Roe v. Wade and his federally guaranteed right to an abortion could be rescinded, but efforts by states to legislate the use of prescribed drugs that terminate pregnancy could prove difficult, experts say.
According to Axios, a national news website, the Supreme Court ruling “immediately shifts the fight over access to abortion to government efforts to restrict medical abortion, or so-called ‘abortion pills’.”
The pills used to terminate a pregnancy — mifepristone and misoprostol — are FDA-approved for use in the first 10 weeks of pregnancy and are often prescribed online and mailed to patients, Axios said.
Medical abortions accounted for 54% of all abortions in the United States in 2020, up from 39% in 2017, according to the Guttmacher Institute, which advocates for abortion rights.
In Indiana, the use of telemedicine to perform a medical abortion is prohibited and a medical abortion is no longer possible after 10 weeks of pregnancy, reports Guttmacher.
To make matters worse, in December the FDA lifted long-standing restrictions and made the pills more widely available via telemedicine appointments and online prescriptions that allow for door-to-door delivery, Axios writes.
Medical abortion will likely be one of the areas to be addressed when the Indiana Legislature meets in special session this month to discuss tougher anti-abortion laws.
Rep. Bruce Borders, R-Jasonville, says, “It’s an issue that I know we’re going to address … We’re going to be looking at some other states, and I’m going to be reaching out to other states and examining their laws as well.” “
He is aware that more than 50% of abortions are performed with drugs. “I have concerns about that. The bottom line is that it still costs one child his life. I’m very worried about it,” he said.
Borders said he doesn’t yet have details on how lawmakers might address the issue. “It’s kind of a new subject for all of us,” he said.
State Assemblyman Alan Morrison, R-Brazil, said House Republicans would meet next week “and it’s going to take us a handful of weeks to pull together everything we’re talking about and where we’re going from there. I will restrain any kind of thought as to where I think the legislation will go or where it will end.”
He added: “Honestly, no one knows. Anyone who says they know where we’re going is misinformed or distorting the truth. It’s going to be a long discussion and we’ll find out where we end up.”
State Rep. Tonya Pfaff, D-Terre Haute, suggests that the Indiana government “should follow the legal guidance of the United States Attorney General.”
Efforts to reach the state. Sen. Jon Ford, R-Terre Haute, and State Rep. Bob Heaton, R-Terre Haute, were unsuccessful.
US Attorney General Merrick Garland issued a statement on June 24 that included:
“We stand ready to work with other parts of the federal government that are trying to use their legitimate powers to protect and preserve access to reproductive care. In particular, the FDA has approved the use of the drug mifepristone. States must not ban mifepristone if they disagree with the FDA’s expert judgment of its safety and efficacy.”
Garland also stated that the Constitution continues to limit states’ power to ban reproductive services performed outside their borders.
“Under basic constitutional principles, women residing in states that have prohibited access to comprehensive reproductive care must remain free to seek that care in states where it is legal. In addition, under the fundamental principles of the First Amendment, individuals must remain free to inform and counsel one another about the reproductive care available in other states,” Garland explained.
He stated that the Justice Department “will work tirelessly to protect and promote reproductive freedom.”
Medical termination of pregnancy is not the same as the morning-after pill or plan B, which is to be taken as soon as possible within the first 72 hours of unprotected sex to prevent pregnancy.
Plan B is an emergency contraceptive pill that is available over the counter.
In medical abortion, a combination of two drugs is usually used to terminate a pregnancy. This method of abortion does not require surgery and can be performed at home, according to an online article by NPR.
The first pill is mifepristone, which blocks a hormone known as progesterone, which the body needs to sustain a pregnancy.
The second drug, misoprostol, is taken 24 to 48 hours later. This drug causes cramping and bleeding and empties the uterus.
Currently, medical abortion is legal in Indiana for up to 10 weeks, said Jody Madeira, a law professor at Indiana University’s Maurer School of Law.
Those in Hoosier State who want a medical abortion must go to a health care provider and cannot be prescribed one via telemedicine.
The person must undergo an examination – including an ultrasound – and seek advice. Then they have to wait 18 hours. “It involves two trips to the supplier,” Madeira said. “It’s the same as any other abortion appointment.”
The second visit would be necessary to obtain the abortion medication to use at home.
As the Indiana Legislature ponders the issue, “Any state drug laws that are regulated by the FDA could contradict federal law and be bad law on that basis.”
Lawmakers could try to make it illegal to receive medicines through the mail. “The problem there is enforcement, unless they open every woman’s mail in Indiana,” she said.
Lawmakers could also seek to make it illegal to travel out of state to obtain the drugs. “But again, that probably won’t stay that way because of interstate travel law,” she said.
The US Constitution and Supreme Court recognize and protect the right to travel between states. The right to travel includes privacy and free domestic movement without government cutbacks.
This is something Supreme Court Justice Brett Kavanaugh has acknowledged, Madeira said.
She believes that “the stricter they (legislators) make their laws, the more difficult it becomes for them to enforce them.”
She believes the use of medical abortions will increase in light of the Supreme Court’s Roe v. Wade decision.
dr Caitlin Bernard, a faculty member at the IU School of Medicine and a practicing OB-GYN at IU Health, worries that those who don’t have access to medical abortion are “the most vulnerable to taking things into their own hands in terms of using unsafe methods.” Holding hands for abortion or forced continuation of pregnancy.”
She also wonders if lawmakers could make it a crime for women to have a medical abortion. An Indiana woman was convicted in 2015 of killing her premature baby by taking pro-abortion drugs; Her fetus conviction was later overturned.
In response to the Supreme Court decision that Roe v. Wade was lifted, Bernard said: “It’s a farce. The interference between a doctor and their patient when making decisions about their healthcare is appalling.”
It will have far-reaching consequences that could include increased maternal mortality, she said. More women are able to resort to unsafe abortion methods. Other consequences could include limiting women’s ability to complete their education or find well-paying jobs, as well as increased episodes of depression and mental health outcomes.
Fewer physicians may choose to specialize in OB-GYN because they fear “having someone look over their shoulder how to practice medicine,” Bernard said.
Sue Loughlin can be reached at 812-231-4235 or at [email protected] Follow Sue on Twitter @TribStarSue