Following the leak of a majority opinion draft, expectations are high that the U.S. Supreme Court will soon overturn the Roe v. Wade’s 1973 affirming women’s constitutional right to abortion, and we have an idea of what the enemies of abortion will next target: pills.
In recent years, a two-drug combination approved by the Food and Drug Administration has become a common method for terminating first-trimester pregnancies.
As most red states drove out providers of surgical abortions, women increasingly turned to drugs, which have been legal in the United States since 2000. More than half of abortions in this country are said to be performed at using pills, and we expect that proportion to increase after the much-anticipated court ruling.
This scenario sets up a serious conflict.
Those who celebrate Roe’s end acknowledge that the coming ruling would lose its impact if most people could still get an abortion by taking a few widely available pills, especially if those pills are available by mail order.
Even as blue states like Illinois defend their new laws to ensure access, abortion advocates are campaigning to expand existing state laws that limit abortion and eliminate access to drugs once the High Court acted.
The Chicago Tribune editorial page has long supported a woman’s right to choose, grounded in our belief in her autonomy over her body and our commitment to individual freedoms. We accept that once Roe is gone, each state will go its own way on this divisive issue, and some will likely impose ruthless outright bans.
The next logical step in enforcing these bans should be of concern to everyone. Further state efforts to restrict access to abortion pills could challenge the Food and Drug Administration’s primacy in nationwide drug regulation. They could erode the freedom to make personal health decisions, to engage in interstate commerce, and to protect privacy online.
Medical abortion begins with mifepristone. Then, sometimes a day or two later, a second drug called misoprostol is taken. The process is safe and effective, although often uncomfortable. It can be self-administered at home and usually costs no more than a few hundred dollars.
The FDA will come under political pressure to further restrict the pills, and its history so far is troubling. The agency only recently removed some medically unnecessary restrictions, while arbitrarily keeping others.
In 2016, it extended the time in which abortion drugs could be taken from seven weeks to 10 weeks after a pregnancy, and during the pandemic it lifted the unnecessary requirement that the first pill be delivered during a home visit. the doctor in person, allowing it to be prescribed by telehealth and delivered by mail.
The FDA continues to require physicians and pharmacies to be certified to supply the first drug and requires patients to sign an agreement stating that they understand the drug’s risks.
Decades of data and the FDA’s own findings show that there is no particular danger justifying these rules, or even its 10-week restriction. To maintain its credibility and autonomy, the agency must regulate drugs based on what is appropriate for the health of Americans, not politics.
Since federal law takes precedence over state law, the FDA should in theory have the final say on how the pills can be distributed in the United States. But regulation of the medical profession is generally handled at the state level, and legal challenges from anti-abortion states could lead to weakened FDA oversight of all drugs.
As conservative states do whatever it takes to prevent their residents from getting abortion pills widely available elsewhere, we see more trouble coming.
More aggressive laws that make it a criminal offense to cross state lines to obtain abortion services, to use telehealth to obtain prescriptions or to receive pills in the mail could impede access to health care unrelated to abortion.
Another potential victim of anti-abortion pill measures could be the privacy offered by the Internet, where women who need the procedure often seek advice. Web searches, app data and phone records could be considered evidence in states that ban abortion, prompting authorities to obtain browsing histories and decipher encrypted messages.
Deceptive practices on the web could also create problems. Anti-abortion activists are already using bogus sites to intercept women seeking to terminate their pregnancies, and we anticipate new sites aimed at tricking women into providing information that could be used against them or their pill suppliers.
These concerns are hypothetical, and recent weeks have seen pro-abortion forces use the court’s draft decision – which is not the court’s final word – to gain support by throwing out many scary scenarios, some more plausible than others.
We believe that the impending fight against abortion pills is indeed a plausible threat to cherished rights that must be taken seriously.