The Coming War On Abortion Drugs

Medication abortion can be obtained in a few different ways, but typically people set up an appointment at their local abortion clinic and are sent home with a bag of pills to be taken over the next 72 hours.

Leigh was recently one of those people, making the 20-minute drive to a clinic in Washington, D.C., to come home with a handful of abortion pills and Netflix their way through the abortion from the comfort of their bed.

“I was thankful I didn’t have to be in a clinic, that I could be at home in familiar surroundings and just try to relax as best as I could,” they said. (Leigh, who is nonbinary, is using a pseudonym for privacy reasons.)

But obtaining abortion pills in a clinic setting is becoming increasingly more difficult depending on where you live.

In the last few years, anti-choice lawmakers have ramped up their efforts to restrict access to in-person clinic care by using targeted regulation of abortion providers, also known as TRAP laws, and other medically unnecessary restrictions, such as state-mandated waiting periods between the consultation and getting the pills prescribed, required counseling that’s not based in science or laws that force people to listen to fetal activity before accessing an abortion. In states like Oklahoma and Texas, which have extreme abortion bans, people are forced to take multiple-day journeys out of state just to access a handful of abortion pills.

Since in-clinic access has all but disappeared in many red states, some providers have moved online, allowing people in certain states to access abortion pills by mail. States including California, New York and Colorado allow telehealth for abortion before the 10-week mark, through online pharmacies like Hey Jane and Abortion On Demand. This means that a physician can virtually prescribe and send abortion pills right to your doorstep, allowing you to manage your abortion from the comfort of your home.

And it’s clear there’s a growing interest in accessing abortion pills from these online pharmacies. Before the Supreme Court draft decision leaked in early May, Elisa Wells, co-founder and co-director of Plan C, an advocacy organization that provides people with information on how to obtain abortion pills, told HuffPost her website averaged around 2,500 visitors every day. The night the draft decision leaked, Wells said her website saw 16,000 visitors. The next day, it had 56,000 visitors.

But with more awareness of the benefits of and easy access to abortion pills, comes more attacks from abortion opponents. Heavyweight anti-choice groups like Susan B. Anthony List and Americans United For Life stated at the start of this year that restricting abortion drugs is a top priority in 2022. Already, 19 states have banned prescribing medication abortion via mail or by virtual telehealth visits.

This year alone, Missouri lawmakers introduced bills that would equate mailing abortion pills to drug trafficking. In Kentucky, lawmakers created a public database that lists the name of medication abortion providers so that people can anonymously report any purported violations of the state’s abortion laws. Tennessee lawmakers passed a bill making it a felony to mail medication abortion, punishable by a $50,000 fine or up to 20 years in prison ― a similar law passed in Texas last year. And all of the draconian abortion bans in places like Texas, Oklahoma and Idaho apply to both procedural and medication abortions.

“In the face of these unjust laws and unjust court decisions, this is what we want people to know: There is something you can do,” Wells said. “We’ll tell you where to find these pills, how to use them, how to get support and what you need to know about the landscape around using pills for self-managed abortion, including the potential legal risk.”

Self-Managed Abortion In A Post-Roe Reality

As access to in-clinic and telehealth abortion dwindles in red states, some women and birthing people will prefer self-managing their own abortions because it’s easier than navigating the ever growing list of barriers. And many will simply be forced to self-manage their abortions because they don’t have any other options.

Thankfully, self-managing your own abortion with medication looks very similar to one done in a clinic or via telemedicine. A self-managed abortion is done outside of a traditional health care setting, often when a person obtains abortion pills not from a physician and undergoes an abortion without medical assistance. Because medication abortion is extremely safe and effective, it will ensure that we don’t go back to the pre-Roe days of botched abortions that left so many dead.

There are several ways to to get abortion drugs outside of the traditional health care setting, including in Mexico, where misoprostol is widely available over the counter. People can also go through Aid Access, an Austria-based nonprofit that prescribes medication abortion via mail to all 50 states.

Aid Access can offer telehealth abortion anywhere in the U.S. despite specific state restrictions because their provider is based in Austria. This allows the group to circumvent U.S. regulations that penalize providers, and prescribe medication free of legal risk. Obtaining abortion pills through Aid Access is not technically characterized as a form of self-managed abortion because patients are guided through the process by a physician. But most people who need to go through Aid Access are likely navigating state restrictions or bans on abortion.

Managing an abortion outside of traditional health care settings brings with it certain legal gray areas.

“People have been targeted for criminalization for self-managed abortion in this century in numerous states where prosecutors misapply laws that were never intended to be used against somebody for ending a pregnancy,” said Sara Ainsworth, the senior legal and policy director at If/When/How: Lawyering for Reproductive Justice.

“One of the reasons we understand that that happens is, in addition to the political opposition to abortion, is that there’s so much stigma that surrounds abortion generally,” she added. “The idea that it must be illegal if someone is managing an abortion on their own is unfortunately very pervasive.”

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