A war is being waged in Federal Court over access to crucial abortion medication, but Los Angeles County residents should be able to breathe easy.

As potential major changes to abortion medication access could take a key abortion medication out of the United States market, Supervisor Lindsey Horvath led a discussion on the Abortion Safe Haven Project, which was instituted in L.A. County following the 2022 Supreme Court case that overturned Roe v. Wade, at the Los Angeles County Board of Supervisors meeting held Tuesday.

The project is meant to ensure that Los Angeles remains a place where people can come to receive safe abortions and other reproductive care. According to the county’s webpage on the project, it consists of a “network of county agencies; nonprofit, academic, and business partners; reproductive health, rights, and justice advocates.”

However, the main topic on the night revolved around the two Federal Court cases that could result in significant and contradictory rulings regarding access to mifepristone — which is part of the two drug regimen used for medication abortions with an over 95% efficacy rate according to a 2015 study.

The first is a challenge in Texas that is looking to pull the Food and Drug Administration’s (FDA) approval of mifepristone. That ruling could be opposed by a clashing one in the state of Washington that seeks to remove federal regulations that make obtaining mifepristone more difficult, and U.S. District Judge Thomas Rice is also weighing whether or not to issue an order that would prevent the FDA from taking action to remove the pill from the market.

These federal rulings could have dramatic effects on abortion access around the country, but the FDA could potentially have a say in that impact. According to the County’s Counsel, the FDA is likely to issue a “Non-Enforcement Letter,” which would say that the FDA would not enforce a ban on the drug.

Doing this would give the state and county a reason to do the same, continuing to maintain its safe haven status and providing open access to abortion care.

Californians won’t have to worry about potential prosecution of the distribution of mifepristone, as the state Attorney General’s office issued a letter on Monday stating they did not intend to prosecute those found distributing mifepristone should it become federally illegal.

A representative from the Los Angeles Sheriff’s Department’s Narcotics Bureau also stated that their department would not actively seek out those potentially distributing mifepristone.

“It’s not feasible for us to dedicate resources to go after someone for this misdemeanor violation,” Capt. Brandon Dean said at Tuesday’s meeting.

Even with these safeguards in place, Supervisor Horvath still hopes that the county is prepared for a worst-case scenario: mifepristone becoming inaccessible. She asked L.A. County Department of Health Services Director Dr. Christina Ghaly about that potential scenario, and how prepared the county is for that.

Ghaly stated the county has approximately 460 doses of mifepristone with plans to double that number. Los Angeles doesn’t keep abortion statistics, but the state of Washington recently stockpiled approximately 30,000 doses of mifepristone to prepare for the same hypothetical crisis, which would last the state approximately three years according to National Public Radio.

At approximately 800 doses per month in a state with around 7,864,400 residents according to recent estimates, it is hard to say how long less than 1,000 doses will last in Los Angeles County — which had close to 10,000,000 residents at the beginning of 2022.

However, Ghaly noted that the marketplace supply for the drug is still robust at the moment and there are no problems accessing mifepristone right now, but the department is waiting to see the final rulings in the cases and the FDA’s reaction to them before making a further judgment on whether to plan a significant stockpile of mifepristone.

Even if US suppliers are shut down, Ghaly said they have looked into several alternatives, including acquiring mifepristone from overseas manufacturers. She also brought up the potential of using just the second half of the abortion pill regimen — misoprostol — but noted that using misoprostol alone decreases the efficacy of the treatment “on the order of two to three times” less effective, according to Ghaly.

Director of the Los Angeles County Department of Public Health Barbara Ferrer spoke about two more initiatives that the county is taking further, one of which is certifying public health clinics as sites to distribute abortion pills.

The other initiative Ferrer discussed is the furthering of efforts to create a central place that can direct anyone in the county to the reproductive health resources in their area. The webpage — which is featured on the county’s Department of Public Health website — has information on abortion as a practice and a resource guide in 11 different languages to help guide people to the facilities they need to visit for treatment among other things.

“At Public Health, we take the obligation to make sure people know the full continuum of services very seriously,” Ferrer said at Tuesday’s meeting. “I think there is a ton of confusion about what people have, what people in California have and what they might not have soon, and that is creating enormous stress on people trying to make decisions about their reproductive health.”

While the looming mifepristone rulings, Horvath and the rest of the county are working to remain a true safe haven for abortions no matter what happens on a federal level.

“I want to make sure that we are dedicated and on the ground and ready and working proactively,” Horvath said, “to ensure people’s safety no matter what happens on another level.”

Photo by Bacsica