The abortion-pill ruling will make abortions as harrowing as possible



Just after graduating college, I got a phone call from a friend who needed a ride to an abortion clinic. Her first encounter with a promising new guy had resulted in a broken condom. She’d immediately taken Plan B, but her period never arrived, and now she was pregnant.

A few days later, she called back. No ride necessary. The clinic told her she could have a medication abortion involving pills rather than a surgical one involving stirrups. She could do it in her own apartment. I talked to her a few times over the weekend. She said the cramps were noticeable but no worse than a period. She was managing them with junk food and a heating pad. At one point, she told me to turn on my television so we could watch a Bridget Jones movie together from our respective living rooms.

This was in the mid-2000s. Today more abortions are done with pills than surgery, but back then medication abortions using mifepristone were new enough that we didn’t even call it “mifepristone.” We called it RU-486, after the French company that made the drug, Roussel Uclaf. Time magazine had run a cover story. “The Pill that Changes Everything,” the headline declared. “A new simpler way to use RU 486 makes abortion truly a personal and private choice.”

That was the promise, right? That was the dream. Maybe dream is the wrong word, because nobody ever dreams about having an abortion. But RU-486 was a big step from the nightmare; a technological advance that could add a sliver of grace to a process that was so often harrowing and stigmatized — the gauntlets of protesters outside clinics, the graphic poster boards. There is never any way to eliminate the lopsided burdens on women that pregnancy places. But for 23 years there was, at the very least, this: a small miracle pill, a heating pad, a pint of Cherry Garcia, and Renée Zellweger cavorting through London. It wasn’t much, but it wasn’t a back alley and a rusty coat hanger, either. It was something.

On Friday evening, a Texas judge named Matthew Kacsmaryk issued a ruling suspending FDA approval of mifepristone. In his opinion, he criticized the FDA for having loosened restrictions, over time, on how the pill is administered. He cited the pill’s alleged side effects, writing, “Many women also experience intense psychological trauma and post-traumatic stress from excessive bleeding and from seeing the remains of their aborted children.”

Read conflicting abortion pill rulings from judges in Texas, Washington

To make things ever more disorienting, a federal judge in Washington state ruled Friday in a separate case that mifepristone is safe and effective and that the FDA should be allowed to continue distributing it. The legal consensus on Friday night was that the two competing rulings would only fast-track the cases to the U.S. Supreme Court. And forgive me for being pessimistic, but I read Justice Samuel Alito’s caustic glee in the opinion he wrote overturning Roe vs. Wade, and I read Justice Clarence Thomas’s concurring opinion, opening the door to revisiting legal protections on contraception, and I watched the confirmation hearings of Amy Coney Barrett, Neil Gorsuch, Brett Kavanaugh, and you know what? I don’t love mifepristone’s chances.

The feminists were right all along. They were right when they tried to warn the country that Roe v. Wade was going to be overturned the second Justice Ruth Bader Ginsburg left the building. They were right that antiabortion activists weren’t going to settle for overturning Roe v. Wade. This was never about individual states being allowed to make their own abortion laws. The endgame was always: No abortions for anyone, anywhere. Earlier this week, Idaho passed an “abortion trafficking” law, making it a crime for an adult to help a minor access an abortion without parental consent, even by traveling to a state where abortion is legal.

Kacsmaryk, a conservative Christian appointed by Donald Trump, used the language of the antiabortion activists in his ruling, referring to abortion-care providers as “abortionists” and to fetuses as “unborn humans.” He did not mention that pregnancy also causes excessive bleeding, far more than abortions. He did not mention that being forced to carry an unwanted pregnancy to term can also cause intense psychological trauma. These omissions and underhanded argumentation should be outraging; instead it’s barely surprising.

The feminists were right all along.

Even after Friday’s dismal news, abortion rights activists were trying to keep their chins up, pointing out that there are other regimens for medication abortions, albeit regimens that are less effective and more painful. There are still surgical abortions, if you can get to a state that will still allow you to have one, or if you can do it before a restrictive “heartbeat law” makes it impossible, if you won’t be arrested upon returning to your home state. It’s still not a back alley and a rusty coat hanger. Not yet anyway. But it’s getting closer.

The banning of mifepristone would not signify an end to abortions, which desperate women and other pregnant individuals will find a way to have, whatever the cost to their own health and bodies. What it would signify is the removal of dignity. The removal of comfort. The yanking away of any expectation that a person trying to end a pregnancy should be able to do with a modicum of privacy or grace.

The banning of mifepristone says that those seeking abortions should suffer, maximally. That they should not be allowed to retreat to their apartments, they must walk through the gauntlets of protesters. That even when the suffering could be prevented, the suffering will not be prevented. There will be no heating pads, no movies, no private rituals of grief or celebration. The suffering is demanded. The suffering is the point.

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