rarebear what’s your point?

Remember, this is not Plan B which I think should be available over the counter. This is an abotificant.

@candidmajor my point is not obvious? Seek. What is my point?

I have continuously addressed the possible medical dangers in my posts. In an informal discussion, such as this is, why should I know the specific contraindications etc?
Seek’s may be the only posts you’re bothering to read through, but she’s not the only one addressing your “point”.

This turned superior & arselickey

While I don’t agree with @CWOTUS specific feelings on this issue, I agree with him that you are being a snide ass. If you wish to educate, then do so. Being a jerk really won’t incline very many of us to take note.

Just as you resorting ad hominem attacks is not likely to get me to be more inclined to educate you.

@canidmajor has been explicit in her agreement with our stance @Rarebear. I believe your question as to the contraindications is more directed to @CWOTUS and @rojo, who have expressed belief that OTC availability would be a good thing.

I am all about making abortion available and safe. OTC abortifacients would not be any safer than encouraging every home gardener to keep a patch of pennyroyal on hand.

Further to the point: OTC pain medications like ibuprofen (Advil/Motrin) and acetaminophen/paracetamol (Tylenol) are distributed in such a way that even if a person takes double the label dose, it’s still just at or barely above a standard prescription dose. The last time I had prescription Motrin it was 800 mg tablets. The OTC pills are 200 mg each.

That way, when people do stupid things like say to themselves, “Oh gee darn this is the worst headache ever, I better take four Tylenol”, they don’t end up destroying their goddamn liver by overdosing.

Since a less-than-clinical dose of an abortion medicine would probably do more harm than good (an incomplete series of medicine can lead to serious birth defects if the abortion isn’t completed surgically) and a double-dose can be deadly, the abortion pill is not a good candidate for an OTC version.

Yup. Exactly.

I answered this question at the beginning and have only read some of the comments, but enough to know that I stand by agreeing to whatever a professional I trust (like @Rarebear ) would say. I’m not a doctor so I have no personal or professional knowledge of whether it’s safe or not. If it’s not safe, or has a more than slight risk of complications a doctor, PA, or NP should prescribe it.