The next battle over abortion access will focus on the pills

SIOUX FALLS, SD (AP) — It took two trips over state lines, navigating icy roads and a patchwork of state laws, for a 32-year-old South Dakota woman to get abortion pills last year.

For abortion seekers like her, such trips, along with pills sent through the mail, will grow in importance if the Supreme Court acts on its leaked draft opinion that would overturn the landmark Roe v. Wade and would allow individual states to ban the procedure. The woman, who spoke on condition of anonymity because she feared for the safety of her family, said the abortion pills enabled her to end an unexpected, high-risk pregnancy and remain dedicated to his two children.

But anti-abortion activists and politicians say these cross-border trips, remote doctor consultations and pill deliveries are what they will try to stop next.

“Medical abortion will be where abortion access is decided,” said Mary Ziegler, a professor at Florida State University College of Law who specializes in reproductive rights. “It will be the battlefield that will decide the applicability of abortion bans.”

The use of abortion pills has increased in the United States since 2000, when the Food and Drug Administration approved mifepristone, the main drug used in medical abortions. More than half of abortions in the United States are now performed with pills rather than surgery, according to the Guttmacher Institute, a research group that supports abortion rights.

Last year, the FDA lifted a longstanding requirement that women obtain abortion pills in person. Mail delivery is also now allowed nationwide.

These measures have stimulated online services that offer information on obtaining abortion pills and consultations to obtain a prescription. After the South Dakota woman discovered the state’s only abortion clinic couldn’t schedule her for a medical abortion in time, she found an online service, called Just The Pill, who advised her to travel to Minnesota for a telephone consultation with a doctor. . A week later, she returned to Minnesota for the pills.

She took the first almost immediately to her car, then cried as she drove home.

“I felt like I lost a pregnancy,” she said. “I love my husband and I love my kids and I knew exactly what I had to say goodbye to and it was a really awful thing to do.”

South Dakota is among several states, including Texas, Kentucky, Arkansas, Ohio, Tennessee and Oklahoma, where Republicans have moved to restrict access to abortion pills in recent months. South Dakota Governor Kristi Noem said additional in-person visits for pills and a ban on mailing them are needed to protect women and save “unborn children.” A total of 19 states require a medical clinician to be physically present when abortion pills are administered to a patient.

In addition to crossing state lines, women can also turn to international online pharmacies, said Greer Donley, a professor specializing in reproductive health care at the University of Pittsburgh School of Law. Some women also have prescribed pills passed across states without restrictions.

“It allows someone to have an abortion without the direct role of a provider. It will be much more difficult for states to control access to abortion,” she said, adding, “The question is how is this going to be enforced?

Sue Leibel, director of state policy for Susan B. Anthony List, a prominent anti-abortion organization, acknowledged that it’s an issue that has “snuck up” on Republican lawmakers in the state. .

“It’s a new frontier and states are struggling with enforcement mechanisms,” she said, adding, “The advice I always give – if you close the front door, the pills go enter through the back door.”

Leibel argued that women should not be prosecuted for seeking abortions, consistent with a long-held principle of many abortion opponents. She suggested that the next target for state law enforcement should be the pharmacies, organizations and clinics that supply the abortion pills. She also said abortion rights opponents should focus on electing a presidential candidate who will work to overturn the FDA decision.

The FDA said scientific review supported expanding drug access and complications were rare. The agency has reported 26 deaths associated with the drug since 2000, although not all of them can be directly attributed to the drug due to existing health conditions and other factors.

However, with new legal battles on the horizon and abortion seekers going to greater lengths to obtain the procedure, Donley, the law school professor, worried that state lawmakers were turning their attention to women who receive the pills.

Indeed, a Louisiana House committee on Wednesday introduced a bill that would make abortion a felony of homicide for which a woman terminating her pregnancy could be charged, as well as anyone assisting her.

“Many anti-abortion lawmakers might realize that the only way to enforce these laws is to sue the pregnant person themselves,” Donley said.


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