Gather ‘round, ladies and themtlemen, because I have a timely suggestion: If you can get pregnant, please consider buying abortion pills as soon as you can. It’s a good idea to have some pills on hand because a judge appointed by Donald Trump could effectively ban the abortion pill nationwide as soon as next Friday, February 10. Yes, blue states, this could affect you, too.
The Europe-based site Aid Access will mail pills to people in all 50 states before they’re pregnant—which is known as advance provision—and a U.S.-based service called Choix does this for people in six states (California, Colorado, Illinois, Maine, New Mexico, and Virginia). Both have sliding scale payment options. If you’re currently pregnant and don’t want to be, this is also your heads up that your abortion options could soon be even more limited, so if you want a medication abortion, now is the time to get it.
Aid Access advises checking the expiration dates when you receive the medicines and note that most pills can be kept up to two years after receiving them as long as they’re unopened and kept at room temperature. People who get pregnant after they obtain pills should contact them immediately for guidance during the process.
Self-managed abortion carries legal risks, so if people are going to buy pills, they should first read this guide on minimizing your risks and digital footprint. It includes information about the Repro Legal Defense Fund and M+A Hotline, or Miscarriage+Abortion Hotline. Learn more on internet safety from If/When/How here:
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How is this happening? We all know the Supreme Court overturned Roe v. Wade, but anti-abortion activists have not been content to leave abortion to the states: They want to ban it everywhere. Activists sued the Food and Drug Administration in November saying the FDA wrongly approved mifepristone more than 20 years ago and asked Judge Matthew Kacsmaryk to revoke its approval. (February 10 is the soonest the judge could issue the ruling.)
If Kacsmaryk sides with the plaintiffs, “The case could result in an injunction requiring the federal government to pull the drugs from the market immediately,” according to Stateline.
As I explained in December:
If Judge Kacsmaryk issues a nationwide ruling revoking the FDA’s approval of mifepristone, it would ban health care providers from prescribing it for abortion. (The drug is also sold as Korlym to treat Cushing’s syndrome.) Even people seeking care in states where abortion is still legal wouldn’t be able to get the pills from brick-and-mortar clinics or from telemedicine services. The only option would be Aid Access, based in Europe, or word-of-mouth networks.
The ruling won’t directly affect abortion procedures at clinics, but it could indirectly make it harder to get an appointment. In 2020, abortions with pills made up a staggering 54 percent of abortions done in medical settings. If U.S.-based telemedicine sites can’t operate, and pills are no longer an option for clinics, clinics will be slammed with requests for in-person appointments. The ripple effects could be devastating, as Greer Donley, associate professor at the University of Pittsburgh Law School, told Jezebel in December.
“The waiting times that we see are going to balloon to the point where it’s really making abortion almost inaccessible throughout the country,” Donley said. “Not just for people in red states traveling, the people in New York wouldn’t feel safe…if the New York clinics are backed up, and you need an abortion, you’re not going to feel like you have access.”
It seems wrong that a single judge could declare that an FDA-approved medication can no longer be prescribed. But Joanna Grossman, a law professor at Southern Methodist University in Dallas, told the Dallas Morning News that, while it’s an “illegitimate use of law,” it wouldn’t be impossible given who’s making the call. Kacsmaryk used to work for the Christian First Liberty Institute and is the same judge who recently ruled that teenagers don’t have a right to birth control.
“Any sort of normal judge, I would say there’s no scenario in which they’re gonna cause a long standing approved drug to suddenly be unapproved, you know, disapproved basically on political grounds,” Grossman said. “But if any judge is gonna do it, this is the judge.”
Surely the FDA would appeal this potential ruling, you say. Yes—but the appeals court that would hear the case is the ultraconservative Fifth Circuit, the very same one that let the Texas bounty hunter abortion ban take effect in September 2021. The next level after that is, you guessed it, the Supreme Court.
If Kacsmaryk orders mifepristone pulled from the U.S. market, Aid Access could still operate—it has a pharmacy in India ship pills to the U.S.—but it’s unclear if the service would be slowed from demand. It can already take up to three weeks for people to get their pills.
It’s horrifying that this is the world we live in, but as the past few years have shown, it’s better to be prepared for the worst.
If you or someone you know needs assistance self-managing a miscarriage or abortion, you can call the Miscarriage + Abortion Hotline at (833) 246-2632 for confidential medical support, or the Repro Legal Helpline at (844) 868-2812 for confidential legal information and advice.
Update, 2/1/23: This post has been updated to include information about legal risks for people self-managing abortions.