WASHINGTON — attention has now shifted to the anticipated legal battle over a popular method American women use to end early pregnancies. This is known as medication abortion.
As women from other states deluge clinics, there will be an increase in medical abortions in Minnesota.
The FDA approved the drug mifepristone in 2000 to legalize medication abortion in the United States. The FDA expanded the period within which the drug was allowed to be used in 2016, from seven to 10 weeks after a woman is pregnant. When women could access the drugs via telemedicine, or any other distance contact with doctors, medication abortions gained popularity again.
Mifepristone is used to prevent pregnancy. Misoprostol is used for medication abortions. The drugs are taken 24 to 48 hours apart. The first drug prevents the development of a baby and the second causes bleeding and contractions similar to those that can be caused by miscarriage.
According to the Guttmacher Institute, more than half (54 percent) of all U.S. abortions will be medication abortions in 2020.
For American women living in states post- Roe that have made it illegal to terminate a pregnancy in their own homes, the right to do so is now at risk. This ruling will likely make abortion illegal in nearly half of the country, and give the state governments the authority to regulate the procedure.
Pre-emption is a doctrine which states that federal law preside over state law in certain situations. This doctrine is the subject of a legal battle. Biden’s administration claims that states cannot prevent residents from using mifepristone because the FDA approved it.
“States cannot ban mifepristone because they disagree with the FDA expert judgment about its safety or efficacy,” stated U.S. Attorney general Merrick Garland.
However, state law governs the “practice” of medicine. States could therefore prohibit prescribing mifepristone.
It’s not clear what the Justice Department can do. Federal appeals courts will likely hear lawsuits involving medication abortion. However, these courts will likely be located in circuits with conservative judges.
Missouri’s Eighth Circuit Court of Appeals, which hears cases from Minnesota, Iowa and North Dakota, South Dakota as well as Nebraska, has 10 of 11 Republican-appointed judges. Former President Donald Trump appointed four of these judges.
Although a loss in a circuit court can always be appealed at the Supreme Court, the Supreme Court’s legal opinion regarding abortion is known. The legal battle over medication abortion will continue to be a hot topic.
“We’re going have so many lawsuits,” stated Wendy Parmet, a Northeastern University expert on public health. “There will be a lot more litigation.”
Parmet stated that anti-abortion countries may limit the ban on mifepristone being used to end a pregnancy. However, the drug can be prescribed for other purposes.
She said, “That would be a more sensible legal path.”
Parmet warned that “supporters for access to these drugs can’t be very sure they will prevail.”
Smith attempts to stop’misinformation
Just days before the Supreme Court overturned ROE, Sen. Tina Smith (D-Minn.) introduced a bill to codify the FDA guidelines for abortion medication. Smith stated that she would protect the FDA’s protections for medication abortions.
Smith stated that medical abortion is an effective and safe way to end a pregnancy. “I wanted FDA rules to be made law.”
The Protecting Access to Medication Abortion Act would ensure that women have access to medication abortion via telehealth, certified pharmacies and mail-order pharmacies.
Smith stated that although it won’t fix the problem created by Roesoverturn but would give “an additional layer of protection” for a popular method of ending a pregnancy, Smith said.
Smith, who was formerly a Planned Parenthood executive is well aware of the low chance that her legislation will be approved by the Senate. The Democrats have 50 votes in the chamber, and 60 are needed to end a GOP filibuster. If it weren’t for the filibuster Democrats in Congress would fight against the Supreme Court’s repeal of Roe by passing legislation that protects all abortion rights. Last month, a bill that guaranteed abortion access across the country was defeated in the Senate.
Smith stated that her bill would raise the issue and counter GOP claims about medication abortions being unsafe.
Smith stated that there are Republican extremist organizations trying to spread misinformation. “I want this legislation counter some of that misinformation.”
Governor of South Dakota Kristi Noem (a Republican) said this week that she would implement a plan approved state lawmakers to limit the use of medication abortion pills.
Noem said that abortion pills are “very dangerous medical procedures.” We don’t believe it should exist, as it can be dangerous for those who are not supervised by a doctor.
Contraception, an international reproductive journal, found that medication abortions were successful in ending pregnancies in 96% of women who participated in 120 medical trials. The journal stated that 119 of the evaluable subjects (0.3%) were admitted to hospital and 45 (0.1%) received blood transfusions.
The Supreme Court’s decision last week has seen a surge in medication abortions. Women from states that outlaw abortion have crossed into Minnesota, where it is legal to have a remote consultation with a doctor or pick up the prescription to terminate a pregnancy.
Just the Pill, a non profit telemedicine abortion provider, is reporting a sharp rise in calls for its services. Its Twin Cities location serves Minnesota, Montana and Colorado as well as people crossing the border from neighboring states. Lisa Falconer, spokeswoman for Just the Pill, stated that the company plans to set up a “fleet of mobile clinics” along the state borders. These will provide consultations for medication abortions as well as dispensing pills.
Just the Pill currently has its mobile clinic fleet deployed in Colorado. Falconer stated that the organization is working to raise money to deploy another fleet in the Midwest.
The Supreme Court has ruled that Roe was invalid. There is a growing trend to order abortion pills online from overseas. However, the legal environment is complicated and poses potential risks.
Smith stated that the greatest tragedy of overturning ROE was that it places people in unsafe situations.