The next battle over access to abortion will focus on pills

Last year, a 32-year-old South Dakota woman had to make two trips across state lines to procure abortion pills, navigating treacherous highways and a patchwork of state laws.

If the Supreme Court follows through on its leaked draft judgment, which would overturn the landmark Roe v. Wade decision and allow individual states to outlaw the procedure, such journeys, as well as pills supplied over the mail, will become more important for abortion-seekers like her. The woman, who asked to remain anonymous for the sake of her family’s safety, said the abortion pills allowed her to end an unplanned and high-risk pregnancy while remaining committed to her two children.

Anti-abortion campaigners and politicians claim that cross-border trips, distant doctor consultations, and pill deliveries are what they will try to stop next.

“Medication abortion will be where access to abortion is decided,” said Mary Ziegler. Mary is a professor at Florida State University College of Law who specializes in reproductive rights. “That’s going to be the battleground that decides how enforceable abortion bans are.”

“Just the pill”

Since the FDA approved mifepristone, the principal medicine to be used in medication abortions; in 2000, the usage of abortion pills has increased in the United States. The Guttmacher Institute is a pro-abortion research organization. As per it, more than half of abortions in the US have been done using tablets rather than surgery.

Last year, the FDA relaxed a long-standing rule that women obtain abortion pills in person. Mail delivery has now been permissible throughout the United States.

These actions have prompted the creation of websites that provide abortion pill information and consultations. A lady in South Dakota discovered that the state’s only abortion clinic was unable to book her for a medication abortion in time. Then, she discovered an online service called Just The Pill. It suggested she drive to Minnesota for a consultation with a doctor. She returned to Minnesota for the pills a week later.

She drove home crying after taking the first one practically immediately in her car.

“I felt like I lost a pregnancy,” she said. “I love my husband and I love my children and I knew exactly what I had to say goodbye to and that was a really horrible thing to have to do.”

“Women can also use internationally-based internet pharmacies”

South Dakota is one of the numerous states where Republicans have tried to restrict abortion pill availability in recent months. It includes Texas, Kentucky, Arkansas, Ohio, Tennessee, and Oklahoma. Additional in-person visits for the tablets, and a restriction on them being supplied through the mail, are needed, says South Dakota Governor Kristi Noem. It is to safeguard women and save “unborn children”. When abortion pills are provided to a patient, 19 states require a medical clinician to be physically present.

Women can also use internationally-based internet pharmacies, according to Greer Donley. Donley is a professor at the University of Pittsburgh Law School who specializes in reproductive health care. Prescription drugs are also being transferred without restrictions via states for some women.

“It allows for someone to have an abortion without a direct role of a provider. It’s going to be much harder for states to control abortion access,” she said. Thereby, adding, “The question is how is it going to be enforced?”

Sue Leibel, state policy director for Susan B. Anthony List, a renowned anti-abortion group, acknowledged that the topic “had crept up” on Republican state lawmakers.

“This is a new frontier and states are grappling with enforcement mechanisms,” she said. Also, adding, “The advice that I always give — if you shut the front door, the pills are going to come in the back door.”

Abortion opponents

Abortion opponents claim they have no plans to prosecute women who seek abortions.

Instead, pharmacies, organizations, and clinics that provide abortion drugs should be the next focus for state regulation, according to a report. She also suggested that opponents of abortion rights concentrate their efforts on supporting a presidential candidate who would fight to overturn the FDA’s ruling.

The FDA stated that a scientific evaluation justified expanding access to the medications and found that side effects were uncommon. Since 2000, the FDA has identified 26 deaths linked to the drug. But not all of them may directly link to the medicine due to pre-existing health issues and other circumstances.

With new legal challenges looming and abortion seekers going to greater lengths to acquire the procedure, Donley, the law professor, is concerned that state lawmakers may eventually focus on the women who take the pills.

“Many anti-abortion legislators might realize the only way to enforce these laws is to prosecute the pregnant person themselves,” she said.

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