Q&A: Pharmacists Help Close Gaps in Abortion Medication Access

Pharmacists are vital in abortion care medication, offering counseling, dosing guidance, and clinical oversight. They also support evidence-based practices through education and advocacy. However, varying state laws and legal restrictions pose major challenges. Staying informed and trained is essential for pharmacists to effectively support safe, accessible abortion care in their communities.

Drug Topics recently sat down with Nicole Cieri-Hutcherson, PharmD, BCPS, MSCP, FCCP, clinical associate professor at the University at Buffalo, to discuss how pharmacists can support patient counseling and education around abortion medication, what types of training or continuing education could better prepare pharmacists to safely dispense medication, and the most significant challenges pharmacists might face in implementing abortion medication services.

Drug Topics: How can pharmacists support patient counseling and education around medication for abortion?

Nicole Cieri-Hutcherson, PharmD, BCPS, MSCP, FCCP: There [are] a lot of [ways in which] pharmacists can provide patients with information,...not only in community pharmacy settings, where this is allowed..., but also in other settings, such as a hospital or an emergency department. As a highly trained health care professional, a pharmacist can not only dispense the medication, but talk the patient through how the therapeutic indication works, how the medication works, interactions, [adverse] effects to expect, what to expect with bleeding, and those very rare other [adverse] effects that might occur that are part of the medication guide.

In hospital or emergency departments, the pharmacist can serve as a safety checkpoint for any mifepristone and misoprostol orders, making sure that the indication is appropriate, that the dose is appropriate, being involved in the REMS [Risk Evaluation and Mitigation Strategy] program, and monitoring for safety. In addition, pharmacists can really work within a health care system to be an advocate for evidence-based medication care and evidence-based medication abortion care. They can provide their expertise in terms of protocol development, guideline development, and advocacy work in ensuring access to abortion medication.

Drug Topics: What types of training or continuing education could better prepare pharmacists to safely dispense abortion medication?

Cieri-Hutcherson: There [are] a lot of different trainings that are available. I'd say that most of them are through private organizations, but sometimes it's as simple as just taking an updated continuing education program on abortion medication care. A couple that I've taken myself that I think were well done include Birth Control Pharmacist––they have some great resources and in their community, on their website––as well as ACOG [American College of Obstetricians and Gynecologists] and the National Abortion Federation. Then there [are] a couple of other private groups out there that provide education about how to counsel a patient on abortion medication, what to expect, [and] variations in state laws. One of the things that I will say is that if you're looking to provide this type of care, make sure that you're aware of the laws within your state and federally, the things that govern your ability to dispense and provide this type of care for patients.

Drug Topics: What are the most significant challenges pharmacists might face in implementing abortion medication services, and how can these be addressed?

Cieri-Hutcherson: The most significant challenges that pharmacists face are related to the ever-evolving legislation involving abortion medication care. There are state laws that ban or restrict abortion and abortion medication, and they don't just apply to abortion procedures. It can apply to the abortion medication as well. There are large sections of the country that ban abortion, and even though federally the FDA has approved mifepristone and said that it's safe and effective following the Dobbs decision, and even prior to the Dobbs decision, there are restrictions on providing abortion medication in different states and who can provide that in a state.

There are other ways that states can restrict access to abortion medication, and sometimes that involves blocking the use of telehealth abortions or mandating inpatient...patient visits. Sometimes it involves pharmacists, especially if they're dispensing or counseling on abortion medication. As part of the steps that have been taken to limit abortion access, some states have taken action against pharmacists providing abortion medication. As I said before, it's really important to know what your state laws are, what's currently banned, and what legislation is in progress, so that you can get involved in that and continue to provide evidence-based...care for your patients.

READ MORE: Pharmacists Play Key Role in Expanding Access to Medication Abortion

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