By Cleo Shapiro
On January 29th, the Supreme Court announced it would begin to hear arguments concerning the use of “at-home” medication abortions in the United States, starting March 26th. This statement comes nearly two years after the Court overturned Roe v. Wade, their 1973 decision which generally legalized abortions, with their ruling in Dobbs v. Jackson Women’s Health Organization. This decision denationalized the right to abortion, and instead placed female reproductive health in the hands of individual states. Many states have since passed extreme laws that restrict abortion, leaving countless Americans to rely on medication abortion for safe and effective pregnancy termination. The Court’s potential ruling against these medications would be detrimental to people’s lives nationwide.
As of now, 50% of all abortions are performed with a combination of the medications Misoprostol and Mifepristone. After consulting with a doctor, many patients opt for medication abortion because it is cheaper, less invasive, and offers more privacy than the surgical termination of a pregnancy. The drug Mifepristone is taken as a progesterone blocker to end a pregnancy, and Misoprostol is taken 24 hours later to induce contractions and expel the fetus.
This medication was approved by the FDA in 2000 and has repeatedly been confirmed as being completely safe— even more so than over the counter medications like Advil and Tylenol. Where it stands, anti-choice lawmakers are attempting to eliminate the availability of Mifepristone; Misoprostol, however, is used for other purposes such as arthritis and heart disease, making it nearly impossible to ban.
Some doctors may continue to prescribe solely Misoprostol for abortions, especially because the cost of medication abortion is significantly lower for the patient than surgical methods. When taken by itself, Misoprostol can safely terminate pregnancies early, but frequently cause excruciating pain and other adverse side effects when taken without Mifepristone.
In the post-Roe world, in addition to procedural abortion restrictions, the current regulations surrounding medication abortion vary state by state. For example, states like Utah and Nebraska (that have not completely banned Mifepristone) require specific, invasive counseling measures before it can be prescribed by a medical professional. Currently, 14 states have near-total bans on this medication, even in cases of incest or rape. As of January 2024, researchers have estimated that there have been around sixty-five thousand pregnancies that have been a result of rape since Roe was overturned. And that is just in those 14 states.
When Mifepristone is taken orally, it appears as a miscarriage, with no way to medically prove that the termination was intentional. However, under new Texas laws, even in cases of somebody who “unknowingly engages in conduct that aids or abets the performance or inducement of an abortion” is subject to legal pursuit. Just the act of helping a pregnant person obtain an abortion pill can result in being sued for $10,000 for each abortion they had a role in under these parameters.
As we navigate the changing landscape of reproductive liberties after Dobbs, it is crucial to reflect on how the bans on Mifepristone not only raise concerns about the infringement on female bodily autonomy, but also reinforce the importance of continued advocacy for comprehensive reproductive health care- no matter what one’s choice may be. Watching powerful men claim authority over what female bodied people are permitted to do is a gutting feeling. As the rights we have worked for decades to secure are robbed, it is becoming increasingly difficult to continue having faith in the power of the vote. However, as UPenn law professor and constitutional expert Kate Shaw emphasizes, “the mechanisms of direct democracy — referendums, initiatives, ballot questions, and the like” make way for voters to “register their preferences directly, bypassing elected officials.” By staying engaged in the conversation and advocating for policies that prioritize reproductive and women’s rights, we can make advancements in the grueling pursuit of a future where reproductive healthcare is truly accessible to all.
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