Explainer: What you should know about the increased demand for abortion pills 
By / Jul 29

Demand for abortion pills has increased significantly since the recent Supreme Court ruling that allowed states to put greater restrictions on abortion. Axios reports that organizations that provide information about or access to abortion pill has skyrocketed in the weeks since the Dobbs decision was released. The result is that chemical abortion is likely to become even more common in the near future. Over half of abortions in the U.S. (54%) in 2020 were medication-induced, up from 39% in 2017, according to the Guttmacher Institute, a research organization that supports access to abortion.

Here is what you should know about abortion pills. 

What is an abortion pill?

The abortion pill is the most common type of chemical abortion. 

The two broad methods for legal abortions in the U.S. are chemical and surgical. A chemical abortion (sometimes referred to as a medication abortion, medical abortion, or pharmaceutical abortion) is a method that uses an abortifacient to stimulate uterine contractions and end the pregnancy in a process similar to miscarriage. An abortifacient is a chemical or drug that causes embryonic death by either killing the child directly or by preventing implantation of the embryonic child in the uterine lining.

While all abortion pills are abortifacients, not all drugs that have, or may have, an abortifacient effect are classified as abortion pills, which have an abortifacient intent. For example, some forms of “emergency contraceptive” may prevent implantation and therefore cause the death of an embryo, but because their intent is not to cause abortion, they are not generally considered abortion pills.

How do abortion pills work?

The method approved by the Food and Drug Administration (FDA) for chemical abortions is a two-step process involving the drugs mifepristone and misoprostol. Mifepristone (brand name Mifeprex) ends a pregnancy by blocking the hormone progesterone, which is needed to maintain a pregnancy. Because this hormone is blocked, the uterine lining begins to shed, removing the child (in the embryonic state) that was attached. The second step, which occurs 24 to 48 hours later, requires taking misoprostol which causes the woman to expel the child and the uterine lining in a matter similar to a miscarriage.

How do abortion pills differ from “emergency contraceptives”?

Emergency contraception—sometimes also known as the “morning after pill”—is a method of contraception that is taken after sexual intercourse with the intention of preventing pregnancy by delaying ovulation (i.e., the process in which a mature egg is released from the ovary).

There are three main types of emergency contraception approved for use in the United States. The first type uses Levonorgestrel (Plan B One-Step, Next Choice One Dose, After Pill, Take Action, and My Way). As with oral contraception, it is unclear whether this drug can ever have an abortifacient effect.

What is Mifeprex (RU-486)?

The most common drug used for medical abortion is Mifeprex, the brand name for mifepristone, a drug that was formerly known as RU-486. The drug was developed in France in the 1980s and banned by President George H.W. Bush Administration’s FDA in 1989. In 1993, President Bill Clinton asked the FDA to review the ban, which was lifted in 2000.

Currently, the drug is approved by the FDA provided it is “dispensed in certain healthcare settings, specifically, clinics, medical offices and hospitals, by or under the supervision of a certified prescriber.” In 2016, the FDA extended the time the abortion pill could be taken to 70 days into a pregnancy. In December 2021, the FDA relaxed some of the rules on mifepristone, allowing patients to pick up the drug at their pharmacy or receive it in the mail.

(Despite how the name might sound—“Are you for 86?” (“86” being slang for ejecting something or someone—RU-486 was derived from the initials of the French pharmaceutical company that patented the drug (Roussel Uclaf) and the serial number (486).)

Is the ‘abortion pill’ restricted by state bans?

It’s currently unclear whether states have the power to restrict abortion pills. After the Dobbs ruling, Attorney General Merrick B. Garland said, “States may not ban Mifepristone based on disagreement with the FDA’s expert judgment about its safety and efficacy.”

Greer Donley, an assistant professor at the University of Pittsburgh School of Law, said that Garland’s statement “was really a nod to the idea that state abortion bans theoretically have to have an exception that allows the dispensing of medication abortion.”

According to the Guttmacher Institute, 32 states require that the provider who administers a medication abortion be a physician. If abortion is illegal within a state, a physician licensed within the state would be unable to prescribe an abortion pill. 

How do telemedicine restrictions limit the use of the abortion pill?

Telemedicine is the use of electronic communications and software to provide medical services that are usually offered in a clinic without an in-person visit. The COVID-19 pandemic increased the popularity of telemedicine, and it became increasingly possible to visit a physician by phone or computer and have a abortion pill mailed to one’s home.

Organizations that provide telemedicine in the U.S., however, are subject to state laws. Currently, 19 states require the person (doctor, nurse practitioner, or physician assistant) providing a medication abortion to be present when the patient takes mifepristone. This prohibits the use of telemedicine for the procedure and prevents doctors from other states from prescribing the abortion pill. More states that ban abortion may choose to implement such restrictions in the future. 

However, women seeking chemical abortions in states that ban the procedure are already finding ways to get around the laws. For example, there has been an increase in the use of telemedicine organizations that operate in foreign countries, which are able to circumvent state and federal laws and mail the abortion pill directly to anyone in the U.S. 

Women seeking a chemical abortion may also be able to use telemedicine within a state that allows abortion and have the abortion pill sent to someone they know in the state or remailed from an in-state address to their own home. 

Thus, Christians must work to ensure that they do not confuse the passing of pro-life legislation or the overturning of the precedents in Roe and Casey as the end of the fight against abortion. Important as that is, if people still desire abortions, these pills will be available. Christians must work tirelessly to proclaim the dignity of every human life and address those factors that lead women to consider abortion.

House passes contraception bill that threatens life and religious liberty
By / Jul 22

The House on Thursday passed the Right to Contraception Act by a final vote of 228-195. The vote was split mostly on party lines, with 220 Democrats and only eight Republicans voting in favor of the bill. It’s still unclear if the Senate will bring the bill forward for a vote. 

The legislation was rushed through because of a comment made by Justice Clarence Thomas in his concurring opinion in Dobbs v. Jackson. Despite the majority opinion insisting that “Nothing in this opinion should be understood to cast doubt on precedents that do not concern abortion,” Justice Thomas wrote that the Supreme Court should “reconsider all of this Court’s substantive due process precedents, including Griswold, Lawrence and Obergefell.” 

In the case of Griswold v. Connecticut (1965), the court ruled that “right to privacy” can be inferred from several amendments in the Bill of Rights, and this right prevents states from making the use of contraception by married couples illegal. Justice Thomas’ point is that the constitution does not include such a “right to privacy” ​​and that the issue should be resolved by the legislature. 

The stated purpose of the bill is, “To protect a person’s ability to access contraceptives and to engage in contraception, and to protect a health care provider’s ability to provide contraceptives, contraception, and information related to contraception.” If this was the actual effect of the ​​bill, it would not be controversial for most Americans—including Protestant Christians, who believe that contraception is a matter of conscience and hold diverse views on the subject. 

However, there are two primary concerns with this legislation. ​The first is that the bill’s definition of “contraception” is so broad it could be used to include potential abortifacients. The second is that it imposes a substantial threat to religious liberty. 

Potential mislabeling of contraceptives 

The purpose of contraceptives is to prevent conception (hence the term “contra”— against conception). The scientific understanding of conception is that it occurs at fertilization. Therefore, the historical meaning of contraceptive—and the one still used by pro-lifers—is any method that prevents fertilization.

However, in 1972 the American College of Obstetricians and Gynecologists changed the definition of conception to mean implantation of the embryo into the wall of the mother’s uterus. As physician Megan Best has explained, under the new definition, any device that prevented the embryo from implanting in the uterus could be marketed as a contraceptive.

“This change of definition means there are two classes of contraceptives,” says Dr. Best, “those that work before fertilization, the classic definition, and prevent the sperm from joining with the egg; and those that cause an early abortion by acting after fertilization.”

The Right to Contraception Act directly states that for the purposes of the law ‘‘’contraceptive’’’ means any device or medication used to prevent pregnancy” and includes any contraceptive devices approved by the U.S. Food and Drug Administration (FDA). The law would not allow states to determine that, to protect the consciences of its citizens, they will err on the side of caution and disallow any contraceptives that might have an abortifacient effect. Instead, the bill, as written, not only allows the FDA sole authority to make such a determination, but also makes it possible for any abortifacient to be automatically protected if the regulatory agency classified it as a “contraceptive.”

The threat to religious liberty

The law also is a threat to religious freedom in general, and the Religious Freedom Restoration Act (RFRA) in particular. 

The RFRA is a federal law passed in 1993 that is intended to prevent other federal laws from substantially burdening a person’s free exercise of religion. The RFRA states that the government shall not substantially burden a person’s exercise of religion even if the burden results from a rule of general applicability, unless it is in furtherance of a compelling governmental interest and is the least restrictive means of furthering that compelling governmental interest. A person whose religious exercise has been burdened in violation of this law may assert that violation as a claim or defense in a judicial proceeding and obtain appropriate relief against a government. 

The most high-profile federal case that relied on RFRA was the 2014 case Burwell v. Hobby Lobby Stores, a challenge to the Affordable Care Act’s Health and Human Services (HHS) contraceptive mandate that required all for-profit companies to cover abortion-inducing drugs—even against the religious objections of these businesses’ owners.

​The Right to Contraception Act would bring back issues that were resolved in ​the Hobby Lobby case. The act would not only supersede any state laws, but would take precedence over any “other provision of Federal law, including the Religious Freedom Restoration Act of 1993.” 

Many politicians and citizens—including pro-lifers and religious liberty advocates—will likely support the legislation because of the mistaken impression it merely protects the use of contraceptives. But the bill needs substantial revision before it should be allowed to pass the Senate. As we enter the new phase of in the post-Dobbs era, Christians need to extra vigilant as abortion supporters will attempt to pass harmful legislation, such as this, under the guise of it being a noncontroversial measure. The ERLC is opposed to this bill, and all legislation that does not protect life and religious liberty, and is committed to advocating against its passage in the Senate. 

Brent Leatherwood, the ERLC’s acting president, said this about the bill,

“While from a distance this legislation may seem innocuous, a review of the details reveals It to be nothing less than an affront to religious liberty. I realize some congressional leaders are lashing out in any number of ways following the Dobbs decision, but to create a carve out of RFRA protections and a pathway for paving over consciences that have sincere religious objections is simply extreme. I would once again implore our policymakers to focus on ways to develop a culture of life where lives are saved, mothers are served, and families are supported.”