Abortion Pills Stand to Become the Next Battleground in a Post-Roe America

Abortion Pills Stand to Become the Next Battleground in a Post-Roe America

Medication abortion allows patients to terminate early pregnancies at home. Some states are moving to limit it, while others are working to expand access.


If the Supreme Court overturns Roe v. Wade, the legal and culture wars over abortion that have consumed the United States for decades would increasingly be fought on a new front: abortion pills.

Medication abortion — a two-drug combination that can be taken at home or in any location and is authorized for use in the first 10 weeks of pregnancy — has become more and more prevalent and now accounts for more than half of recent abortions in the United States. If the federal guarantee of abortion rights disappears, medication abortion would likely become an even more sought-after method for terminating a pregnancy — and the focus of battles between states that ban abortion and those that continue to allow it.

“Given that most abortions are early and medication abortion is harder to trace and already kind of becoming the majority or preferred method, it’s going to be a big deal,” Mary Ziegler, a visiting law professor at Harvard, said. “It’s going to generate a lot of forthcoming legal conflicts because it’s just going to be a way that state borders are going to become less relevant.”

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About half the states are expected to quickly make all methods of abortion illegal if the justices’ decision in a Mississippi case resembles a draft opinion leaked this week that would nullify the 1973 ruling that legalized abortion. Other states would likely continue to allow abortion, and several are already taking steps to accommodate patients from the states where abortion may be outlawed.

Medication abortion is less expensive and less invasive than surgical abortions. In December, the Food and Drug Administration made access to it significantly easier by lifting the requirement that patients obtain the first of the two pills, mifepristone, by visiting an authorized clinic or doctor in person. Now, patients can have a consultation with a physician via video or phone or by filling out online forms, and then receive the pills by mail.

But many conservative states have already begun passing laws to restrict medication abortion, including banning it earlier than 10 weeks’ gestation and requiring patients to visit providers in person despite F.D.A. rules. Nineteen states ban the use of telemedicine for abortion. This year, Americans United for Life, an anti-abortion advocacy group, listed laws against medication abortion as first among the organization’s “pressing priorities” for 2022.