The fight against the abortion pill

Since the end of Roe v. Wade, the battle over legal abortion has largely shifted to access to pills.

Since the end of Roe v. Wade last June, access to abortion pills eased some of the effects of tough restrictions on abortion that 14 states have imposed. Abortion opponents have responded by trying to reduce access to these pills. The resulting struggle has become the main battle to watch in the post-Roe landscape.

Today's newsletter takes a look at the latest developments - including a court ruling expected soon - and explains what is likely will happen next.

How access to the pills has grown

The most effective and effective method of medical abortion the safest requires two drugs. The first, mifepristone, terminates the pregnancy. The second, misoprostol, causes cramping and bleeding to empty the uterus, like a miscarriage. By approving this diet in 2000, the F.D.A. imposed restrictions on mifepristone due to questions then about its safety. Among other rules, patients had to go to a clinic, doctor's office or hospital to receive the drugs.

In 2021, during the pandemic and after the entry according to President Biden, the F.D.A. lifted the requirement in person. This change opened a new path for telemedicine abortions. In about 30 states, women could legally terminate their pregnancies at home, with pills prescribed through an online consultation and sent by mail. If they had questions, they could call a private national hotline to speak to medical professionals.

After the Supreme Court struck down Roe last year , the demand for abortion pills by mail has increased. An international organization, Aid Access, provided prescriptions for the pills from European doctors, often filled in India, to patients in banning states. Foreign pharmacies, online advertising, also ship abortion pills without a prescription to all states.

These offshore routes, which operate in a legal gray area in states that ban abortion, will likely remain open. But they carry potential legal risks for women and it can take a few weeks for the drugs to arrive from abroad, a delay which can create problems since medical abortion is more effective and less likely to cause complications at home. early pregnancy.

How Opponents Fight Back

Abortion opponents have a bold counter-strategy. They want to block the use of mifepristone not only in abortion-banning states, but across the country.

In November, anti-abortion organizations and doctors sued in Texas to challenge the F.D.A. the approval of medical abortion 23 years ago. They argue that mifepristone is dangerous. In fact, research has clearly established the safety and effectiveness of the F.D.A.-approved diet. Serious complications are possible but rare. So on the merits, the lawsuit may seem far-fetched.

But plaintiffs made sure to sue (a practice some pundits call "judge shopping") in a division of a federal district court with a judge, a Trump appointee named Matthew Kacsmaryk who has long-standing anti-abortion views. If he blocks F.D.A. approval, it would be unprecedented, experts said in an amicus brief.