Limited Abortion Access that Applies to All of Us, Not Just Texas: A Message for Wisconsin
Lauren Glusman (PPS ‘25)
Restricting access to mifepristone is the new means to inhibit reproductive health. Texas Judge Matthew Kacsmaryk, a Trump-appointee and opponent of abortion, ordered the drug off the market claiming the pill is unsafe and the FDA approval process was flawed. The FDA approved mifepristone in 2000, with a special regulatory framework, to be used in combination with another drug, misoprostol. The two-drug regime accounted for over half of abortions nationwide. 5.6 million people have used the drug with a survival rate of 99.99% which is higher than Tylenol. As of now, mifepristone remains on the market but with restrictions because the FDA’s 2016 guidelines to extend access were rolled back. The Texas ruling impacts Wisconsin residents by restricting mifepristone access and threatening a lower standard of care with reproductive implications.
Restricting Access to Mifepristone
Wisconsin residents face barriers to abortion access. Currently, medication abortions are illegal in Wisconsin. It is legal, however, for Wisconsin residents to travel to another state to receive medication but prescriptions must be picked up or mailed to an address in that state. Outsourcing services and resources to other states results in travel expenses, extended time away from responsibilities, limited appointment availability, and waiting periods.
New mifepristone restrictions exacerbate the existing barriers to abortion access. It is harder for Wisconsin residents to obtain mifepristone because services and resources are now strictly in-person. Patients must visit a doctor three times to receive a prescription. This forces Wisconsin residents to extend their stay or number of travel times to meet the requirements. Extended travel time is difficult to schedule and not economically feasible for many families. Mandatory in-person services and resources are deliberately more time-consuming and cost-sensitive than readily accessible alternatives such as video conference consultations and mailed prescriptions. Further, the window to use mifepristone decreased from 10 weeks to 7. A smaller time-frame forces expensive and difficult to schedule travel arrangements and does not account for limited appointment slots at high demand clinics. Ultimately, these restrictions force women to meet unrealistic expectations and timeframes that if unmet, may result in self-administered abortions or carrying the baby to term.
Restricting access perpetuates existing inequalities. Low-income patients and patients of color are most likely to experience pregnancy-related complications and maternal morbidity. Restricting mifepristone, limits medication access for these communities, exacerbating inequality.
Reproductive Implications of a Nationwide Mifepristone Ban
The ruling has the potential to impact the nation. The FDA cannot eliminate the drug in one state and not in others. If the FDA is forced to comply with Texas law, then it would abolish the drug in every state. This would be the second round of legislation, after Dobbs v. Jackson, that impacts the nation.
Eliminating mifepristone jeopardizes reproductive health. Mifepristone in combination with misoprostol is proven to be safe and effective. Prescribing solely misoprostol risks abortion effectiveness and additional side effects such as cramping and bleeding. Medication abortion is often the only accessible abortion method because it is cheaper and less allergen-inducing than surgical procedures which many clinics do not even offer. Limited legal exceptions to receive abortion care force even more doctors to turn away patients in need of help. Subjecting women to less effective medicine, waitlists for surgical procedures, and subjective expectations is unjust.
The absence of mifepristone perpetuates a lower standard of care. Mifepristone in combination with misoprostol increases patient comfort. Forcing higher doses of misoprostol causes increased side effects such as nausea, vomiting, fever, and gastrointestinal distress. Further, mifepristone alleviates the side effects of a miscarriage when misoprostol works to empty the uterus. So, the absence of mifepristone inflicts more discomfort on those already suffering from a miscarriage. Banning mifepristone could eliminate access to a standard of care by increasing discomfort for pregnant people nationwide.
Recommendation
There are local and nationwide channels to provide abortion access. Wisconsin residents should use available resources to access care. Abortion Finder guides you through the process by showing you where to access the pill and how you can receive funding assistance. On the federal level, Planned Parenthood should be the designated medication provider. This is practical because Planned Parenthood already prescribes the pill as one of its many services in states where abortion is legal. Focusing attention on Planned Parenthood, increased funding, resource allocation, and staff recruitment would ensure there is enough mifepristone available and accessible for in and out-of-state patients.
Lauren Glusman is from Milwaukee, WI and an Undergraduate at Duke University’s Sanford School of Public Policy. This piece was submitted as an op-ed in the Spring ‘23 PUBPOL 301 course. This content does not represent the official or unofficial views of the Sanford School, Polis, Duke University, or any entity or individual other than the author.
