“The Biden administration helped expand access to medication abortion last week, with the US Food and Drug Administration finalizing a rule to make the pills more readily available in pharmacies. But this effort to help patients get pills to end a pregnancy could be dwarfed by a major push to restrict access to the medication from anti-abortion leaders and their Republican allies.
As lawmakers head back to statelegislatures this month, many for the first time since Roe v. Wade was overturned in June, Republicans face new pressure to restrict access to the combination of abortion-inducing drugs, mifepristone and misoprostol, used typically within the first 10 to 12 weeks of a pregnancy. Medication abortion has become the most common method for ending pregnancies in the United States, partly due to its safety record, itslower cost, diminished access to in-person care, and greater opportunities for privacy.
Restricting access to the pills is not a new goal for the anti-abortion movement; the Guttmacher Institute tracked 118 medication abortion restrictions introduced last year across 22 states, and many conservative states already have laws on the books for dispensing the drugs that go beyond what the FDA requires and what leading health organizations recommend.
But efforts to crack down on abortion pills have taken on new urgency since the Dobbs v. Jackson decision. More women are finding ways to bypass abortion bans through organizations like Aid Access in Europe, pill suppliers from Mexico, and methods like mail forwarding from states where abortion is legal. While a study from the Society of Family Planning estimated that legal abortions nationwide declined by more than 10,000 in the two months following the Supreme Court’s decision, some or many of those abortions may have been replaced by pills women privately obtained and researchers couldn’t count.
“Everyone who is trafficking these pills should be in jail for trafficking,” Marjorie Dannenfelser, the president of Susan B. Anthony Pro-Life America, told the Washington Post in December. “It hasn’t happened, but that doesn’t mean it won’t.”
Some of the restrictions onmedication abortion leaders areconsideringextend well beyond those pursued by lawmakers in previous years, when their focus was generally on banning telemedicine and adding more requirements fordispensing pills in person, like mandatory ultrasounds, waiting periods, and visits with doctors.
Anti-abortion activists are exploring new strategies, such as laws to ban websites like Aid Access and Plan C and laws to make health care providers newly liable for disposing ofaborted fetal tissue. In a federal lawsuit filed in November, one religious conservative group has challenged the FDA’s approval of mifepristone writ large, alleging the agency abused its authority 23 years ago in authorizing the drug at all.
Some lawmakers are looking to test the limits of their extraterritorial powers, exploring how and whether they could punish a resident for getting an out-of-state abortion, or retaliate against providers in other states who facilitate them.
“Anti-abortion advocates are throwing the kitchen sink in an attempt to see what might work,” said Jenny Ma, a senior attorney at the Center for Reproductive Rights. “That’s the same playbook the anti-abortion movement had before Dobbs … but they’ve become emboldened.””