Medication Abortion

Medication abortion, also referred to as medical abortion or the abortion pill, is a pregnancy termination method that involves the use of two medications. The U.S. Food and Drug Administration (FDA) first approved medication abortion in 2000. In 2016, the FDA approved a new evidence-based regimen and drug label, which guides current clinical practice. This medication abortion regimen includes two medications: mifepristone and misoprostol.

Mifepristone blocks progesterone, an essential hormone for the development of a pregnancy, and prevents an existing pregnancy from progressing.

Misoprostol is taken 24 to 48 hours after mifepristone and works to empty the uterus by causing cramping and bleeding, similar to an early miscarriage. Within two weeks, a follow-up visit is conducted to confirm the pregnancy was terminated. This medication abortion regimen is approved for use during the first ten weeks of a pregnancy.

Medication Abortion in Kansas

Under current Kansas law, medication abortion is permitted. KSA 65-6724 prohibits abortion after 22 weeks of pregnancy, with an exception for medical emergencies. State law has requirements for accessing abortion procedures, including medication abortions. Before performing an abortion procedure, physicians are required to:

• Have the informed consent of the patient receiving the abortion procedure. If such patient is a minor, the written consent of both of that patient’s parents or the legal guardian is also required;
• Wait 24 hours from the time the patient provides such consent before performing the procedure [Note: A Johnson County District Court Judge temporarily suspended this requirement on October 30, 2023.];
• Inform the patient that they have the right to view an ultrasound image of the fetus at least 30 minutes prior to the abortion procedure, at no extra cost; and
• Inform the patient that they have the right to listen to the heartbeat of the fetus at least 30 minutes prior to the abortion procedure, at no extra cost.

If a medical emergency compels the performance of an abortion, the physician must inform the patient why the procedure is necessary to prevent their death or substantial and irreversible impairment.

2023 Legislation

During the 2023 Legislative Session, HB 2264 was enacted and requires that any facility or clinic that provides medication abortions using mifepristone must post a sign informing patients that it may be possible to reverse the intended effects of a medication abortion induced by mifepristone. The bill also requires that, at least 24 hours before such medication abortion, physicians inform patients of the same possible reversal message both in writing and in person or by telephone. The bill also requires physicians to inform patients in a prescribed manner at least 24 hours before such medication abortion of the same possible reversal message, and that more information is available on the Kansas Department of Health and Environment website.

[Note: A Johnson County District Court Judge temporarily suspended the requirements set forth in HB 2264 on October 30, 2023.]

Use of Telemedicine

KSA 65-4a10(b) prohibits medication abortion from being prescribed and administered via telemedicine. KSA 65-4a10(b) requires the patient and physician to be physically present in the same room when prescribing and administering mifepristone. [Note: On November 23, 2022, a Shawnee County District Judge granted a Wichita abortion clinic’s request for a temporary injunction of this law.]

Medication Abortion in Other States

Most states, as well as the District of Columbia, permit the use of medication abortion. Of the states that permit medication abortion, some have similar requirements for accessing abortion care as Kansas. Kansas is one of 16 states that authorizes only physicians to prescribe abortion medication, and 6 of the 16 states also require the prescribing physician be in the physical presence of the patient.

In 20 states and the District of Columbia, an advanced practice clinician, such as an advanced practice registered nurse (APRN), is authorized to prescribe abortion medication.

Georgia and South Carolina limit the use of medication abortion to the first six weeks of pregnancy, and Indiana limits its use to the first eight weeks of pregnancy. All three states require a physician to prescribe the medication, and Indiana and South Carolina require the physician to be in the physical presence of the patient.

In 14 states, medication abortion is prohibited.

The map below illustrates which states require abortion medications to be prescribed by a physician or require the physician be in the physical presence of the patient.