A Washington state-based nonprofit has launched a program that trains pharmacists to prescribe abortion medications via telemedicine. Organizers hope other states will adopt this model to expand access to abortion.
Abortions are largely legal in Washington state until the fetus reaches viability, which is generally between 24 and 26 weeks of pregnancy. But Dr. Beth Rivin, president and CEO of nonprofit Uplift International, said there are still many people in Washington who face barriers to accessing abortions because of where they live, income and other factors. These people could benefit most from access to telemedicine, Rivin said, and the availability of pharmacists helps boost that availability.
The nonprofit teamed up with an online pharmacy called Honeybee Health to launch what it calls the Pharmacist Abortion Access Project. Ten pharmacists were recruited and trained to prescribe mifepristone and misoprostol, the standard abortion medications approved by the U.S. Food and Drug Administration, to patients in Washington up to 10 weeks of pregnancy.
Rivin said the team reviewed its training protocol with Dr. Sarah Prager, a professor of obstetrics and gynecology at the University of Washington. The program also includes a list of clinics to which patients can be referred if in-person follow-up care is required, including ultrasound, blood work or other examinations.
“If (patients) had questions, the platform enabled communication between the pharmacist and the individual, and patients were followed up for one week and four to five weeks after the prescriptions were written,” Rivin said.
Over the past two years, anti-abortion groups have increasingly called for stronger state legislation against abortion drugs, claiming that telemedicine for abortion pills is risky to a pregnant person’s health. Research has repeatedly shown that telemedicine prescriptions are just as safe and sound as in-person treatment current study This shows that 99.7% of patients in a sample of 6,000 had no stern complications. Likewise, 97.7% did not require any additional follow-up care.
“Research confirms that medication abortions can be prescribed through telemedicine as safely as in person, and it confirms that pharmacists can specifically prescribe medication abortions,” Rivin told States Newsroom. “The training they receive as part of the project mirrors the training other providers receive.”
The Heritage Foundation, the conservative group behind a set of policies called Project 2025, has done this collected several examples of abortion pills given to pregnant women without their consent. Based on these examples, the organization recommends that states ban telemedicine and mail-order abortion pills and strengthen or enact laws against forced abortion. There have also been calls to utilize a dormant federal law called the Comstock Act to ban the mailing of abortion pills entirely.
No proof of residency is required to receive pills by mail
By the end of the Washington pilot program, which took place between October 31 and November 26, 2024, pharmacists successfully prescribed medication abortion to 43 people deemed eligible. In addition to meeting current medical protocol, to qualify, the patient had to be at least 18 years venerable and have an address in Washington to which the medication could be shipped. The recipient of the medication is not required to prove that they are a Washington resident, but must provide a valid Washington address. Washington has protective laws that prevent states where abortion is illegal from investigating medical providers if a resident of that state has an abortion in Washington.
After the success of the pilot, Uplift International said it plans to expand the program across Washington and study pharmacists who prescribe medication abortion in person at brick-and-mortar pharmacies.
Rivin said the hope is that the project paves the way for other states to adopt the same model, especially as President-elect Donald Trump takes office and Republicans in Congress may consider stronger federal abortion restrictions.
“It is the first step in establishing pharmacists personally as prescribers of medication abortions,” Rivin said.
Don Downing, professor emeritus of clinical pharmacy at the University of Washington and co-director of the project, said Washington has one of the most progressive pharmacy laws in the country. State law has recognized pharmacists as health care providers since 1979 and allows them to prescribe many FDA-approved medications.
Washington shares this advanced status in pharmacy law with one of its border states, Idaho, where pharmacists can also prescribe medications for minor ailments such as frosty sores and allergies, as well as medications to treat illnesses such as the flu and strep throat. Downing said Idaho’s pharmacy laws are even more progressive than those in Washington.
However, Idaho has abortion policies that couldn’t be more different. It is the only state in the Northwest with a near-total ban on abortion, a civil enforcement law that allows family members to sue medical providers who perform an abortion, and a so-called “abortion trafficking law” that makes taking a minor into one a felony State with legal access to abortions without parental permission.
Ironically, Downing said the pilot team announced the Idaho project during an annual pharmacy meeting held at a resort in Coeur d’Alene with pharmacists from Montana, Oregon, Washington, Idaho and Alaska.
“We presented the idea at that meeting that pharmacists should be much more involved in drug access to abortion, and that was surreal because at that time Idaho was only addressing women’s access to abortion,” Downing said.
Providing prescriptions via telemedicine was an initial priority, he said, because after several listening sessions before the pilot launched, the women surveyed agreed that they preferred the privacy of an online experience.
“If you’re in a small town and you go to the doctor’s office, the school nurse, or the pharmacy, there’s a good chance you’re going to run into a neighbor or a relative, and someone’s definitely going to go too. “I want to ask you what you’re doing there today said Downing. “Women across the country are increasingly saying, if I can buy it online the same way we buy it on Amazon, if I can do that without running into my aunt, all the better.”
