Last month, the Food and Drug Administration announced that people seeking abortion pills during the Covid-19 pandemic will no longer have to visit a doctor’s office to get a prescription. Under the Trump administration, patients were required to receive the first of the medication’s two doses in person, a mandate upheld by the Supreme Court in January. The new policy instead allows for telemedicine consultations and pills sent by mail.
The decision is a practical one for the Covid era: It reduces unnecessary face time in doctor’s offices, which cuts down the potential for exposure. It could also be a huge blow to the anti-abortion movement. Groups like the American College of Obstetricians and Gynecologists have been pushing the Biden administration to make the F.D.A.’s decision permanent. Last week, in a legal filing, the agency announced it was reviewing their restrictions on the medication.
For years, anti-abortion activists have tried to impose their morality under the guise of women’s health and protection. Legislators have proposed anti-choice bills with names like “woman’s right to know,” which sound compassionate but in reality force doctors to falsely claim that women who end their pregnancies suffer physical and mental harm. The primary political strategy of abortion foes relies on the claim that abortion is brutal and dangerous, a myth that is much harder to perpetuate when people can easily access medicine to safely end their pregnancies at home.
Early abortion and medication abortion are already the norm. As of 2017, almost 40 percent of women who ended a pregnancy had chosen pills over an in-office procedure. Medication abortion is safer than over-the-counter ibuprofen, with serious complications occurring in about 0.5 percent of patients. Multiple studies have also confirmed the efficacy of abortion consultation via telemedicine.
Every abortion advancement — from earlier, less invasive procedures to increased access to medication abortion — forces anti-choice activists and legislators to show their most extremist hand: Their goals have almost nothing to do with health, safety or even babies but everything to do with controlling women.
Those who continue to insist that ending a pregnancy is terrifying and gruesome don’t have science — or common sense — on their side. Though anti-choice activists contend that medication abortion puts women in grave danger, waiting for your pregnancy to end at home after taking a few pills doesn’t fit into that narrative. Nor does telling the truth about abortion more broadly.
In 2018, nearly 78 percent of women ended their pregnancies in the first nine weeks (before the embryo becomes a fetus), and nearly 90 percent of abortions occurred in the first 13 weeks. In early abortions, the procedure usually takes less than 10 minutes; in the earliest weeks, women can opt for a nonsurgical manual aspiration procedure which uses the suction of a simple syringe. Complications are more common in getting a wisdom tooth pulled than in ending a pregnancy.
And so abortion opponents focus on the false or the rare — anything to bolster the assertion that ending a pregnancy is brutal business. It’s why Republicans (like former President Donald Trump and former Vice President Mike Pence) have falsely claimed that women are getting abortions up until the moment of birth and that states allowing compassionate withdrawal of care from terminally ill babies are actually legalizing infanticide.
It’s also why conservative lawmakers are so intent on passing 20-week bans — as they’ve done in multiple states — even though the small number of abortions performed after that point are almost always owing to severe fetal abnormalities or to save the life or protect the health of the mother.
What’s most troubling, though, is that because the anti-choice movement relies on a grisly political message, it would seem the movement has a political interest in stopping the safest and earliest kinds of abortion. In fact, the kinds of procedures Republicans claim to be the most appalled by also happen to be the abortions their policies are most responsible for. These are hurdles put in place by lawmakers who block Medicaid funding for abortion and put clinics out of business through onerous and arbitrary regulations, such as mandating that clinics have specifically sized hallways.
And according to the Centers for Disease Control and Prevention, the two of the three states with the highest percentage of abortions performed after 15 weeks also happen to have some of the toughest anti-choice laws in the country: Arkansas’s governor signed into law a near-total ban on abortion in March, even in cases of rape and incest; Missouri has only one abortion clinic left in the state.
If conservatives truly wanted to curb later abortions, they wouldn’t make it so incredibly difficult for so many women to get earlier ones. Of course, if their concern were actually about women’s health and safety, they wouldn’t be trying to make abortion illegal at all.
The F.D.A.’s new rule on telemedicine consultations and abortion by mail will soon arm pro-choice organizations with more studies reiterating the safety of medication abortion and show how shipping pills poses no risk to patients. It will also make it that much more difficult for opponents to make specious arguments about unsafe practices.
Exposing this hypocrisy doesn’t come without a risk. If current trends continue, people ending their pregnancies will increasingly do so at home — circumventing the restrictive policies focused on clinics. Without the ability to use science, reason or even scare tactics in their messaging and legislation, Republicans will, as they have in the past, resort to punitive measures. Already, multiple women who have used medication abortion without going through a doctor have been arrested — and in some cases charged.
For women who live far from clinics or who can’t take extended time off work to travel, access to this medication could be the difference between being forced to carry an unwanted pregnancy and making safe choices about their own lives and futures.
That’s why it’s so important that those who care about abortion rights redouble their efforts to make medication abortion permanently legally available by mail.
Jessica Valenti is the author of six books on feminism and publishes the newsletter All in Her Head.
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