Last week, the Supreme Court ruled to block the mail order of mifepristone, a thoroughly tested progesterone-blocking medication with many uses. Along with terminating pregnancies within their first 70 days, mifepristone treats miscarriages, uterine fibroids and other medical conditions. The decision to block this medication was met with swift backlash from pharmaceutical companies that claimed the decision had caused sudden chaos and confusion in the world of reproductive healthcare, and a short-term administrative stay went into effect May 4. This administrative stay paused the block, allowing mifepristone mail delivery to continue until Thursday, May 14.
Since the Dobbs decision overturned Roe v. Wade in 2022, ruling that the right to abortion is not encoded in the Constitution, the mifepristone block has been one of many obstacles for those seeking reproductive healthcare.
Erin Carr, a law professor at Seattle University who specializes in areas of educational inequality, juvenile and criminal justice, power and privilege and constitutional law, explained the 2022 ruling.
“The reasoning of Dobbs is that there are no constitutional protections to be found in the 14th Amendment that would provide privacy-based rights to make these decisions about bodily autonomy,” Carr said.
Dobbs left the issue of reproductive rights to individual states, 28 of which now have abortion bans based on gestational period, and 13 of which have banned abortions entirely. Although many states still ensure access to abortion, such as Washington, which says it will stockpile mifepristone, this new ban will be felt on a national scale, unlike preceding restrictions which vary state to state.
The ban will affect medical practitioners like Dr. Wendy Smith, a Portland-based obstetrician-gynecologist.
“It’s taking a safe and effective drug and making us use alternatives that are not as safe and not as effective,” Smith said.
She outlined the widespread misconceptions regarding the medication. It isn’t simply an ‘abortion pill’ as it’s framed by legislators: it is used frequently and effectively in a variety of medical capacities. Carr stated that mifepristone was initially used in ulcer repair and other medical treatments unrelated to abortion.
She explained how state residents will face new obstacles in accessing mifepristone, even with Washington state’s stockpiling of the medication. Though the state is in support of reproductive rights, the ban will still have negative effects for some WA residents, like rural and other communities who may rely on telehealth for facilitating healthcare.
“Even if the drug itself is still physically available, the process of getting access to it is going to become more onerous,” Carr said.
The Dobbs decision was a result of President Trump’s appointment of three conservative judges in his first term, which solidified a conservative majority in the Supreme Court. The ramifications of this ruling span beyond the scope of abortions, as Roe v. Wade is deeply linked to legal understandings of personal privacy.
“You can’t disconnect those two concepts. This is part of a much broader, much more ambitious project of limiting the very significant civil rights, goals and accomplishments of the last 50 years and trying to undermine those. You see the same populations by and large being targeted and experiencing the greatest impacts from these cases and these Supreme Court rulings,” Carr said. “Because of Dobbs, there has been an invitation of litigation, to try to undermine privacy-based rights for certain populations who have only just been able to access those rights.”
Smith worries that patients will omit information about their medical needs out of fear that records will be shared with employers through insurance systems, or that they will face consequences for intimate choices of personal autonomy. She emphasized that this isn’t a theoretical risk, but a real issue that can lead to greatly increased risk, adverse health outcomes and death.
Edward Donalson III, the director and doctor of ministry for the school of theology of Seattle U and a serving member of the Board of The Religious Coalition for Reproductive Choice and Faith Action Network, was unsurprised by this decision.
Donalson sees the decision as emblematic of the Trump administration’s broader ideology.
He stressed the severe ramifications of these legislative actions and how marginalized populations will endure the worst of them.
“The conversation needs to be about so much more than abortion pills. We need to be having a much larger conversation about who has access to healthcare, who has bodily autonomy and whose voices are at the table when these decisions are being made….So the working poor, the poor and black and brown bodies will be disproportionately affected by these shifts in bodily autonomy,” Donalson said.
Donalson also referenced Ubuntu, an African philosophy of compassion, when discussing the disparity within access to healthcare between locations, socioeconomic status and other factors. Through this philosophy, he continued to advocate for mutual aid societies and systems of mutual care and accountability.
“We come into being, we co-create each other in this world. The false security of my own accessibility is a mirage… the truth is, we’re interconnected and deeply interdependent,” Donalson said. “This is really what we can do: be responsible for our neighbors.”
