Less than a month after Texas’ six-week abortion ban went into effect in September, Gov. Greg Abbott (R) quietly signed another anti-choice bill that restricts access to medication abortion. On Thursday, that restriction became law, largely cutting off what little access Texans had left to abortion care.
The new law restricts abortion medication by prohibiting doctors from prescribing the abortion pill after seven weeks of pregnancy, three weeks less than the U.S. Food and Drug Administration’s limit of 10 weeks. The law also makes it a felony for physicians to send abortion pills to a patient by courier, delivery or mail, specifically requiring physicians to do an “in person” examination before providing medication abortion in person. Punishable by up to two years in jail and a fine of $10,000, the law only applies to doctors, not pregnant people.
“It’s been three months since Texas imposed a near-total ban on abortion procedures ― and now, lawmakers are once again coming after choice by restricting medication abortion, ignoring FDA and medical evidence of its safety and effectiveness,” said Texas state Rep. Donna Howard (D). “This one-two punch will strip away the ability of Texans to make their own health care decisions.”
Parts of the law are redundant, given the six-week ban, and are likely in place in case that law gets shut down by the Supreme Court. Other sections, however, are poised to have a major impact on Texans seeking abortion care early in pregnancy. Just over half of abortions in Texas were medication abortions prior to the six-week ban. Even with the six-week ban in place, medication abortion likely accounts for a large number of abortions in the state.
Across the country, medication abortion is the most common abortion method for people who are 10 weeks pregnant or less, according to the Guttmacher Institute, a research and policy organization that supports abortion rights. Medication can also be much less expensive: Abortion pills can cost a person as little as $110 by mail, versus at least $300 for a surgical procedure.
“This one-two punch will strip away the ability of Texans to make their own health care decisions.”
– Texas state Rep. Donna Howard (D)
Part of the reason abortion pills are so widely used is that they make accessing care much easier, especially when people can get them via mail. It’s a much more flexible option for people who aren’t able to travel to access care.
“Time is a big factor,” said Dyana Limon-Mercardo, the president of Planned Parenthood Texas Votes. “Many people are living paycheck-to-paycheck, they are working demanding jobs where they might not have paid time off or may have irregular hours. [It’s helpful for] people who already have children to be in a setting where they know they have child care available, or they’re able to begin that process at home when their children are already asleep. Many people choose medication abortion because they’re able to set the time and place for their abortion.”
Medication abortion is also extremely safe. The likelihood of complications from a medication abortion procedure is less than 1% when the medication is obtained via telemedicine or in person, according to the American College of Obstetricians and Gynecologists.
The Texas law, however, inaccurately depicts two abortion medications, mifepristone and misoprostol, as having “significant medical complications” associated with them, such as “uterine hemorrhage” and “pelvic inflammatory disease.” According to the leading research group Advancing New Standards in Reproductive Health, when mifepristone and misoprostol are combined, the medications are over 95% effective and safer than Tylenol.
“Medication abortion is so safe and complications are so rare that there is absolutely no justification for this law,” said Elizabeth Nash, a principal policy associate at the Guttmacher Institute.
Access to abortion care in Texas was already abysmal before Dec. 2. The state’s six-week ban, which offers a financial incentive for private citizens to enforce the law, has had profoundly harmful effects on people seeking abortions in Texas. Many are leaving the state to get care, while other, less privileged people are being forced to give birth. Abortion clinics in neighboring states like Oklahoma are overwhelmed with Texas patients, leaving clinic staff overworked as they try to accommodate the influx of new patients.
“Between the six-week ban and the medication abortion restriction, Texas has limited abortion access to the absolute minimum,” Nash said. “Even just getting the information out that some abortion is available can be difficult, much less figuring out how to access it. It got drastically more difficult to access care after Sept. 1 with the six-week ban, and now it will be even more difficult with the medication abortion restrictions in effect.”
Texas’ medication abortion restriction is part of an ongoing whirlwind of attacks against abortion rights. Indiana, Montana and Oklahoma all passed similar medication abortion restrictions this year (although the Montana and Oklahoma laws are not currently in effect, and are both stalled in lower courts). Additionally, the Supreme Court heard oral arguments this week in Dobbs v. Jackson Women’s Health Organization, a case that threatens Roe v. Wade, the landmark ruling that protects a person’s right to choose.