The ongoing struggle over reproductive rights and democracy

Bob Sheak, May 2, 2023

Introduction

This post focuses on the ongoing struggle between those who support the reproductive rights of women/females and those who oppose them. It is an issue that is highly emotional, in which religious beliefs are important to opponents, but in the final analysis it is a political issue that will be decided by whom voters elect. One of the central issues in this intense controversy and debate is the right-wing religious view that, from the moment of conception or early in a pregnancy, the embryo is a “person” with constitutional rights. It follows from this view that abortion should be banned, not only in some states but in all states. The purpose of this post is to challenge the right-wing perspectives and support the reproductive rights of women.

Reproductive Rights

Human Rights Watch offers a succinct summary of the meaning of reproductive rights and why they should be supported (https://hrw.org/topic/womens-rights/reproductive-rights-and-abortion).

“Reproductive rights are essential for women to enjoy their human rights. These rights are centered on women’s ability to make the best choices for their lives, including around the number of children they have, if any, and the spacing between their children’s births. Reproductive rights include prenatal services, safe childbirth, and access to contraception. They also include access to legal and safe abortion. Abortion bans violate the rights to be free from violence, to privacy, to family, to health, and even the right to life. And bans are most devastating for people of color, young people, and marginalized communities, who already have trouble accessing health care and other needed services. Governments should trust women to know what is best for their bodies, their physical and mental health, and their lives.”

The Anti-Abortion stance

The embryo as “person”

The anti-abortion position is based most fundamentally on the notion that the embryo is a “person” and deserving of legal protection when there is detectable heartbeat, which according to the Mayo Clinic, usually occurs in week 9 of a pregnancy (https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20045302). The embryo heart begins to form in week 6, but a heartbeat can typically be detected only by week 9, according to the Cleveland Clinic (https://my.clevelandclinic.org/health/articles/7247-fetal-development-stages-of-growth).

Anti-abortion advocates oppose any effort to abort a pregnancy, even as early as six weeks into the pregnancy, though most women will not be aware this early that they are pregnant There is no universal agreement in the anti-abortion movement on such details. Some may make exceptions if the mother’s life is at stake or if the fetus is dead or unviable. Some will even support abortions that are the result of rape or incest. But some want a total ban, beginning at six weeks or whenever a pregnancy can be identified.

Kate Zernike reports on the anti-abortion position that insists that the “fetus is a person” (https://nytimes.com/2022/08/21/us/abortion-anti-fetus-person.html).

“So-called fetal personhood laws would make abortion murder, ruling out all or most of the exceptions for abortion allowed in states that already ban it. So long as Roe established a constitutional right to abortion, such laws remained symbolic in the few states that managed to pass them. Now they are starting to have practical effect. Already in Georgia, a fetus now qualifies for tax credits and child support, and is to be included in population counts and redistricting.” And in August 2022, the Indiana “Republican-controlled legislature banned abortion starting at conception — one of the strictest laws in the nation — some conservative lawmakers objected that the law included exceptions for rape and incest. “This bill justifies the wicked, those murdering babies, and punishes the righteous, the preborn human being,” one lawmaker said, pushing instead for a fetal personhood law with no exceptions.”

Under such laws, pregnant women will be subjected to laws and punishment imposed by right-wing courts and lawmakers that will severely diminish if not eliminate their ability to control their reproductive decisions. This is a viewpoint held by anti-abortion advocates for generations. Even after Roe v. Wade was passed into law in 1973, “red” states had instituted restrictions that made getting an abortion increasingly burdensome. Diana Greene Foster provides data in her book The Turnaway Study to verify this last statement (pp. 2-3). The book was published in 2020 when Roe v. Wade was still the law of the country.

“Conservative statehouses have passed countless regulations, keeping abortion legal but rendering it all but inaccessible for many Americans who don’t have the resources to travel great distances to less restrictive states. Forty-three states ban abortions for most women after a certain point in their pregnancy. A third of states currently ban abortion at 20 weeks’ gestation. And in 2019, at least 17 states introduced legislation that would ban abortion at six weeks into pregnancy or even earlier. The bills became law in Georgia, Kentucky, Louisiana, Mississippi, and Ohio but immediately faced legal challenges that postponed their implementation.”

The Supreme Court overruled Roe v. Wade in June 2022, giving the anti-abortion movement added vigor and justification to fight for further restrictions on access to abortion. The ruling allows states decide on whether to outright ban abortion. Anti-abortion activists want more, a national ban on abortion.

Public opinion is opposed to abortion bans

The anti-abortion movement has momentum in many states, but public opinion today is on the other side, supporting “choice.” Steven Shepard looks at some of the evidence (https://politico.com/news/2023/04/08/republican-party-abortion-trap-00091088).

He refers to a 2022 national exit poll that found “29 percent of voters believed abortion should be ‘legal in all cases,’ while another 30 percent thought it should be ‘legal in most cases.’ That left 26 percent who thought it should be ‘illegal in most cases and only 10 percent who said it should be illegal in all cases.’” That is,

“roughly six-in-10 voters supporting legal abortion in most cases — with the median voter supporting some restrictions — and just over a third who want it to be entirely or mostly illegal.” Another 2022 midterm exit poll in Wisconsin found

“a combined 63 percent of Wisconsin voters said abortion should be legal in all or most cases, while only 34 percent thought it should be illegal in all or most cases.”

Republicans want to portray “Democrats as too permissive, willing to support ‘abortion on demand, for virtually any reason, up until the moment of birth,’ according to a press release from the Republican National Committee on Thursday [April 6, 2023].

“But” Shepard points out, “those attacks are largely falling flat. President Joe Biden has said repeatedly he supports the Roe v. Wade framework, which allowed states to impose modest restrictions on abortion later in pregnancies. And according to the Centers for Disease Control and Prevention, only 1 percent of abortions in 2020 occurred after 20 weeks of pregnancy,” that is, after 5 months of pregnancy.”

Potential political effects

The anti-abortion position may well have political consequences in favor of those who support reproductive rights, as it appears to have had in the 2022 midterm elections when Democrats were able unexpectedly to end up with control of the Senate.

Anti-abortion is one position in a larger right-wing, anti-democratic agenda

The anti-abortion position of the Republican Party and its right-wing allies is part of a larger agenda to move the country in an authoritarian direction based on Christian Nationalism, white supremacy, anti-immigration, unfettered capitalism, and extreme gender biases, along with efforts to suppress votes of opponents, gerrymander state congressional districts, and give legislators the power to decide elections in ways that override the popular vote. If they succeed, the country will be ruled by a minority of voters, right-wing lawmakers, and their rich and powerful allies.

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Historical background

Historian Jennifer L. Holland considers the “History of the Pro-Life Movement in America” on the Internet site of the Organization of American Historians (https://oah.org/tah/issues/2016/november/abolishing-abortion-the-history-of-the-pro-life-movement-in-america). Holland is an assistant professor of history at the University of Oklahoma. “She specializes in the histories of the North American West, gender, sexuality, and race. She is currently writing a book about the modern anti-abortion movement in four western states.”

She writes that the anti-abortion movement has existed for two centuries. However, prior to 1840, “abortion was a widespread, largely stigma-free experience for American women. During that period, the American legal system used the quickening doctrine from British common law to decide the legality of abortion.”

“Quickening occurred when the pregnant woman could feel the fetus move, typically between the fourth and sixth month of pregnancy.” Holland notes: “Post-quickening abortion was a crime, but only a misdemeanor” and “Only women themselves could testify to fetal movement.” If there was concern about abortion, it had to do with how many women died attempting abortion.

In the mid-19th century, physicians became the principal anti-abortion advocates. They wanted laws that restricted abortion, reduced or outlawed the practice among non-physicians, and gave physicians more authority in the process. They claimed that their “scientific medicine” would benefit their patients, some, in order to hurt lay healers’ business, sought governmental licensing and regulation to weed out the competition. Physicians used anti-abortion laws, pushed in state legislatures, to increase their own stature and undermine their opponents.” However, Holland points out that there was little substance to their claim of knowledge about the development of the embryo and fetus in pregnant females.

Nonetheless, “by 1900, every state had a law forbidding abortion at any stage, whether through the use of drugs or procedures. Almost all the laws passed during this time included a therapeutic exception, where licensed physicians could provide abortions at their own discretion as long as the abortion preserved the life of the mother. While this loophole allowed many women to obtain abortions, it also made doctors the ultimate arbiters of the morality and legality of abortions. These laws also created a large black market for women who could not access or obtain abortions through medical channels.”

In the years, 1900-1959, There was not much of an anti-abortion movement “because the state did its work. Police, courts, and lawmakers prosecuted abortionists and harassed women who procured the procedure.” 

Then, in the 1960s, the issue became politicized and movements on both sides of the abortion issue emerge.

Pro Reproductive Rights

“…in the 1960s, some Americans began to demand change from their states. In 1959 the American Law Institute, a group of professionals that put together model legislation, advocated for the liberalization of abortion law. They suggested that the law should make exceptions for women who were raped, whose fetuses were deformed, and whose mental or physical health was at stake. The abortion reform movement was made possible by a larger cultural shift in Americans’ ideas about reproduction and abortion. In the 1960s Americans witnessed the heartbreak of infant death and extreme fetal deformity. Thalidomide, a sleeping pill, caused thousands of birth defects in Europe and the United States. Later, an outbreak of German measles produced thousands of stillbirths and cases of babies born with major abnormalities. Images of white middle-class women and their deformed infants peppered American media, capturing the imaginations and parental fears of many Americans. [5] In the late 1960s a nascent feminist movement began to argue that women could not be full citizens unless they could control reproduction. Together these shifts helped push state legislatures to reform their abortion laws. Colorado was the first to amend its law in 1967, followed quickly by others, most famously California in 1967 and New York in 1970.”

Anti-abortion movement also gains momentum

“In the midst of states’ efforts at abortion reform, the modern antiabortion political movement was born. Small groups of Catholic doctors, nurses, lawyers, and housewives joined together to oppose liberalization. In 1967 the National Council of Catholic Bishops aided their campaigns with support, money, and the formation of the National Right to Life Committee. Early Catholic activists were often joined by a handful of non-Catholics, usually Protestants, Mormons, or Orthodox Christians. Supporters of abortion reform argued that “right-to-life” forces were attempting to push Catholic values on a diverse American populace, and consequently many antiabortion groups worked to present themselves as ecumenical or non-denominational. Most of these early groups failed to stop changes in their state’s abortion law but they did have some successes in the early 1970s, suggesting that not every state was ready for abortion reform.”

The Supreme Court’s decision to overthrow Roe vs. Wade in 1973gave all 50 states the power to determine the extent to which abortion would be restricted or not. In the wake of his decision, antiabortion activists retained their focus on individual fetal rights. “The tools that had the largest effect were graphic pictures of aborted fetuses, including “pictures of fetuses, in utero and aborted, fetal models, and fetuses in jars in the 1970s; fetal pins, dolls, jewelry, and clothes in addition to a proliferation of pro-life movies in the 1980s; and ultrasound visuals of fetuses in the 1990s and 2000s. Using these images, activists made a political pitch and moved fetal bodies squarely into American political culture.”

They were partially successful, as some states across the country passed laws that required parental notification, ‘informed consent’ (mandating women view materials about fetal development and the risks of abortion), and waiting periods between the initial consultation and the abortion.

“In 1992 the Supreme Court validated the legality of such laws in Planned Parenthood of Southeastern Pennsylvania v. Casey, crafting a new rationale to determine the constitutionality of laws regulating abortion. Restrictions were legal as long as they did not place an “undue burden” on women seeking the procedure, validating the work of anti-abortion activists and making abortion increasingly difficult to access—especially for rural or poor women.” The words “undue burden” were open to various interpretations and easily politicized.

Those opposed to abortion had grand aims at making “pro-life politics central to social conservatism and by extension the Republican party. They made fetal life central to how many Christians viewed their religion and their politics. They asked conservative children to think of themselves as ‘survivors of the Abortion Holocaust.’ And they helped new ‘family values’ constituents consider the fetus a member of the family and legal abortion the biggest challenge facing the modern family. In all these efforts, activists were successful, not for all Americans but for enough to build an expansive movement with the defense of fetal life as its core.”

Historian Michele Goodwin offers the following comments on the relevance of “fetal personhood” in criminal law in her book, Policing the Womb (publ. 2020). She writes: “…legislative advocates of fetal protection adopt the standard that fetuses are persons. Under this framework, a fetus is a child for purposes of criminal prosecution. Viability and the capacity to live outside the womb are neither deemed necessary or relevant….it normalizes treating the unborn as if they were born and alive at the time of injury [or the abortion].

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The Supreme Court overturns Roe v. Wade

On June 24, 2022, the U.S. Supreme Court overturned Roe v. Wade in the decision on Dobbs v. Jackson Women’s Health Organization, ending the right to abortion that had existed since 1973. Nina Totenberg and Sarah McCammon review the new law for NPR (https://npr.org/2022/06/24/1102305878/supreme-court-abortion-roe-v-wade-decision-overturn). Here are excerpts and comments from their analysis.

“The decision, most of which was leaked in early May [2022], means that abortion rights will be rolled back in nearly half of the states immediately, with more restrictions likely to follow. For all practical purposes, abortion will not be available in large swaths of the country. The decision may well mean too that the court itself, as well as the abortion question, will become a focal point in the upcoming fall elections and in the fall and thereafter.”

Concurring with Justice Samuel Alito 78-page decision were Justice Clarence Thomas, appointed by the first President Bush, and the three Trump appointees — Justices Neil Gorsuch, Brett Kavanaugh and Amy Coney Barrett. Chief Justice John Roberts, appointed by President George W. Bush, concurred in the judgment only, and would have limited the decision to upholding the Mississippi law at issue in the case, which banned abortions after 15 weeks.”

“Dissenting were Justices Stephen Breyer, appointed by President Clinton, and Justices Sonia Sotomayor and Elena Kagan, appointed by President Obama. They agreed that the court decision means that ‘young women today will come of age with fewer rights than their mothers and grandmothers.’ Indeed, they said the court’s opinion means that ‘from the very moment of fertilization, a woman has no rights to speak of. A state can force her to bring a pregnancy to term even at the steepest personal and familial costs.’”

Totenberg and McCammon continue.

“Writing for the majority, he [Alito] said forthrightly that abortion is a matter to be decided by states and the voters in the states. ‘We hold,’ he wrote, that ‘the Constitution does not confer a right to abortion.’ As to what standard the courts should apply in the event that a state regulation is challenged, Alito said any state regulation of abortion is presumptively valid and ‘must be sustained if there is a rational basis on which the legislature could have thought’ it was serving ‘legitimate state interests,’ including “respect for and preservation of prenatal life at all stages of development.” In addition, he noted, states are entitled to regulate abortion to eliminate “gruesome and barbaric” medical procedures; to “preserve the integrity of the medical profession”; and to prevent discrimination on the basis of race, sex, or disability, including barring abortion in cases of fetal abnormality.”

In sum, “states appear to be completely free to ban abortions for any reason.” While Alito emphasized that the court’s decision is only about abortion. At the same time, in a concurring option, “Justice [Clarence] Thomas said the legal rationale for Friday’s decision could be applied to overturn other major cases, including those that legalized gay marriage, barred the criminalization of consensual homosexual conduct, and protected the rights of married people to have access to contraception.”

Some 15 states, in the South, West, and Midwest, have “trigger bans,” that go into effect as soon as Roe v. Wade is overruled and will act quickly to ban abortion. Totenberg and McCammon refer to an analysis by the Guttmacher Institute that finds “South Dakota, Kentucky and Louisiana have laws in place that lawmakers designed explicitly to take effect immediately upon the fall of the Roe precedent. Idaho, Tennessee, and Texas – where most abortions are already illegal after about six weeks of pregnancy – have similar laws, which would take effect after 30 days. Guttmacher says seven other ‘trigger ban’ states have laws that would require state officials such as governors or attorneys general to take action to implement them.”

Additionally, “many states also have passed gestational bans prohibiting abortion at various stages of pregnancy. Courts have blocked many of those laws in response to legal challenges, including laws in Georgia, Ohio, and Idaho that ban abortions after six weeks of pregnancy. Now those laws may take effect immediately. So too, could a law recently enacted in Oklahoma, that makes performing abortion a felony punishable by time in prison.”

At the same time, “some [progressive] states are trying to expand access to abortion in preparation for more patients traveling from restrictive states for procedures. Connecticut lawmakers passed legislation this year designed to protect abortion providers from out-of-state lawsuits.”

Totenberg and McCammon cite University of Michigan law professor Leah Litman who says that “the anti-abortion movement will not be satisfied with this win.” Litman is also thinks this: “The next time the Republicans win control of the Senate and White House and the House of Representatives a national abortion ban is going to be on the table.”

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Abortions carried out in a clinic or health-care setting

Planned Parenthood provides an overview of “in-clinic abortion procedures,” positing they are “safe and effective” (https://plannedparenthood.org/learn/abortion/in-clinic-abortion-procedures). Such are not considered “surgery.” There are two such procedures. One type is called suction abortion (also called vacuum aspiration). It is the most common type of in-clinic abortion. It uses gentle suction to empty the woman’s uterus. It’s usually used until about 14-16 weeks after the woman’s last period.”

Dilation and Evacuation (D&E) is another kind of in-clinic abortion procedure. “It uses suction and medical tools to empty your uterus. You can get a D&E later in a pregnancy than aspiration abortion — usually if it has been 16 weeks or longer since your last period.”

According to Planned Parenthood, “In-clinic abortions are extremely effective. They work more than 99 out of every 100 times. Needing to get a repeat procedure because the abortion didn’t work is really rare.”  

Anti-abortionists have had some success in reducing medical abortions

Anti-abortionists have had some success in reducing the number of abortions done in clinics or health-care centers by physicians or those with medical credentials.  

Margot Sanger-Katz and Chris Cain Miller report on a major new study that legal abortions carried out by medical providers fell by 6 percent in the six months after Dobbs, that is, through December 2022 (https://nytimes.com/2023/04/12/upshot/legal-abortions-fell-dobbs.html). The study is from WeCount, a research effort of the Society of Family Planning, which supports abortion rights (https://societyfp.org/wp-content/uploads_April2023Release.pdf).

They write that the WeCount “collected abortion counts from 83 percent of clinics, hospitals and telehealth providers in the country. For the places that did not provide data, the group estimated the changes based on historical data and the trends for nearby clinics.”

The reasons for the decline are the result of efforts by the anti-abortion movement and their political allies. “The overall decline exceeds what was estimated by some researchers before the Supreme Court ruling. New restrictions and the obstacles they create — including travel logistics and expenses, long wait times at some clinics and confusion or fear about laws — seem to have prevented even more women than expected from obtaining legal abortions.

“For many women seeking an abortion, ‘the barriers that were in place were not surmountable,’ said Alison Norris, an Ohio State professor of epidemiology and one of the authors of the report. Though many clinics expanded capacity, she said, ‘it’s insufficient to manage the losses.’”

Sanger-Katz and Miller refer to some of the specific findings.

“The data goes through Dec. 31, by which point 13 states had banned abortion with almost no exceptions and another, Georgia, had banned it after six weeks of pregnancy. Legal abortions in the states with total bans fell to nearly zero — an average decrease of around 7,300 abortions a month compared with April and May. They increased by an average of 2,100 a month in states where abortion remained legal, suggesting that some women traveled across state lines. The increase offset only a third of the decrease in the states with bans.”

“After the Dobbs decision, the average number of legal abortions performed each month across the U.S. fell from over 82,000 to about 77,000.”

Going out of state

Melissa Quinn refers to research that shows three developments (https://cbsbnews.com/news/supreme-court-abortion-pill-access-mifeprestone). One, “Research has shown that the women most likely to be deterred by long distances are poor, Black or Hispanic. Teenagers, immigrants and people with child care or elder care responsibility are also more affected.” Two, thousands of women are traveling long distances to obtain abortions, the data shows. Three, “The number of abortions increased substantially in several states that have preserved access and are near states with bans. The largest increases in the number of abortions performed were in Florida, Illinois and North Carolina. States in regions where abortion remains legal, the West Coast and Northeast, did not experience surges.”

Medication abortion

While the number of legal abortions done by medical procedure in a clinic or comparable setting may overall have gone down, there is some evidence that “medication abortions” may have gone up, at least for the time being. The Kaiser Family Foundation provides information in an April 19, 2023 article on the availability and use of medication abortion” (https://kff.org/womens-health-policy/fact-sheet/the-availability-and-use-of-medication-abortion).

They point out that the Supreme Court’s ruling overturning Roe v. Wade allowed
states to “set their own policies protecting or banning abortion without any federal standard protecting access to abortion. This has created a new focus on medication abortion as an option for expanding access to people facing barriers to abortion care.

“Medication abortion, also known as medical abortion or abortion with pills, is a pregnancy termination protocol that involves taking two different drugs, Mifepristone and misoprostol, that can be safely used up to the first 70 days (10 weeks) of pregnancy according to the U.S. Food and Drug Administration (FDA).  The World Health Organization has authorized use to 12 weeks of pregnancy. Since the FDA first approved the drug in 2000, its use in the United States has quickly grown. By 2021, over half of abortions in the US were medication abortions. The medication abortion drug regimen approved by the FDA is available in many states across the nation, however, dispensing these pills for the purpose of terminating a pregnancy is now banned in some states.”

“Although the overall rate of abortion has declined over the past two decades, the use of medication abortion as a share of all abortions has greatly increased over the years. According to Danco Laboratories, by 2016, over 2.75 million women in the United States had used Mifeprex [mifepristone] since its FDA approval in 2000. Data from the Centers for Disease Control and Prevention (CDC) show medication abortions have increased steadily over the past 15 years. A 2022 Guttmacher Institute Report found that medication abortion accounted for 53% of all nonhospital abortions.”

Mifepristone and Misoprostol Regimen

“The most common medication abortion regimen in the United States involves the use of two different medications: mifepristone and misoprostol. Mifepristone, also known as the abortion pill, or RU-486 is sold under the brand name Mifeprex and through a generic manufactured by GenBioPro in the United States. Mifepristone works by blocking progesterone, a hormone essential to the development of a pregnancy, and thereby preventing an existing pregnancy from progressing. Misoprostol, taken 24–48 hours after mifepristone, works to empty the uterus by causing cramping and bleeding, similar to an early miscarriage. A follow-up visit can be scheduled a week or two later, to confirm that the pregnancy was terminated via ultrasound or blood test. The FDA has found that medication abortion is a safe and highly effective method of pregnancy termination. When taken, medication abortion successfully terminates the pregnancy 99.6% of the time, with a 0.4% risk of major complications, and an associated mortality rate of less than 0.001 percent (0.00064%).”

“Research has shown the misoprostol-only regimen to be a safe and highly effective method of pregnancy termination, however it may result in a higher incidence of side effects, particularly diarrhea, fever and chills. When taken, the misoprostol-only regimen successfully terminates the pregnancy approximately 80-100% of the time, with a complication rate of less than 1%. Some U.S. telehealth organizations have been providing the misoprostol-only regimen as an option for medication abortion for a number of years.” 

Efforts to limit or eliminate medication abortions

The KFF gives some examples.

 “There are other ways that state laws also affect use of and access to medication abortion. Some states require that patients be counseled about unsubstantiated claims about the ability to reverse an abortion after mifepristone is ingested.  For example, Nebraska, a state that hasn’t banned abortion, requires patients to be counselled that medication abortion may be reversed if given a high dose of progesterone after taking mifepristone—despite a lack of scientific evidence to support this claim. Similarly, Utah requires counseling that mifepristone alone is not always effective in ending a pregnancy and that patients may still have a viable pregnancy after taking mifepristone despite its record of effectiveness. Similar laws were passed in Arizona, North Dakota, and Kansas, with courts blocking the laws in Arizona and North Dakota, and the Governor vetoing the bill in Kansas. Prior to banning abortion Arkansas, Idaho, Kentucky,  Oklahoma, South Dakota had similar requirements. Research demonstrates that APCs, such as nurse practitioners, physician assistants, or nurse-midwives, can dispense abortion pills as safely as physicians can, but they are only permitted to do so in 20 states and DC.”

“As part of efforts to limit abortion access, some states have taken action to block the use of telehealth for abortion. Among the states that have not banned abortion, eight states have at least one restriction that requires at least one trip to the clinic, and effectively ban telehealth for medication abortion (Figure 1).

“The use of medication abortion has grown significantly since its approval by the FDA in 2000. The FDA update of the REMS could expand the availability of medication abortion and broaden the use of telehealth dispensing. However, state abortion bans, specific bans on telehealth for medication abortion, and state-level requirements for in-person dispensation of mifepristone and for in-person counseling visits and ultrasounds that are not medically recommended will continue to restrict access in many states.”

“Since the FDA approved mifepristone in 2000, it has made several changes to the rules surrounding the abortion pill. In 2016, the agency increased the gestational age limit from 7 weeks to 10 weeks, reduced the number of required in-person clinic visits, and broadened the set of healthcare providers to prescribe the drug. In 2019, the FDA approved a generic version of mifepristone and in 2021 lifted a requirement that the pills be dispensed in-person, which allowed the drug to be prescribed by a provider during telemedicine appointments and sent by mail. Earlier this year, the Biden administration widened the availability of the abortion drug to more retail and online pharmacies” (https://cbsbnews.com/news/supreme-court-abortion-pill-access-mifeprestone).

Judge in Texas issues a federal ban on medication abortions

The legal battle targeting medication abortion intensified in November, 2022, with a lawsuit filed by the Alliance Defending Freedom on behalf of the doctors and medical groups, as reported by Melissa Quinn (https://cbsbnews.com/news/supreme-court-abortion-pill-access-mifeprestone).

“The challengers argued the FDA failed to adequately consider mifepristone’s health and safety risks when it approved the drug in 2000. They sought to obtain a federal ban on this drug.” The case was filed in the federal court in the 5th Circuit in Amarillo, Texas, where U.S. District Judge Matthew Kacsmaryk, appointed by President Donald Trump, overseas cases.

The Biden administration appealed the decision to the Supreme Court.

“Backing the Biden administration in its push to preserve mifepristone’s FDA approval were 23 blue states and the District of Columbia and 235 Democratic lawmakers, who separately filed friend-of-the-court briefs with the Supreme Court warning the lower courts’ orders would have far-reaching ramifications if allowed to stand.

“On the other side of the aisle, 21 red states and 147 Republican lawmakers had urged the Supreme Court to leave the 5th Circuit’s decision in place.”

The Supreme Court decided to send the case back to the 5th circuit in order to provide further substantiation for the medication abortion ban.

Concluding thoughts

The anti-abortion movement continues to push for either a total ban on abortion or a law that severely restricts legal access to it. The movement has been very successful in achieving this aim in “red” states, but not in “blue” states. What will it take to preserve or expand legal access to abortion? In the end, the decision will be made by voters if their votes are honestly and fairly counted. And if opinion polls have validity, they show that a majority of people outside of the Republican Party support the continued availability of abortion options and view the rights and health of pregnant women and teenagers over the alleged rights of an embryo.