Missing mifepristone at tribal health facilities serving native Americans


      The Risk Evaluation and Mitigation Strategy (REMS) associated with mifepristone limits the number of providers of mifepristone. Mifepristone increases the efficacy of medical management of early pregnancy loss, but difficulties in acquiring the drug causes delays for Indian Health Service and Tribal faciliites attempting to utilize the medication.


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        • Schreiber CA
        • Creinin MD
        • Atrio J
        • Sonalkar S
        • Ratcliffe SJ
        • Barnhart KT.
        Mifepristone pretreatment for the medical management of early pregnancy loss.
        N Engl J Med. 2018; 378: 2161-2170
        • Bulletins—Gynecology
        ACOG practice bulletin no. 200: early pregnancy loss.
        Obstet Gynecol. 2018; 132: e197-e207
      1. Rosay A. Violence against American Indian/Alaska native men and women, (accessed January 31, 2021).

      2. Magnitude of Sexual Violence in Arizona, 2015. Arizona department of health services, (accessed January 31, 2021).

        • Arnold SB.
        Reproductive rights denied: the Hyde Amendment and access to abortion for Native American women using Indian health service facilities.
        Am J Public Health. 2014; 104: 1892-1893