Opponents of abortion are increasingly targeting the accessibility of abortion pills, which are widely used to terminate pregnancies in the U.S. Recently, the Texas attorney general’s office filed a lawsuit against a New York doctor for allegedly violating Texas law by providing abortion pills to a patient in Texas through telemedicine. This legal action marks the first of its kind and may challenge a New York law safeguarding providers who prescribe these medications to patients in states where abortion is prohibited.
In addition to legal maneuvers, anti-abortion officials are pursuing other avenues through legislative measures and lawsuits. Concerns have also been raised among abortion rights advocates regarding potential restrictions on access under the incoming administration of President-elect Donald Trump.
Abortion pills have become the preferred method of abortion in the U.S., especially following the landmark Supreme Court decision overturning Roe v. Wade in 2022. By then, more than half of abortions were being carried out using medication, typically a combination of mifepristone and misoprostol. These drugs are distinct from emergency contraceptives like Plan B, which are typically taken within days after potential conception, before pregnancy is confirmed. Studies have shown that medication-induced abortions are generally safe and successful over 97% of the time, though slightly less effective than surgical procedures.
By the latest count from the Guttmacher Institute, nearly two-thirds of abortions in recent years have been medication-induced. A significant portion of this increase is attributed to the rise of telehealth services for prescribing abortion pills, with some estimates suggesting that telehealth prescriptions accounted for about 10% of all abortions in the U.S. by mid-2024.
Despite laws in some states, including New York, aimed at protecting providers who offer abortion pills to patients in states with abortion bans, Texas Attorney General Ken Paxton has targeted a New York doctor for prescribing such pills to a patient in Texas. This legal challenge could have implications for the enforcement of New York’s protective law. Legal experts suggest that any ruling may not dissuade other out-of-state doctors from providing similar services, as demand for these medications persists.
In parallel, other states are pursuing legal actions to curb the availability of abortion pills through different approaches. The landscape surrounding abortion pills and access to reproductive healthcare remains complex and subject to ongoing legal and political developments.
The U.S. Supreme Court recently made a significant ruling regarding a group of anti-abortion physicians and their representing organizations. The Court determined that they lacked the legal standing to challenge federal approvals for mifepristone, a medication commonly used for medical abortions. This decision came after the state attorneys general from Idaho, Kansas, and Missouri filed a legal motion in October asserting their ability to make such arguments.
Rather than focusing solely on the drug’s original approval back in 2000, these states are examining subsequent changes made by the U.S. Food and Drug Administration (FDA). These changes expanded the approved usage of mifepristone to include the first 10 weeks of pregnancy and allowed for telemedicine prescriptions. The legal proceeding initiated by the state attorneys general is still pending, with the possibility of an appeal to a higher court once a ruling is handed down.
In response to these developments, several states are contemplating legislative measures aimed at regulating abortion pills. Louisiana made headlines by becoming the first state to classify both mifepristone and misoprostol as “controlled dangerous substances,” requiring additional steps for medical professionals to access them. Concerns have been raised that such reclassification could lead to delays in administering these drugs during emergencies, such as postpartum hemorrhaging.
Meanwhile, other states are exploring ways to restrict access to abortion pills in their upcoming legislative sessions. In Tennessee, for instance, a Republican lawmaker proposed a $5 million civil liability penalty against individuals involved in delivering or facilitating access to abortion pills with the intent of terminating a pregnancy. Similarly, Missouri is considering legislation that would criminalize the distribution of mifepristone or other abortifacient drugs.
Recent political shifts, including the administration change from Trump to Biden, have also sparked discussions about potential federal actions regarding abortion pills. During his campaign, President Trump displayed varying stances on abortion policy, creating uncertainty within both abortion rights advocates and opponents. While the Trump administration could have pursued enforcement of an 1873 law prohibiting the mailing of abortion-related medications or instruments, President Biden’s administration opted not to do so.
Looking ahead, there remains the possibility that the FDA may revise its approvals for these drugs independently of any court mandates. The evolving landscape of abortion policy underscores the complex and contentious nature of reproductive rights issues in the United States.
