State Abortion Laws May Apply to Mifepristone Use.

Office-based physicians who perform medical abortions may be affected.

Now that the abortive agent mifepristone is on the market, some physicians who are interested in offering medical abortion but who weren't previously offering surgical abortion may find themselves facing strict state regulations, experts say.

Because many state laws and regulations refer to abortion broadly without specifying whether the procedure is done medically or surgically they apply to medical abortion by default, said Bonnie ScottJones, an attorney at the Center for Reproductive Law and Policy in New York.

And while some of the laws in a handful of states may seem irrelevant or inappropriate in the context of medical abortion, they're still enforceable. For example, in some states, the ceiling of an abortion provider's facility must be of a certain height. Other states require examination of fetal tissue following an abortion. It's going to take some time to negotiate with state attorneys general and to set some legal precedents to sort out what applies to mifepristone (Mifeprex) and what doesn't, she said.

Physicians ought to investigate their state laws--either through a colleague who is knowledgeable about local abortion law or through a national organization, such as the National Abortion Federation--before they prescribe their first dose of mifepristone, advised Caitlin E. Borgmann, an attorney with the American Civil Liberties Union Foundation, New York.

Of all state abortion laws, socalled TRAP (targeted regulation of abortion providers) laws are likely to pose the greatest challenge for private practitioners who want to start offering mifepristone for abortions. Eighteen states enforce TRAP laws. However, those regulations vary substantially both in terms of the burden they impose as well as their applicability to medical abortions in private office settings.

Despite the fact that with medical abortion the fetus is typically aborted at home, North Carolina law, for example, dictates that abortion providers must have patient locker facilities, a nourishment station, an examining room, a preoperative room, and a recovery room. Systems must also be in place to recirculate the air in the procedure and recovery areas at least six times per hour.