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Iowa AG warns pharmacies about mailing abortion pills

Bird signs on to GOP letters to Walgreens, CVS

By Caleb McCullough,

Gazette-Lee Des Moines Bureau

DES MOINES — Iowa Attorney General Brenna Bird signed on to a letter this week warning pharmacy chains Walgreens and CVS of legal trouble if they follow through on plans to deliver abortion pills by mail.

The letter, signed by 20 Republican attorneys general, argued the pharmacies risked violating federal law by mailing abortion pills — known as a medication abortion — contradicting guidance from President Joe Biden’s administration.

Bird on Friday told the Quad-City Times she disagreed with the way the drug, mifepristone, was approved for distribution and had safety concerns about the broader accessibility of medication abortions. “Any process to approve a drug to be distributed that way needs to be done the right way, according to the book,” she said. “We need to make sure that it is safe.”

The U.S. Food and Drug Administration last month finalized a rule allowing for retail pharmacies to dispense mifepristone, including through the mail. The sale of the drug was previously restricted to more specialized clinics.

Walgreens and CVS said that when the FDA rule changed they were in the process of becoming certified to sell the medication.

Bird said she is concerned the broader availability of the drug would lead to it being prescribed without an exam to decide if a pregnancy is in the right stage for the drug. The pills can be taken up to 11 weeks into a pregnancy, according to Planned Parenthood.

“It’s not having a doctor examine the patient before prescribing in order to determine how far along the pregnancy is,” Bird said. “That’s where the complications come along from that pill. And when it’s an internet, mailing prescription, that is not in the best interest of women’s health.”

Iowa has allowed for telemedicine-based medication abortions for years, but women need to receive an ultrasound before receiving the medication.

Associated Press)

Telehealth provider Carafem offers mailed medication abortions after a patient receives an ultrasound.

CHALLENGE COMING?

In the letter, the attorneys general pointed to a federal law that prohibits using the mail to send or receive “every article or thing designed, adapted, or intended for producing abortion.”

Biden’s Justice Department last month issued contrary guidance, saying the law is only intended to prohibit the mailing of materials that would cause an abortion by unlawful means.

The letter called the Biden administration’s guidance a “bizarre interpretation” and suggested it could be challenged in court.

“But the text, not the Biden administration’s view, is what governs,” the attorneys general wrote. “And the Biden administration’s opinion fails to stand up even to the slightest amount of scrutiny.”

Asked if she would sign on to a lawsuit, Bird said a decision would be “premature at this point.”

“That would be something I would consider once I knew all of the facts,” she said.

‘DANGEROUS PRECEDENT’

In a statement on Thursday, Iowa Democratic Party Chair Rita Hart criticized the move as well as Republican Gov. Kim Reynolds’ efforts to restrict abortion in the state.

“When Brenna Bird quietly signed on to this letter full of thoroughly debunked inaccuracies, she set a dangerous precedent and signaled that she doesn’t understand that her job is not to be a lackey for Kim Reynolds,” Hart said.

“The majority of Iowans believe that abortion should be legal, and our leaders should respect and protect our reproductive freedoms.”

LEGISLATION

Medication abortion is legal in Iowa, but that could change under a bill proposed in the Iowa House.

House File 146 would ban the prescribing, sale or transfer of mifepristone and other common drugs used for medication abortions. If the bill passes and is signed into law, dispensing the drugs would be a Class C felony.

But it’s unclear what the prospects of the bill are, given that the Iowa Supreme Court is considering a bid from Reynolds to reinstate a 2018 law that would ban abortions once cardiac activity can be detected in a fetus, usually around six weeks of pregnancy.

Republican leaders in the House and Senate said before this year’s legislative session they wanted to wait for a decision in that case before enacting further restrictions on abortion.

Comments: cmccullough@qctimes.com Sarah Watson of the Quad-City Times contributed to the report.

Iowa Attorney General Brenna Bird, shown speaking Nov. 8, said this week she signed on to a letter from Republican attorneys general warning Walgreens and CVS of legal trouble if they follow through on plans to deliver abortion pills by mail. (Charlie Neibergall/

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