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Reversing Roe was never going to be enough

Now antichoice zealots are coming after medication abortion, even in states like ours.

Protesters held up signs supporting access to abortion medication at a rally outside the federal courthouse in Amarillo, Texas, on Wednesday. David Erickson/Associated Press

Well, we certainly got here quickly.

Abortion rights advocates have been warning forever that antichoice zealots would not stop at overturning Roe v Wade last summer, a reversal that cleared the way for bans in roughly half the country. The extremists have always wanted a national ban, and one that goes beyond surgical abortion to medication-assisted abortion.

Still, even the most clear-eyed among us thought the regression would be slower than this.

“Roe may have fallen, but this isn’t 1972,” I wrote last July . “We’re not going back.” Though surgical abortion was less available to millions of Americans, I argued, we still have medication — safe, widely available, and used in more than half of abortions already — for those who want to end their pregnancies, even in states with bans.


But that medication is now under wider threat, too. On Wednesday morning, abortion opponents argued that FDA approval of mifepristone, one of the drugs used in medication abortion, should be withdrawn. And they did it in a relatively remote federal courtroom in Amarillo, Texas, where they knew the case would be presided over by a Trump appointee who is a conservative zealot with a record of bending the law to his extremist views on immigration, gay rights, and choice.

That judge, Matthew Kacsmaryk , is seriously entertaining the ludicrous claim that mifepristone is unsafe, even though scientists and 20-plus years of use by millions clearly demonstrate the opposite. This judge, who believes gay people are disordered and that being transgender is a mental illness, also laments widespread contraception and the elimination of legal penalties for fornication and adultery .

Conservative extremists knew what they were doing when they placed him in Amarillo, where he’d be overseen by a partisan Fifth Circuit court of appeals happy to support his hinky legal reasoning which, according to Vox’s Ian Millhiser , is profuse. And, above them, by a Supreme Court all too ready to leave even a wrongheaded conservative decision in place long enough to do real damage.


So this case isn’t just about abortion pills. It’s also about democracy and the rule of law. It’s about Republicans manipulating the system: weighting it to their advantage with mountains of dark money ; rushing conservative antiabortion Judge Amy Coney Barrett onto the Supreme Court right before the 2020 election; stacking conservative judges up and down the line so there would be no checks on their overreach; placing Kacsmaryk in isolated Amarillo, where he hears almost every case ; finding ways to bring monumental matters under his sway so he can remake federal policy alone.

“We have been playing by the rules we believed to exist,” said Rebecca Hart Holder, head of Reproductive Equity Now. Now, she said, “We are holding our breath to see if another draconian judge will overturn more rights.”

It’s important to note that even if Kacsmaryk does side with the antichoice zealots, medication abortion will not end in this country — not yet, at least. The Texas decision, if it stands, would be limited to one brand of mifepristone. It is unclear whether or how quickly the FDA would have to comply with his judgment. Further, mifepristone is just one of the drugs used in medication abortion; other drugs will still be available. Mifepristone is also available from a range of services that provide abortion medication by mail, outside the regular American medical system.


But this case will still do damage.

“We already have an access crisis in the United States,” said Elisa Wells, cofounder of Plan C , which provides information on how to get abortion medication. “This is going to lead to more confusion and fear and disruption, and that is of course part of the strategy of the antichoice extremists.”

All of it has a chilling effect, especially on those with less power and fewer resources, including those on low incomes, undocumented immigrants, and people of color. Those who want to take away their control over their own life choices will not stop at mifepristone. They want to ban medication abortion entirely, in every state. They are coming for IVF and birth control, too.

And they’ll keep succeeding, unless the majorities who support choice and medication abortion, in this country show up, in numbers big enough to take power.

To restore control over our bodies, we must restore our democracy.

Globe columnist Yvonne Abraham can be reached at [email protected] . Follow her on Twitter @GlobeAbraham .