Next battle over access to abortion will focus on pills

May 4, 2022, 8:48 AM | Updated: May 5, 2022, 1:24 pm
Bottles of the drug misoprostol sit on a table at the West Alabama Women's Center on Tuesday, March...

Bottles of the drug misoprostol sit on a table at the West Alabama Women's Center on Tuesday, March 15, 2022 in Tuscaloosa, Ala. The drug is one of two used together in "medication abortions." According to Planned Parenthood, misoprostol, taken after mifepristone, causes cramping and bleeding to empty the uterus. (AP Photo/Allen G. Breed)

(AP Photo/Allen G. Breed)

SIOUX FALLS, S.D. (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 journeys, along with pills sent through the mail, will grow in importance if the Supreme Court follows through with its leaked draft opinion that would overturn the landmark Roe v. Wade decision and allow individual states to ban the procedure. The woman, who spoke on the condition of anonymity because she was concerned for her family’s safety, said the abortion pills allowed her to end an unexpected and high-risk pregnancy and remain devoted to her two children.

But anti-abortion activists and politicians say those cross-border trips, remote doctors’ 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, 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.”

Use of abortion pills has been rising in the U.S. since 2000 when the Food and Drug Administration approved mifepristone — the main drug used in medication abortions. More than half of U.S. abortions are now done with pills, rather than surgery, according to the Guttmacher Institute, a research group that supports abortion rights.

Two drugs are required. The first, mifepristone, blocks a hormone needed to maintain a pregnancy. A second drug, misoprostol, taken one to two days later, empties the uterus. Both drugs are available as generics and are also used to treat other conditions.

The FDA last year lifted a long-standing requirement that women pick up abortion pills in person. Federal regulations now also allow mail delivery nationwide. Even so, 19 states have passed laws requiring a medical clinician to be physically present when abortion pills are administered to a patient.

South Dakota is among them, joining several states, including Texas, Kentucky, Arkansas, Ohio, Tennessee and Oklahoma, where Republicans have moved to further restrict access to abortion pills in recent months.

Those moves have spurred online services that offer information on getting abortion pills and consultations to get a prescription. After the woman in South Dakota found that the state’s only abortion clinic could not schedule her in time for a medication abortion, she found an online service, called Just The Pill, that advised her to drive across to Minnesota for a phone consultation with a doctor. A week later, she came back to Minnesota for the pills.

She took the first one almost immediately in 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 children and I knew exactly what I had to say goodbye to and that was a really horrible thing to have to do.”

Besides 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 Law School. Some women also are having prescribed pills forwarded through states without restrictions.

“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, adding, “The question is how is it going to be enforced?”

Abortion law experts say it’s an unsettled question whether states can restrict access to abortion pills in the wake of the FDA’s decision.

“The general rule is that federal law preempts conflicting state law,” said Laura Hermer, a professor at the Mitchell Hamline School of Law in St. Paul, Minnesota. “There is no question that the FDA has proper authority to regulate the drugs used in medication abortions. The question is whether a state can make a viable, winning argument that, for public health purposes, it needs to further regulate access to the relevant medications.”

Hermer said she doesn’t think there is a valid public health reason because the published evidence is that the drugs are “exceptionally safe.” But if the Supreme Court overrules Roe v. Wade and a state gives embryos and fetuses full rights as people “then all bets would be off.”

The Planned Parenthood regional organization that includes South Dakota doesn’t believe it can legally mail abortion pills to patients there.

Telemedicine providers have to abide by the laws of the state where the patient is, said Dr. Sarah Traxler, chief medical officer for Planned Parenthood North Central States in St. Paul. She acknowledged that some organizations disagree. “But,” she added, “we don’t feel like we have liberty to mail pills from Minnesota to other places in the country where it’s illegal to provide medication abortion.”

Sue Leibel, the state policy director for Susan B. Anthony List, a prominent organization opposed to abortion, acknowledged that medication abortions have “crept up” on Republican state lawmakers.

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

Leibel maintained women should not be prosecuted for seeking abortions, keeping with a long-standing principle of many abortion opponents. She suggested the next target for state enforcement should be the pharmacies, organizations and clinics that provide the abortion pills. She also said abortion-rights opponents should focus on electing a presidential candidate who would work to reverse the FDA’s decision.

The FDA said a scientific review supported broadening access to the drugs and found complications were rare. The agency has reported 26 deaths associated with the drug since 2000, though not all of those can be directly attributed to the medication 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 will turn their attention toward the women who get the pills.

Indeed, a Louisiana House committee advanced a bill Wednesday that would make abortion a crime of homicide for which a woman ending her pregnancy could be charged, along with anyone helping her.

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

___

Associated Press writer Steve Karnowski contributed from St. Paul, Minnesota.

Copyright © The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

AP

Associated Press

Teen sought in ambush outside school that killed 1, hurt 4

PHILADELPHIA (AP) — Police are seeking a 16-year-old youth in last week’s ambush shooting outside a Philadelphia high school that killed a 14-year-old and wounded four other teenagers after a football scrimmage Police said Tuesday that the 16-year-old is wanted on active arrest warrants for a charge of murder and multiple counts of attempted murder […]
2 days ago
Associated Press

Estonian PM urges not to give in to Putin’s nuclear threats

TALLINN, Estonia (AP) — Estonia’s prime minister said Tuesday that the West must not give in to Moscow’s nuclear threats or premature peace proposals but stand firmly in support of Ukraine as the invaded country fights to rid its occupied territories of Russian soldiers. Kaja Kallas, who has led Estonia’s government since last year, told […]
2 days ago
A protester carries a piece of wood simulating a weapon during a protest demanding the resignation ...
Associated Press

Haiti at breaking point as economy tanks and violence soars

PORT-AU-PRINCE, Haiti (AP) — Daily life in Haiti began to spin out of control last month just hours after Prime Minister Ariel Henry said fuel subsidies would be eliminated, causing prices to double. Gunshots rang out as protesters blocked roads with iron gates and mango trees. Then Haiti’s most powerful gang took it a step […]
2 days ago
This image made available by NOIRLab shows a plume of dust and debris blasted from the surface of t...
Associated Press

Smacked asteroid’s debris trail more than 6,000 miles long

CAPE CANAVERAL, Fla. (AP) — The asteroid that got smacked by a NASA spacecraft is now being trailed by thousands of miles of debris from the impact. Astronomers captured the scene millions of miles away with a telescope in Chile. Their remarkable observation two days after last month’s planetary defense test was recently released a […]
2 days ago
In a Friday Jan. 8, 2016, photo, Flint residents shout while protesting outside of Flint City Hall ...
Associated Press

Key moments in Flint, Michigan’s lead-tainted water crisis

FLINT, Mich. (AP) — A Michigan judge’s order dismissing charges against seven people in the Flint water scandal is the latest development in a crisis that started in 2014. That was when the city began taking water from the Flint River without treating it properly, resulting in lead contamination. Here’s a look at some key […]
2 days ago
Antonio Garcia, of the Colombian guerrilla National Liberation Army (ELN), left, shakes hands with ...
Associated Press

Colombia and ELN rebels to restart peace talks

BOGOTA, Colombia (AP) — Delegates of Colombia’s government and the nation’s largest remaining guerrilla group met on Monday and announced that they will restart peace talks that were suspended in 2018. After meeting in Venezuela’s capital city, representatives of the Colombian government and the National Liberation Army issued a statement saying a date for the […]
2 days ago

Sponsored Articles

Anacortes Christmas Tree...

Come one, come all! Food, Drink, and Coastal Christmas – Anacortes has it all!

Come celebrate Anacortes’ 11th annual Bier on the Pier! Bier on the Pier takes place on October 7th and 8th and features local ciders, food trucks and live music - not to mention the beautiful views of the Guemes Channel and backdrop of downtown Anacortes.
Swedish Cyberknife Treatment...

The revolutionary treatment of Swedish CyberKnife provides better quality of life for majority of patients

There are a wide variety of treatments options available for men with prostate cancer. One of the most technologically advanced treatment options in the Pacific Northwest is Stereotactic Body Radiation Therapy using the CyberKnife platform at Swedish Medical Center.
Work at Zum Services...

Seattle Public Schools announces three-year contract with Zum

Seattle Public Schools just announced a three-year contract with a brand-new company to the Pacific Northwest to assist with their student transportation: Zum.
Swedish Cyberknife 900x506...

June is Men’s Health Month: Here’s Why It’s Important To Speak About Your Health

According to the Centers for Disease Control and Prevention, men in the United States, on average, die five years earlier than women.
...

Anacortes – A Must Visit Summertime Destination

While Anacortes is certainly on the way to the San Juan Islands (SJI), it is not just a destination to get to the ferry… Anacortes is a destination in and of itself!
...

Ready for your 2022 Alaskan Adventure with Celebrity Cruises?

Celebrity Cruises SPONSORED — A round-trip Alaska cruise from Seattle is an amazing treat for you and a loved one. Not only are you able to see and explore some of the most incredible and visually appealing natural sights on the planet, but you’re also able to relax and re-energize while aboard a luxury cruise […]
Next battle over access to abortion will focus on pills