‘What’s their game plan now?’: Accutane users say they were told to terminate pregnancies. What happens post-Roe?

Half of America lost access to federally protected, legal abortions at the end of last month with the overturn of Roe v. Wade. Now, TikTokers who were prescribed acne-reducing medications—and say they were asked to terminate any pregnancy while taking the pills—wonder how Accutane (or, isotretinoin, a Vitamin A derivative) will work in a post-Roe v. Wade America.

In a TikTok posted on June 26, Charli (@dietpeachsnapple2) posted a video of an Accutane package showing the birth defects it could cause to fetuses if someone taking the pill gets pregnant. The video includes TikTok’s Horace effect, which shows a small man dancing.

“Dancing on those birth defects,” Charli wrote in the video’s overlay text about Horace. On Tuesday, Charli’s video had over a million views.

Accutane is a medication used to treat acne, and its side effects include an “extremely high risk for severe birth defects,” and “spontaneous abortion,” also known as miscarriages or incomplete abortions. Incomplete abortions, which usually present as vaginal bleeding, are reportable offenses in states with abortion bans, like Texas.

In a comment on the video, Charli said she is currently on Accutane for the third time and clarified that she didn’t mean Accutane could be used to terminate a pregnancy—but that if someone became pregnant while using Accutane, they wouldn’t be able to abort a fetus that might have severe birth defects. The Daily Dot reached out to Charli via TikTok comment but was not met with a reply.

@dietpeachsnapple2

Dancing all over them birth defects

♬ original sound – Low Fro Photography

In a statement to the Daily Dot, Dr. Jen Villavicencio, an obstetrician-gynecologist with a specialty in complex family planning speaking on behalf of the American College of Obstetricians and Gynecologists, said that patients of reproductive age have been denied medications they need “out of concern for a potential pregnancy” in the “chaos and confusion” following Roe v. Wade being overturned.

“It is critical that patients be able to access needed medications as prescribed by their doctors in the context of their unique, individual health conditions,” Dr. Villavicencio told the Daily Dot. “Abortion bans pit people with health conditions against their potential to get pregnant—often times limiting the essential health care they need.” 

Commenters who had been on Accutane discussed how their doctors asked them to promise to not get pregnant while on the pill through the iPLEDGE system. iPLEDGE is a risk evaluation and mitigation strategy from the Food and Drug Administration that asks patients to promise to take pregnancy tests and use multiple contraceptive methods or be abstinent while taking Accutane.

“I had to sign paperwork on [Accutane] that said I would for sure get an [abortion] if I got preg,” @gnomewife commented. The TikToker user said they signed paperwork in California.

“I had to sign paperwork saying I would terminate if I got pregnant on Accutane,” @blb8675309 wrote. “Wonder how that will work now.”

“I literally had to sign a contract saying I’d get an abortion if I got pregnant on it & the federal gov tracks it,” @tnavarre16 commented, referring to the iPLEDGE system. “So what’s their game plan now.”

Many guessed that Accutane will be restricted or banned due to abortion bans in many states.

In an email statement to the Daily Dot, an FDA official said that iPLEDGE’s enrollment forms and related documents do not require or recommend patients get abortions if they become pregnant on Accutane and that patients who do become pregnant while taking the pills should consult with an OB-GYN.

“Patients who can become pregnant must sign the patient enrollment form, agreeing to use two forms of effective birth control unless they have chosen abstinence, and that, if the patient becomes pregnant, they must stop taking isotretinoin immediately,” the FDA official told the Daily Dot. “The patient should be referred to an obstetrician/gynecologist experienced in reproductive toxicity for further evaluation and counseling.”

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