Texas moves to shut down telemedicine abortion following 6-week ban

Earlier this month, the most restrictive abortion ban in the United States went into effect in Texas. Now pro-choice activists are scrambling to find alternative ways to ensure people have access to abortions, but the state is moving quickly to shut those down, too. 

Services exist to help people in states hostile to abortion obtain the drugs used in medication abortions. One such service is Plan C, which does not provide medication abortions but helps connect people with organizations that do. In most cases, this involves having a doctor from outside the United States prescribe the medications or purchasing the medication directly from overseas pharmacies. 

While it might initially seem like a risky proposition to procure the drugs used in medication abortions in such a relatively unregulated fashion, those drugs — mifepristone and misoprostol — are extremely safe. 

In the last 20 years, approximately 3.7 million people had a medication abortion, with 24 deaths reported associated with the procedure during that time, according to the FDA. The mortality rate of erectile dysfunction drugs such as Viagra, to name one example, is roughly four times greater.

The Biden administration has expanded the availability of drugs used for medication abortion. In April 2021, the FDA lifted Trump-era restrictions against prescribing pills via telehealth appointments and providing them to patients by mail, for use at home, for the duration of the pandemic.

Further, the FDA is reviewing the restrictions placed on medication abortion drugs, and the possibility exists that the prohibition on mailing the drugs or having them filled in a pharmacy will be permanently removed. 

Except, it seems, Texas is rushing to foreclose that option as well. The Legislature just passed a bill, now on GOP Gov. Greg Abbott’s desk, that would prohibit any “manufacturer, supplier, physician, or any other person” from mailing, delivering, or couriering abortion drugs. It also requires an in-person visit before a doctor can prescribe the pills. 

This could undermine, and even entirely stop, groups like Aid Access, which has provided tens of thousands of online consultations for medication abortions in the last three years. It’s unclear whether Texas’ prohibition on mailing abortion drugs could somehow be said to apply to the pharmacy in India that fills prescriptions prescribed by Aid Access doctors.

However, that may not be a chance that a person who needs an abortion wishes to take, and it may not be a chance that Aid Access or the Indian pharmacy wishes to take either. The law, therefore, has the effect of creating confusion about the availability of medication abortion that originates outside of Texas. 

Texas isn’t the only state taking these steps. South Dakota’s GOP governor, Kristi Noem, issued an executive order on Sept. 7 decrying the Biden administration’s efforts to make abortion more accessible, saying they “will put South Dakotan women at risk of serious health complications from abortion-inducing drugs.” The order goes on to say that medication abortion drugs only be dispensed by a physician licensed in South Dakota and only after an in-person visit.

Noem’s order also takes express aim at organizations like Aid Access, saying that “no manufacturer, supplier, physician, or any other person may provide any abortion-inducing drugs directly to women in South Dakota via courier, delivery, telemedicine, or mail service.”

Such a measure is necessary in part, says Noem, because the “abortion industry is targeting young women via social media and school bathrooms are at risk of becoming the new abortion clinics.”

There’s no evidence that Noem’s claims regarding school bathrooms as medication abortion hotbeds are justified. However, there are actual dangers that arise when someone is unable to obtain an abortion.

The Turnaway Study found that people who were forced to give birth rather than get an abortion experienced a higher rate of household poverty that lasted four years longer than someone who was able to get an abortion.

The study also found that for years after they were unable to obtain an abortion, people were still unlikely to be able to cover basic expenses such as food or housing. That poverty, in turn, led to increased debt, bankruptcies, and evictions. People who were denied abortions also report much higher levels of depression and anxiety. 

When Texas passed its six-week ban with a private enforcement mechanism, many other states indicated they would follow suit. Given that South Dakota has already copied Texas’ move to restrict medication abortion access, we may see a flood of similar laws in this area as well and, with that, access will continue to decrease.

Published with permission of The American Independent Foundation.