Methotrexate is an essential medicine for autoimmune conditions, yet US abortion bans affect people’s access to it
Methotrexate is an essential medicine, and it must stay that way.
Over the past few months, an increasing number of news stories have left me shouting, ‘Well, this is terrifying’ to my husband. I know this sounds like a valid reaction to most of the news these days. But these particular stories are about the impact of abortion bans in the United States on people’s ability to fill their regular prescriptions for medications that, in different circumstances, are also used as abortifacients.
I first read about this in May when Slate published a piece about how the abortion ban in Texas meant pharmacists were worried about S.B. 4, a law that restricts the distribution of medications that can induce abortions, including misoprostol and methotrexate (MTX).
In July, a woman with lupus tweeted that her rheumatologist informed her they were “stopping all refills of methotrexate because it is considered an abortifacient.” She lives in Virginia, where abortion is legal, but this was six days after SCOTUS overturned Roe v. Wade. Doctors were uncertain of its implication for prescribing MTX in any circumstances.
In August, The Washington Post spoke to Becky Hubbard, a 46-year-old woman with a history of infertility, about her decision to get sterilised to continue taking methotrexate to treat her rheumatoid arthritis. Hubbard decided this soon after the Dobbs ruling when her rheumatologist informed her that she needed to go on birth control to continue her treatment.
Last week news broke of a 14-year-old girl in Arizona being denied methotrexate by her pharmacist even though she has taken this medication for years. While the pharmacy eventually filled Emma’s prescription, the situation should never have happened.
Speaking to KOLD News 13, Dr Deborah Jane Power, Emma’s rheumatologist, summed the issue up by saying, “My 25 years as a physician, what I’ve learned, what I’ve trained, all the extra hours of study, is just being tossed away by lawmakers.”
I was diagnosed with juvenile arthritis in my early teens. Over twenty years later, methotrexate is still a crucial part of my treatment. The conversations about the effect of MTX on pregnancy and the importance of using contraception are familiar to me. With every new doctor visited, the chat happens again. Yet, in reading these articles, I am grateful that Ireland’s abortion ban didn’t prevent me from accessing this life-changing treatment.
First developed as a chemotherapy agent, in lower doses, methotrexate is considered a disease-modifying antirheumatic drug (DMARD). It treats rheumatoid arthritis, juvenile idiopathic arthritis, psoriatic arthritis, psoriasis, lupus, vasculitis, and other autoimmune conditions. It is also used for the medical management of ectopic pregnancies.
The National Institutes of Health estimate that autoimmune diseases affect 23.5 million Americans, with around 80% of people with an autoimmune condition being women. Figures for the number of people living with an autoimmune disease in Ireland are not readily available, but of the approximately 45,000 people with rheumatoid arthritis alone, 70% are women.
When we talk about abortion bans affecting healthcare access for everyone, this is what we mean. This reluctance to prescribe methotrexate or fill prescriptions for it is the result of a chilling effect on doctors and pharmacists. We are all too familiar with the chilling effect when doctors must decide whether a pregnant person’s life is at risk enough to be allowed an abortion legally.
Having the medication you take to treat your autoimmune condition suddenly withdrawn because it is an abortifacient when taken in different circumstances is terrifying. Having treatment disrupted or delayed is detrimental to people’s health.
Methotrexate is an essential medicine, and it must stay that way.
But What Can I Do?
Justyna Wydrzyńska, an activist and a member of the Aborcyjny Dream Team and Abortion Without Borders, is facing charges in Poland for aiding an abortion. Justyna’s case is being heard on Friday, October 14th.
Aborcyjny Dream Team has a list of actions you can take — I am Justyna.
Sign and share the Abortion Rights Campaign letter to the Polish Ambassador to Ireland, Anna Sochańska — Drop the charges against Justyna Wydrzyńska.
Show your support for Justyna on social media using #IamJustyna and #jakJustyna. You’ll find solidarity art and social media assets here and here.
Follow Aborcyjny Dream Team on Instagram, Facebook and Twitter for updates.
Events
Online activist meeting for Northern Ireland, Thursday, October 13th: Alliance for Choice is hosting an activist meeting open to all pro-choice people to discuss updates on commissioning and upcoming Alliance for Choice plans — Email alliancechoice4@gmail.com for more information.
Online event, Tuesday, October 18th: Join the National Women’s Council of Ireland and Frontline Defenders for My Body My Choice: Abortion Rights Activism Across the Globe, a panel discussion exploring Exploring the reproductive rights movements across the island of Ireland and Poland — My Body My Choice: Abortion Rights Activism Across the Globe.
In-person event in Northern Ireland, Thursday, October 20th: Alliance for Choice in conversation with Bernadette Devlin McAliskey about the struggle against reproductive coercion in Belfast — Email alliancechoice4@gmail.com to register.
In-person workshop in Northern Ireland, Saturday, October 22nd: Alliance for Choice Derry, in collaboration with Ulster University Pro-Choice Society and Queen’s University Belfast Project Choice, is hosting their abortion pills and stigma workshop in Belfast — Stigma and Pills Workshop, Belfast.
Protest in Ireland, Saturday, October 29th: March with ROSA - Socialist Feminist Movement to commemorate the 10th anniversary of Savita Halappanavar's death — Savita's 10th anniversary - march for health, equality and bodily autonomy.
Documentary screening in London, Sunday, October 30th: Abortion Rights is hosting a screening of The Janes documentary, followed by a Q&A — Abortion Rights hosts The Janes documentary screening and Q&A.
Share information on how to access abortions
In Ireland, if you are pregnant and do not want to be, or someone you know needs an abortion, the HSE’s MyOptions service will help you find your nearest provider. Freephone 1800 828 010.
The Abortion Rights Campaign has written a blog post about how the legislation works and on what grounds abortion is permissible after the 12-week on-request period has passed — Need an abortion?
In Northern Ireland, Alliance for Choice Belfast and Alliance for Choice Derry have shared information on accessing abortion services in the North.
Alliance for Choice Belfast — I Need An Abortion Now.
Alliance for Choice Derry — Abortion Help.
In Northern Ireland, Lucht Cabhrach Abortion Doulas provide support at home before, during or after your abortion.
Phone 07397 902774 or email abortion@luchtcabhrach.com — What are doulas?
Email allianceforchoicederry@gmail.com to contact Alliance for Choice Derry’s abortion doulas — Our Abortion Doulas.
In the US, ineeda.com provides up-to-date information on how to get an abortion.
Donate to abortion funds
In Europe, donate to Abortion Support Network, Aborcyjny Dream Team, Abortion Network Amsterdam, and Abortion Without Borders.
In the US, the National Network of Abortion Funds lists funds in every state — donating here means your donation supports 90+ organisations.
Know about abortion pills
Everyone Loves a News Round-Up
“A compromise was reached whereby we could set up the stand in the main refreshments area, as long as we covered up the word abortion where it may be visible to attendees of the Children’s Trust conference,” the statement said. “Though we weren’t sure about censoring ourselves, on balance, we decided that this was an excellent example of why our organisations are so desperately needed.” — Posters censored at abortion care conference, doctors claim [The Guardian]
“The Western Trust has recommenced its early abortion services on Monday.
Services were suspended at the trust's early medical abortion clinic in April 2021 due to "staffing resourcing issues" — Abortion: Western Trust recommences early medical service [BBC]
“I found myself in this unique position as an outsider where I won’t suffer those kinds of consequences for standing up and speaking out about something that I think is wrong,” Ms Prudente said. — I was at risk of dying and denied an abortion. Now I’m battling a country’s ban from 6,000 miles away [The Independent]
“Depending on the outcome of November’s elections, the outlook for abortion access in these states could be grim, limiting residents’ options and further stressing the resources of neighboring states where abortion remains legal.” — The states where the midterms will directly decide the future of abortion access [Vox]
“This provision, which sees the will of the pregnant person as subordinate to public interest in their fertility, temporarily places women’s bodily autonomy on hold, subjecting it to the community’s decision. This is then compounded by the alarming number of conscientious objectors in hospitals and clinics all over the country — the national average is calculated to be around 70 percent.” — The fight for abortion access in Italy continues [Politico]
“Madolline Gourley says she was asked whether she’d had an abortion while detained at Los Angeles airport in June. It came days after Roe v Wade – the landmark court case that legalised abortion – was overturned in the United States.” — Australian woman deported from US says border agency told her questions about abortion were policy [The Guardian]
“In the months that have followed, what can be described only as chaos has unfolded at the state level, with trigger laws passed in advance of the ruling taking effect or facing legal challenges — or sometimes both — leaving patients and physicians to navigate a complicated and confusing landscape.” — It’s been 100 days since Dobbs. What has changed? [The 19th*]
“Some of the popular fertility tracking apps have strong ties to the anti-abortion movement. With more than 400,000 users, one called Femm boasts that it’s “as effective as the pill.” It does not mention that one of its main funders is powerful hedge fund manager and Catholic anti-abortion activist Sean Fieler, as a 2019 Guardian investigation found. But Femm isn’t the only religious cycle-tracking group courting a secular audience.” — Inside Anti-Abortion Groups’ Campaign to Sell Women on Unreliable Birth Control “Alternatives” [Mother Jones]
“To be clear about what’s happening here: The beauty industry — which makes its money by marketing its various products and procedures as pathways to health, wellness, empowerment, and bodily autonomy — is using its money to fund legislators intent on stripping people of their health, wellness, power, and bodily autonomy by restricting access to abortion.” — The Beauty Brands Backing Abortion Bans [The Unpublishable]
“University employees were also advised not to speak in support of abortion at work. If an employee appears to promote abortion, counsel in favor of abortion, or refer a student for an abortion procedure, they could face a felony conviction and be permanently barred from all future state employment, according to an email obtained by The Washington Post.” — U. of Idaho may stop providing birth control under new abortion law [The Washington Post]