Bethel, Alaska Joins Mifepristone Case, Making History & Preparing to Fight
Alaska’s Attorney General is taking aim at abortion, making it clear reproductive rights are no longer a given.
You’ll find Bethel, Alaska about 400 miles from Anchorage, but you won’t find it by car because there are no roads in or out. In order to reach the 6,200-some residents that call this ice-swept city home — 82% of whom are American Indian or Alaska Native — you’ll need a boat or a plane.
There’s snow 7 months of the year, which is one reason why there are more cabs per capita than any other city in the United States; cars are prohibitively expensive to bring in, and of the 50 square miles that encompass the 46 distinct villages of Bethel, only 10 are paved.
The cost of living is extraordinary (food is about 5x what folks pay in the lower 48, a gallon of milk costs $10 for example) and 28% of the population lives below the poverty line.
Time, distance, resources, and weather hinder everything the light touches—like reproductive healthcare and abortion access.
Bethel’s remoteness is both its allure and its Achilles heel.
On Tuesday, April 25th, the Bethel Council Members voted for the first time in the city’s history to join as amicus — “friend of the court” — in federal litigation, and they did it to support the availability of mifepristone in the Yukon-Kuskokwim Delta Region.
“The fact that this therapeutic pharmaceutical is available is important,” Council Member Mark Springer said during the meeting. “I just think that as the governing body of the largest community on the Delta, we sometimes take positions on issues that affect the entire region, and this is one of those issues.”
Springer stressed that he believed mifepristone is rarely used as an abortifacient (mifepristone blocks progesterone, a necessary chemical for pregnancy).
“I may be wrong, but if I’m wrong or if I’m right, it’s none of my business. The reason I’m sponsoring this resolution is because of the therapeutic use of this drug for women we love, and women we know who are experiencing spontaneous abortion miscarriage.
And this is used to prevent the need to have them be sent to a higher level of care.”
Aadika Singh, a reproductive rights attorney at Public Rights Project, is an Alaska resident and had urged the City of Bethel to enter the mifepristone fight on the national stage.
She points out that Bethel is also a hub for people living in villages that are even more remote in even more challenging environments — extreme cold, ubiquitous snow, no formal healthcare access — so any further barriers to access would spell disaster, and quickly, for the people of Bethel and the wider Yukon-Kuskokwin Delta.
Councilwoman Sophie Swope also voiced her concerns during the mifepristone vote, insisting that individuals cannot instill their beliefs in other people, and that “taking something away that is beneficial to miscarriages and other complications beside abortion would detrimentally impact how far we’ve come. I don’t think that it’s in our right to say how a drug is used — that is between a patient and their provider,” she continued.
Singh says that this vote in Bethel is key to ensuring and expanding access to reproductive healthcare in Alaska.
Alaska has a rights-protective Supreme Court when it comes to reproductive healthcare, but a conservative Governor, Michael James Dunleavy, and the Anchorage mayor David Bronson narrowly won on his platform not to enforce any COVID mandates (and is currently embroiled in all kinds of scandal), and an Attorney General, Treg Taylor, who is leading a spurious interpretation of Alaska’s abortion statute.
“Abortion is protected in the state constitution as interpreted by the Alaska Supreme Court so nothing changed in Alaska after Dobbs and Alaskans believed nothing would,” Singh told me.
But Taylor’s recent signing of the letter to Walgreens and stepping out to join the other side of the mifepristone litigation — which conjures the dangerously antiquated Comstock Act and argues medication abortions are riskier to pregnant women than procedural abortions when myriad studies have patently found the opposite — has thrown into sharp relief that reproductive rights in Alaska are not the given they once seemed.
Singh says she recently spoke with a health care provider in the YK Delta who frequently administers mifepristone for miscarriage management to Bethel residents and those who fly or boat to Bethel from even more remote villages; she told Singh that administering mifepristone for these miscarriages eases bleeding and discomfort and allows the patients to go home sooner.
“Without mifepristone, they would have to wait for the miscarriage to pass, which could take days, all the while hundreds of miles away from home with no support,” Singh explained.
“Access to evidence-based healthcare care is so visibly critical in a place like Bethel.”
A case is now before a lower court in Alaska challenging the state’s statute that abortions can only be provided by a physician. Planned Parenthood filed the case last year, and won a preliminary injunction, to expand that definition. They argued that “provide” should actually mean “prescribe,” so for now, advanced care clinicians can also supply abortion medication and begin to bolster new options for self-managed care from telehealth and by-mail to Mom and Pops pharmacies, Costco, and the like.
Singh stresses that regression in access to reproductive healthcare could have deeper and further-reaching impacts in Alaska where practical barriers, not legal barriers, have already impaired the availability of care. Challenging geography, less infrastructure, and a dispersed and largely rural population make any further burden enormously burdensome.
Singh points to Taylor’s purposeful misrepresentation of Alaska reproductive health law as a potential harbinger of what’s to come.
“He’s sowing confusion around what is lawful, which in turn makes available care seem tenuous and difficult to access. It shouldn’t be. The City of Bethel’s leadership shows that Alaskans are ready to hop in the fight — not only to protect access to care, but expand it.”
