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Good news: Despite court threats, access to abortion is improving

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3912bb14 c572 7ed6 431b 5433d26b9076 Good news: Despite court threats, access to abortion is improving
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Even with seeming legal threats to medication abortion, there is still good news.

The U.S. Supreme Court heard oral arguments yesterday on the high-stakes abortion case centered around mifepristone, the most commonly used abortion pill, after a Christian nationalist district judge attempted to ban mifepristone last year. Thankfully, the Supreme Court has temporarily allowed the needed abortion pill to remain on the market until it makes its decision. Hopefully, this means that even the ultraconservative Supreme Court does not want to partake in this orchestrated attack on medication abortion.

And there is further reason to cheer. CVS and Walgreens are both set to start dispensing abortion pills in states where it is currently legal to do so. Massachusetts, Rhode Island, New York, Pennsylvania, California and Illinois will facilitate access to abortion medication at the leading pharmacy chains, with more states to come. This was made possible when the FDA passed a rule last year allowing pharmacies to dispense abortion medication, removing the longstanding requirement that patients had to pick up abortion pills directly from their doctors. With the onslaught of states banning abortions, this will be crucial to expanding abortion accessibility. President Biden said recently that ensuring the largest pharmacies can fulfill abortion medication requests was “an important milestone in ensuring access to mifepristone. … I encourage all pharmacies that want to pursue this option to seek certification.”

On the anniversary of Roe, Biden issued a presidential memorandum to affirm access to safe and legal abortion medications and safeguard patient safety and security. Biden directed the Secretary of Health and Human Services to “consider new guidance to support patients, providers, and pharmacies who wish to legally access, prescribe, or provide mifepristone — no matter where they live.” This access will be a major focus moving forward, for both abortion advocates and opponents.

Abortion pills have become the most accessible way for pregnant people to get abortions nationwide after the fall of Roe. In states where abortion is legal, doctors are using new legislation, coined telemedicine abortion shield laws, to send out abortion pills to the vulnerable women who live in states where the procedure is illegal in an honorable example of “medical civil disobedience.” States participating in these efforts are Massachusetts, Washington, Colorado, Vermont, New York and California.

The shield laws require that officials and agencies of states will not cooperate with another state’s efforts to investigate or penalize providers who prescribe abortion pills. These laws will likely be challenged in federal court on the grounds of supposed state sovereignty violations, but their brief enactment to date has facilitated tens of thousands of needed abortions in states with restrictive abortion bans. Shield laws are undoubtedly helping pregnant patients who are low-income or cannot travel to procure abortions, removing barriers in very restrictive states. One organization is currently using shield laws to serve an estimated 7,000 patients per month, with nearly 90 percent of the abortions taking place in states with encompassing bans.

Despite the overturning of Roe and implementation of abortion bans throughout the nation, an estimated 1,026,690 abortions took place in 2023, which was a 10 percent increase from 2020 and was the highest number measured in the United States in over a decade. Clearly, Americans with unwanted pregnancies will continue to seek abortion care, even when states are doing everything they can to restrict access. The drastic reduction of abortion access is being offset by the notable efforts of clinics, abortion funds and nonprofit organizations that help facilitate abortions through financial and functional support. States without total abortion bans saw a 25 percent increase in abortions in 2023 from 2020, especially in the states bordering ban states.

This is encouraging news, but we cannot ignore that Dobbs and subsequent anti-abortion policies have drastically exacerbated the health inequities marginalized communities face in this country, especially for Black, Brown and low-income communities. States with abortion bans have fewer maternal care providers and higher maternal death rates, which disproportionately impacts Black and Brown people.

And with Louisiana’s abortion ban, standard pregnancy care has perilously been disrupted. A report titled “Criminalized Care: How Louisiana’s Abortion Bans Endanger Patients and Clinicians,” outlines how pregnant patients have been given risky, unnecessary surgeries, denied treatment for miscarriages and ectopic pregnancies and are forced to wait for abortions until they are at the brink of death. Doctors operating in states with abortion bans are doing everything they can to avoid the penalties of facilitating abortions. Doctors are using extreme and dangerous caution to avoid even the slightest appearance of providing an abortion. This is because Louisiana’s doctors providing abortion care face up to 15 years in prison and $200,000 in fines under the state’s abortion ban.

Consequently, some Louisianian women who experienced preterm premature rupture of membranes, before the fetus was viable, have been forced to undergo impromptu cesarean section surgeries instead of receiving abortion care. One New Orleans OB-GYN said, “I want to emphasize that this is not what’s in the best interest of the patient. This is what’s in the best interest of … the physician in protecting themselves from criminal prosecution.” Out of fear of breaking Louisiana’s law, doctors are delaying routine prenatal care until the risk of miscarriage drops and pushing back treatment for miscarriages and ectopic pregnancies. One ectopic pregnancy patient said that her care was so delayed that her fallopian tubes ruptured and that she could have died. Louisiana suffers from some of the highest rates of maternal mortality and morbidity in the United States, and Black women are more than twice as likely to die because of their pregnancy as compared to white women there.

With the Supreme Court set to decide on the future of mifepristone in the nation, we can only hope the conservative majority court will side with reason and morality. Restricting abortion medication will not stop abortions, it will only kill women, with reproductive health suffering nationwide. Abortions continue despite severe restrictions nationwide and the Biden administration and abortion advocates are taking effective steps to ensure abortion accessibility is protected as possible. The Supreme Court needs to rule against the unfounded attempted mifepristone ban.

ABOUT THE AUTHOR

5ed5b3f6 e3c2 e3df 0d83 19beb0b5769f Good news: Despite court threats, access to abortion is improvingCaitlin Berray is the Governmental Affairs Coordinator for the Freedom From Religion Foundation. Caitlin graduated from Baylor University with a B.A. in International Studies and a minor in Political Science in December 2021. After graduation, Caitlin interned with various nonprofits dedicated to progressive U.S. politics and international development.  Joining FFRF in October 2022, Caitlin first worked as FFRF’s Governmental Affairs Intern.

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