As the Supreme Court overturns Roe v. Wade says more American women will try to stock up on abortion pills – in some cases as a precaution for future use, health experts say
By Emma Batha
LONDON – (Thomson Reuters Foundation) – U.S. Supreme Court decision to overturn a 1970s ruling that nationwide legalized abortion would fuel a surge in demand for pregnancy-terminating pills, reproductive health experts say .
At the same time, conservative states – which have already struggled to limit the use of the pills – are expected to tighten restrictions further.
The Supreme Court on Friday overturned the landmark 1973 Roe v. Wade decision that recognized a woman’s constitutional right to abortion, a step that is expected to lead half of the nation’s states to heavily restrict or ban abortion.
Aid Access, a doctor-backed service that ships pills across the country, said demand skyrocketed in May following a leaked Supreme Court document indicating its intentions.
He said the women ordered the drugs to keep in their bathroom cabinet in case they needed them in the future.
What are abortion pills?
The abortion pill, also known as medical or medical abortion, usually involves two drugs, mifepristone and misoprostol, taken 24-48 hours apart.
They are approved for use in the United States during the first 10 weeks of pregnancy. Mifepristone blocks the pregnancy hormone progesterone, while misoprostol induces uterine contractions.
The pills can be provided at a clinic or mailed to a woman’s home after an online consultation, depending on state laws.
Some women, especially in states with restrictive laws, turn to online pharmacies that ship from overseas.
Abortion pills are often a lifesaver for women who have difficulty accessing a clinic, according to health experts.
According to the Guttmacher Institute, a research group that supports abortion rights, people in rural areas or other areas without abortion providers may have to travel hundreds of miles to get to a clinic.
The need to take time off work and to arrange childcare and overnight stays can add to costs and logistical challenges.
How many women use abortion pills?
Medical abortions accounted for 54% of abortions in the United States in 2020, up from 39% in 2017, according to a study published this year by Guttmacher.
In some European countries, they represent 80 to 90% of abortions.
The COVID-19 pandemic has likely increased the use of abortion pills due to greater difficulty in accessing clinics and the growth of online healthcare.
Abortion pill suppliers said demand had increased following the Supreme Court leak.
“Most were from people who weren’t pregnant and got the pills ahead of time,” said Aid Access clinician Robin Tucker. “It’s brand new – we’ve never seen anything like it before.”
Plan C, a US organization that shares information on how to access abortion pills, said visits to its site skyrocketed after the leak.
About 85% of requests Aid Access receives are from women living in states with restrictive laws, according to Abigail Aiken, a medical abortion expert at the University of Texas.
She said demand tripled in Texas last year after abortion was banned beyond about six weeks, giving an indication of what will happen in the coming months as more and more of states would repress.
What are the laws around the abortion pill?
In response to the pandemic, the U.S. Food and Drug Administration lifted rules stipulating that pills must be dispensed by a clinician at a health care facility, allowing women to receive them by mail to take home.
But 19 states ban the use of telemedicine for pregnancy terminations, requiring the clinician to be physically present when the drug is administered.
Many states have taken additional steps this year to ban the use of abortion pills, ban mailing pills, or stop the use of telehealth for medical abortion.
“The anti-abortion movement is currently focused on abortion pills,” Aiken said.
Individual state laws applying to gestational limits for surgical abortions also apply to medical abortion.
Abortion pill suppliers in liberal states cannot send pills to restrictive states.
But Aid Access founder Rebecca Gomperts, who is registered as a doctor in Austria, provides consultations to women in restrictive states and prescribes pills that are sent from India.
Reproductive health experts said that while most states have not specifically banned “self-directed” home abortions, some women have been prosecuted in the past under various laws.
What do abortion pill suppliers do?
They have beefed up help desk staff ahead of Friday’s Supreme Court ruling and checked that pharmacies have enough supplies to meet any surge in demand.
They also looked for ways to help women in restrictive states access the pills without putting anyone at legal risk.
Here are some of the ideas explored:
– Women in restrictive states can ask suppliers in the United States to send pills to post offices in neighboring liberal states and cross state lines to pick them up.
– Abortion providers are discussing the use of vans to provide medical abortions in border areas neighboring restrictive states.
– Some abortion clinics in restrictive states are opening sister clinics in more liberal states.
– Some groups offer women living in restrictive states assistance with travel costs to access abortion services elsewhere.
– Aid Access provides abortion pills in advance to women who are not pregnant.
– Some women in restrictive states use vendors in liberal states in conjunction with mail forwarding services so that the vendor does not ship the pills directly to their home.
Aid Access founder Gomperts suggested that misoprostol could also be provided to women who are not pregnant to keep in the cupboard.
Misoprostol can be used alone as an abortion drug, although it is less effective than the two-pill method.
Gomperts said that if the woman was not pregnant, the provider could not be sued for assisting with an abortion, adding that misoprostol also has other medical uses.
Some liberal US states are also introducing laws that would protect someone in that state from arrest or extradition if they prescribed pills in a restrictive state.
Connecticut has already passed a law. New York and California currently do. But such laws are largely untested.