Not only did the U.S. Supreme Court’s decision to strike down the landmark Roe v. Wade ruling impact a person’s right to a safe and legal abortion, but it also impacts the ability of millions of Americans to receive lifesaving medicine.
Northern Virginia resident Becky Schwarz depends on methotrexate to treat her lupus disease. She told the Los Angeles Times it was “shocking” when she received a note from her rheumatologist telling her that because of the reversal of Roe, “we are pausing all prescriptions and subsequent refills of methotrexate.”
“I am a 27-year-old woman. I am fully educated about what’s best for me and for my body,” Schwarz told TODAY. “The frustrating thing is you start to feel like you’re being babysat. Why am I not capable of taking care of myself?”
RELATED STORY: Indigenous activists shut down idea of using tribal land to open abortion clinics
Campaign Action
In addition to treating lupus, methotrexate, which was approved in 1959 to treat rheumatoid arthritis, also treats inflammatory bowel disease, psoriasis, and a variety of cancers, including breast cancer, lymphoma, leukemia, and lung cancer. But in some cases, the medication is used to end ectopic pregnancies, according to the American College of Obstetricians and Gynecologists—and that’s where things get sticky.
About 1 in 50 pregnancies in the U.S. are ectopic. Without treatment, an ectopic pregnancy can cause serious bleeding or death in a pregnant person.
Dr. Cuoghi Edens, an assistant professor of internal medicine and pediatrics at the University of Chicago Medicine, tells the Times he’s gotten reports “where children have been denied methotrexate for their juvenile arthritis until they’ve proven they’re not pregnant.”
The difficulty in getting methotrexate in states that ban abortions after six weeks or those that intend to implement a near-total ban on abortions is a terrifying possibility for patients who need it.
Dr. Grant Schulert, a pediatric rheumatology specialist at Cincinnati Children’s Hospital, tells the Times, “It’s one of the most common medications that I prescribe … It’s really a mainstay of our practice.”
Although methotrexate is not usually used in elective abortions, Time reports the medication can be used for that as well. The more common abortion-inducing drugs are mifepristone and misoprostol. Texas has recently placed a restriction on the use of methotrexate. In Kentucky, pharmacists recently received an email from the Kentucky Board of Pharmacy that read: “if a pharmacist receives a prescription and it doesn’t say, ‘for the induction of abortion,’ they can assume that it’s not for abortion.”
The right to an abortion remains protected in nine U.S. states, but 12 states will either pass laws totally outlawing the procedure or are in court fighting to do so.
Dr. Kenneth Saag, president of the American College of Rheumatology (ACR), told TODAY that he has heard of numerous patients complaining about not being able to get prescriptions for methotrexate.
“The American College of Rheumatology is quite concerned about this,” Saag said.
“We’ve got a lot of people on a very effective medicine who may now have limited access to it due to concerns, particularly by pharmacists, and we need ultimately to clarify policy and to make sure patients continue to have unfettered access to medicines.”
The ACR offered this statement on its website:
“The ACR opposes any action which interferes with the practice of evidence-based medicine or intrudes upon the doctor-patient relationship,” read the statement. “Pregnancy often complicates the management of women with rheumatic diseases and may threaten the life of the mother. Rheumatologists and other rheumatology professionals must be able to provide the best evidence-based care and guidance for all of their patients.”
Edens says, “As a physician, I took an oath to do no harm … To me, this is doing harm.”
Privacy as a foundational value in a post-Roe landscape on Daily Kos' The Brief podcast