MONTGOMERY, Ala. — More than 20 attorneys general have signed on to a letter to Food and Drug Administration Commissioner Robert Califf condemning the FDA’s decision to allow remote prescribing and administration of abortion pills.

The FDA decided to permanently allow doctors to prescribe the Mifeprex (mifepristone) with misoprostol medication remotely, a decision that was initially allowed due to the COVID-19 pandemic. The pills can terminate pregnancy up to 10 weeks.

“In direct contravention of longstanding FDA practice and congressional mandate, the FDA’s rollback of important safety restrictions ignores both women’s health and straightforward federal statutes. We urge you to reverse your decision,” the Jan. 13 letter states.

The letter indicates the FDA should leave such decisions to individual states.

“In our states, we prioritize the health and safety of women and children and our laws reflect this.,” the letter continues. “And in many states, including Alabama, elective abortion is illegal. … Our States will not yield to the Administration’s radical pro-abortion policies.”

Abortions are only permitted in Alabama in cases of a medical emergency and must be performed under the close supervision of a qualified physician, per Alabama law.

“Alabama’s law carries criminal penalties for providers and, as you seem to acknowledge, your recent change in policy does nothing to dilute the strength of state laws,” the letter states.

Alabama Attorney General Steve Marshall, Georgia AG Chris Carr — who is enforcing a six-week abortion ban — and attorneys general from 20 other states where abortion is illegal or restricted, signed the letter.

The attorneys general cited potential risks — including infection and bleeding — associated with the drug as reason for supporting previous FDA rules requiring the medication to be prescribed by a qualified physician and administered in a hospital, clinic or medical office and only by or under the supervision of such a physician.

However, the FDA suggests the pills are a safe and effective way of terminating a pregnancy, reporting low numbers of hospitalizations from the pill.

From September 2002 through last December, more than 1,000 of the 3.7 million abortion pill usages have led to hospitalization.

“Though the FDA has abdicated its responsibility to protect women’s health, we have not,” the attorneys general conclude in their letter. “To be crystal clear, you have not negated any of our laws that forbid the remote prescription, administration and use of abortion-inducing drugs. The health and safety of our citizens — women and children included — is of paramount concern. Nothing in the FDA’s recent changes affects how we will protect our people.”

Under a more recent guidance from the FDA for the mifepristone risk evaluation mitigation strategy program, pharmacies can now become certified to dispense the medication by completing a Pharmacy Agreement Form. Pharmacies that get certified to dispense the mifepristone must be able to ship it using a shipping service that provides tracking information and ensure the pill is dispensed to the patient in a timely manner, the FDA states.