Rural Alaska

Bethel set to join brief supporting mifepristone access in federal lawsuit

The Bethel City Council voted this week to co-sign a brief — soon to be filed in a high-profile federal lawsuit over abortion pill authorization — in support of preserving access to mifepristone, a drug commonly used to terminate pregnancies and help manage early miscarriages.

The Western Alaska hub is one of dozens of local governments across the nation, and the only community in the state so far, to sign on to an amicus brief that will be filed Monday in the 5th Circuit Court of Appeals urging continued access to the drug, according to Aadika Singh. Singh is an Anchorage attorney who works for the Public Rights Project, a nonprofit based in the Lower 48 that’s filing the brief on behalf of the local governments.

Mifepristone is most commonly known as an abortion pill. It works by blocking the hormone progesterone and causing the lining of the uterus to break down. During a medical abortion, a second pill, misoprostol, causes the uterus to empty.

That two-drug regimen can also be used to help medically manage the loss of an early pregnancy.

The amicus brief is part of a fast-moving legal battle over whether to restrict how mifepristone is used, and whether the U.S. Food and Drug Administration should have approved use of the drug more than two decades ago. Since its FDA approval in 2000, mifepristone has been used by millions of people with few complications, medical groups have recently noted.

Earlier this month, the U.S. Supreme Court temporarily preserved access to the drug while a lower court reviews the merits of the case beginning next month.

The resolution adopted in Bethel, which was proposed by City Council member Mark Springer and passed Tuesday night in a 5-1 vote, focuses on the way the drug is most often used in the Yukon-Kuskokwim Delta region: for medical miscarriage management.


“This drug allows patients to experience less discomfort and get home faster after miscarriage,” the resolution says.

Springer said in an interview this week that Singh’s testimony a few weeks earlier at a City Council meeting was what inspired him to ask Bethel City Attorney Libby Bakalar to draft the resolution.

A 2018 study published in the New England Journal of Medicine found a two-drug regimen of mifepristone and misoprostol to be quicker and more effective for managing an early miscarriage than taking misoprostol only, and that it decreased the risk of patients requiring additional medical care.

In Alaska, the state’s main abortion provider, Planned Parenthood, requires patients to travel in person to one of their clinics in Anchorage, Juneau or Fairbanks for either a surgical abortion, or the two-dose medical abortion regimen.

In Bethel, health providers at the Yukon-Kuskokwim Health Corp., the region’s tribal health provider, “frequently” administer mifepristone for miscarriage management, the resolution states.

“Health care providers in Bethel use this drug for folks who travel to the region who choose medication management when they have a miscarriage,” Singh said at Tuesday’s City Council meeting in favor of the resolution. “This allows them to go home faster. It decreases their suffering and their bleeding.”

A spokesperson from YKHC declined a request for an interview with a medical provider or any comment for this story.

One City Council member, Patrick Snow, said during the meeting that he opposed the resolution because it didn’t make a distinction between the drug being used for medical management of miscarriages, a use for the drug he supports, and for abortions, which he does not.

Springer, who introduced the resolution, said during Tuesday’s meeting that Bethel’s status as a major health care hub for dozens of villages off the road system — meaning people already have to travel miles to access important health care — makes preserving all kinds of health care access particularly important.

“We all know women that have had miscarriages,” Springer said later in an interview. “And it’s sad enough that they’re having one, and to then have to go through what might end up requiring a more complicated medical intervention than using this medication ... just adds to the burden on them.”

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Reporter Annie Berman is a full-time reporter for the Anchorage Daily News covering health care and public health. Her position is supported by Report for America, which is working to fill gaps in reporting across America and to place a new generation of journalists in community news organizations around the country. Report for America, funded by both private and public donors, covers up to 50% of a reporter’s salary. It’s up to Anchorage Daily News to find the other half, through local community donors, benefactors, grants or other fundraising activities.

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Annie Berman

Annie Berman covers health care for the Anchorage Daily News. She's a fellow with Report for America, and is a graduate of the University of California Berkeley Graduate School of Journalism. A veteran of AmeriCorps and Vista volunteer programs, she's previously reported for Mission Local and KQED in the Bay Area.