South Dakota makes it harder for women to get abortion meds

South Dakota Gov. Noem spoke at the Family Leadership Summit in Des Moines, Iowa. South Dakota is one of the hardest places in the US to get abortion pills. In this file photo, a person is standing.

South Dakota is one of the hardest places in the US to get abortion pills.

The rule requires women to return to the doctor if they want to get the second of the two drugs used in the abortion. Women usually receive both drugs in one visit and take the second at home.

The rule was decried by doctors and abortion rights advocates as a dangerous intrusion on the relationship between doctors and patients.

The FDA's decision to permanently remove a requirement that women seeking abortion pills pick them up in person was the reason why the rules change was initiated in September. The new rules were put on hold last month after Republican Sen. Timothy Johns said he did not see any evidence that the requirement was necessary for the abortion-seeker's safety.

The rule change, which is expected to take effect later this month, was approved by three other Republicans on the committee.

Women in South Dakota must visit a provider, wait 72 hours, then return to take the first drug in a medical abortion. They also receive a hormone blocker called misoprostol, which is usually taken in the days after the baby is born.

Women will have to wait at least a day after receiving the first drug to return to receiving the second one.

The Supreme Court is considering a case that could severely erode abortion rights that have stood for half a century.

Noem's administration argued that the extra visit is necessary to make sure women don't have any problems with the drug.

Making it harder for women to get the second drug is dangerous. The South Dakota Section of the American College of Obstetricians and Gynecologists says that going without the second drug increases the risk of bleeding.

Nancy Turbak Berry, a lawyer for the organization, asked how many women would be unable to comply, unable to return for the third time in a week, and decide they just have to take their chances and skip the second drug. "How many emergency rooms and clinics in the outlying areas of our state are going to be used for medical emergencies?"

One medical trial tried to study the effects of not taking the second drug or taking the hormone progesterone, which anti-abortion activists claim may stop a medical abortion. The trial was halted after three participants were rushed to the hospital with bleeding. Two of the women did not receive any medication in the second round, while the other did.

There have been limited studies on stopping the medical abortion process, but Dr. Schipper pointed out that abortion-causing medication has a long track record of safety.

Since 2000, the FDA has tracked 26 deaths associated with the drug, but not all of them can be attributed to the medication due to underlying health conditions. It's a low risk, considering that drugs like acetaminophen account for an estimated 150 deaths a year.

Schipper said that the rule will cause more problems than it will solve and that it could delay treatment for patients who get abortions for medically-necessary reasons.

Several physicians testified to the committee that medical abortions do present risks and that extra visits helped mitigate them. The third visit was an opportunity to evaluate whether the woman needed to take the second drug, according to Dr. Glenn Ridder, the medical director at the Alpha Center.

Two Democrats stopped Noem's rule last month because they thought it was a law that should be debated in the Legislature. Noem supports legislation to make the rule a law.

The Department of Health made the steps necessary to implement the rule, which was the focus of the debate on Thursday.

In voting to approve the rule, Johns said that he was troubled by it.

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