Abortion pill restrictions begin in Texas, but will be hard to enforce

The law narrows the window to prescribe abortion-inducing medication, and makes it illegal to mail that medication.

By Sara Hutchinson & Michael MarksDecember 8, 2021 2:06 pm, ,

A law that went into effect on Dec. 1 bans prescribing abortion-inducing medication to anyone more than seven weeks pregnant, and prohibits mailing such medicine altogether.

Enforcing the law, however, will be difficult.

Abigail Aiken is an associate professor at the LBJ School of Public Affairs at the University of Texas at Austin. She spoke to Texas Standard about the impact of the new measure. Listen to the interview above or read the transcript below.

This transcript has been edited lightly for clarity:

Texas Standard: How common is medically induced abortion in Texas and around the country?

Abigail Aiken: Well, medication abortion has been becoming more common. It is a method of abortion that many folks who are earlier on in their pregnancies prefer. And it’s something that can be safely carried out at home. In fact, in many states, people can get their abortion via telemedicine. That’s not the case here in Texas because of our state laws. But certainly, it is becoming more common. Really. In recent years, we’ve seen a lot of the restrictions on this type of abortion be lifted

For those who are not familiar with the process. It’s my understanding that it requires patients to take two pills 24 to 48 hours apart to terminate a pregnancy. Is that right

That’s right. There are two pills in the regimen. The first called mifepristone is swallowed and the second, misoprostol, is a set of pills that are taken usually 24 hours later and placed under the tongue to dissolve.

Are there any important side effects to the use of these two pills?

Well, we have decades of evidence now showing us that they’re very, very safe and effective medications. What you would expect would be bleeding as the pregnancy is passed and then cramping and pain. And that will vary a lot by individual. Some people may experience nausea along with that or chills. It’s really quite variable from person to person. But in general, the main thing to know is that these medications. We have great evidence for their safety and their effectiveness.

This new law, as I understand it, prohibits the mailing of abortion pills. But if a doctor is not writing the prescription in Texas or practicing in Texas, how would the state go about prosecuting an individual who was providing these medications across state lines?

As you mentioned, this bill really is doing two things. The first part of it, the restriction that [limits abortion after] seven weeks of gestation, is aimed at clinical and clinic-based providers. The FDA says that a medication abortion can be carried out up to 10 weeks gestation, and so that three week rollback could be very consequential and inhibit access if Senate Bill 8, the ban on abortion at about six weeks is struck down by the Supreme Court.

The second part of the bill is the prohibition on the mailing of abortion pills. And that really, I think, is a reaction to the idea that when restrictions are put in place on in-clinic abortion, we know that people will often self-manage their abortions. That means they’ll do their own abortions outside of the formal health care setting. And one of the main ways of doing that is by going online to find these medication abortion pills and then they’re mailed to the person’s home.

And I think the idea is that this would create a chilling effect on anyone who might try to mail abortion pills. So short of going through people’s mail. I have no idea how the state actually intends to enforce this. But my sense is that they’re trying to create this chilling effect by putting a punishment in place that will try to deter people who might want to help out other people in Texas.

Are there particular providers this bill seems to be targeting?

I think that it is trying to target those who are helping folks get abortions outside the formal health care setting. The last decade or more in Texas has seen bill after bill after bill aimed at in-clinic providers, aimed at shuttering clinics, aimed at burdening or intimidating or harassing clinic-based providers. And as a reaction to those restrictions, people are now oftentimes taking matters into their own hands and self-managing. I think it’s a challenge for those who want to ban abortion, and for legislators to try to stop that practice because it is happening outside of the formal health care system. So this is an attempt to do that and to stop one way in which someone might self-manage, which is to get abortion pills through the mail. Although my sense is that this bill will probably not make any difference to that practice.

This story has been updated to reflect the fact that the new law makes the abortion pill illegal after seven weeks of pregnancy, not before.

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