What would the end of Roe v. Wade for access to the abortion pill?

​​If you

By Amy Sherman —

A Supreme Court bill that would overturn Roe v.

Wade means that abortion pills may become a key aspect of the next legal frontier for abortion access.

The bill seeks to overturn Roe v.

Wade, the 1973 ruling that established the national right to abortion, as well as a later ruling, Planned Parenthood v.

Casey, who asserted that right.

If that happens, each state could make laws about whether and when to allow abortion.

Some states already have laws that would reinstate restrictions on abortion if Roe v.

Wade.

We wonder what such a court decision might mean for medical abortion, commonly known as the abortion pill.

About half of the states are expected to enact laws banning abortion, and that would apply to both surgery and the abortion pill.

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"If Roe v. Wade is overturned, states will be able to ban abortion, period," said Kelly Krause, a spokeswoman for the Center for Reproductive Rights, a legal and advocacy organization.

"The method of abortion does not matter."

Each state will decide whether and under what circumstances abortion will be allowed, which would include medical abortion, said Heather Hacker, a Texas attorney who previously worked for the Texas attorney general.

Many states have already passed restrictions that reduce access to medical abortion.

Some "states may allow abortion, but require an ultrasound first, which may not be compatible with ordering abortion pills by mail," Hacker said.

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"Some states have regulations that apply directly to medical abortion, such as requiring the pill to be delivered in person after providing informed consent information or prohibiting telehealth abortions, which could also affect the legality of getting pills by mail." , stated the lawyer.

Other states may implement their own restrictions.

The effect could be profound: As of 2020, abortion pills became the most common way to end a pregnancy in the United States, according to preliminary data from the Guttmacher Institute, a pro-choice research organization.

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The leaked draft of the Supreme Court bill that was published by Politico on the night of May 2 caused a huge spike in people seeking information on how to access abortion, including on Plan C, a website that compiles information on how to get abortion pills in every state.

Plan C's website went from about 2,300 hits a day in recent weeks to about 56,000 on May 3, said co-director Elisa Wells.

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How patients get medical abortion

The medication option for abortion in about the first 11 weeks of pregnancy involves a combination of two drugs, mifepristone and misoprostol, usually taken about 24 hours apart.

Studies have found that about 95% to 98% of patients who take the drugs as prescribed will end their pregnancies without harm.

This method gained popularity amid the COVID-19 pandemic as patients increasingly turned to telehealth and after years of clinic closures.

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wade]

In 2021, the Food and Drug Administration (FDA) lifted restrictions on access to the pills, allowing patients to receive the medication by mail in states that do not restrict telehealth for abortion pills .

There are two main methods of medical abortion: physician-assisted, which means patients have a consultation, by video, phone, or email, before a provider mails them pills or fills them at a drugstore.

The other way is self-managed abortion in which a person finds the pills online without a doctor, or from another country.

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Aid Access, which launched in 2018, provides abortion medications in all 50 states, said Christie Pitney, a midwife who works at Aid Access.

The organization has American providers who prescribe in 20 states, while in the other states that have erected barriers to abortion pills, a doctor in Austria writes the prescription.

Pills from a US supplier typically cost around $150 and are mailed out in two to three days.

Prescriptions issued from Europe can cost around $110 and shipping from India can take two to three weeks.

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Interest in advanced prescriptions soared from about 40 a day to more than 5,000 in the first two days after the court bill was leaked, Pitney said.

Some states have put legal barriers on abortion pills

In February, the Kaiser Family Foundation found that 19 states had policies that prohibited telehealth for abortion or made it difficult to do so by asking for an ultrasound or in-person counseling.

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Following that Kaiser analysis, a couple more states passed restrictions, including Kentucky, which has banned abortion medication by mail, and South Dakota, which has signed into law an executive order banning telemedicine for abortions.

That law is under a court order.

If Roe v.

Wade, several states will ban or severely restrict abortion.

"In many cases, clinics will no longer be able to operate and will be forced to close, meaning a loss of access to medical abortion," said Rebecca Wang, an attorney with If/When/How, a reproductive justice legal group.

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It becomes more complicated legally when it comes to obtaining abortion pills outside of the formal health care system, Wang said. Both mifepristone and misoprostol are considered prescription drugs, and all legal requirements apply to them.

Currently, Oklahoma, Nevada, and South Carolina explicitly prohibit self-managed abortion.

Organizations that provide abortion medications and are located outside the United States are not subject to US law enforcement, whether private, state or federal, the Center for Reproductive Rights said.

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However, during the Trump Administration in 2019, the FDA sent a cease and desist letter to Austria-based Aid Access.

The letter stated that the specific brand of mifepristone and misoprostol that Aid Access was shipping was not approved by the FDA.

That didn't stop Aid Access, which has continued to prescribe the same drug to patients in the US.

The Susan B. Anthony List, a national group that supports political candidates pushing abortion restrictions, told PolitiFact that it "will strongly support legislation and candidates that seek to restrict access to abortion pills."

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Roe nullification and new state laws will raise legal issues

There are many unresolved questions about the liability of people who ship drugs from another state to be consumed by a woman in a state where they are prohibited, said Priscilla J. Smith, director of the Reproductive Justice Study program at the University of California College of Law. Yale.

"Doing so will depend on whether a state's law applies to out-of-state conduct," Smith said.

Kimberly Mutcherson, co-dean of Rutgers Law School and an expert on reproductive justice, said that if states want to punish out-of-state vendors for mailing pills, "they're going to have to be able to identify the seller and get jurisdiction over them." , which could also be difficult to the extent that people could mask their identities or could be operating abroad."

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Prosecutors also have discretion when it comes to deciding which cases to prosecute.

Following the passage of laws in numerous states restricting access to abortion, dozens of local and general attorneys signed a statement through a group called Fair and Just Prosecution in 2020 pledging not to prosecute women who obtain abortions. nor to the health professionals who assist them.

But it is also possible that some prosecutors prioritize those cases.