WASHINGTON — The coronavirus had started to shut much of the country down in March 2020 when Larada Lee found out she was six weeks pregnant.
She wanted to end her pregnancy and decided that instead of a surgical abortion, she would use medication, a process she could complete at home. This, she thought, was her best chance of limiting her exposure to Covid-19.
But Lee, then an Ohio State University student, was still forced to make a series of in-person doctors’ visits before she could get access to the drugs — all while grappling with the frightening new pandemic reality. Even then, she was still required to pick up the two-pill regimen at a health clinic, taking the first, mifepristone, there and the second, misoprostol, at home 24 hours later.
“Accessing abortion feels like one of the worst games of Tetris,” she said. “I am working full time and in school and I have hopes and aspirations for myself that would not be attainable if I was a parent.”
Women facing stay-at-home orders in other states have had an easier time getting prescriptions — through telehealth appointments. In an effort to expand access, the Food and Drug Administration temporarily eased long-standing in-person dispensing requirements for mifepristone — first in July 2020 in response to a court order that was later reversed by the Supreme Court, and again in April — so that women could order the pills by mail for the duration of the pandemic.
The agency’s move, along with the explosive growth in telehealth services and increase in self-managed medication abortions, sparked a flurry of legislative activity in Ohio and other Republican-led states. They further limited access to the pills, adding to restrictions on their use already in place in dozens of states around the nation.
“Over the past year, we’ve seen states really target medication abortion in a way that we hadn’t seen,” said Elizabeth Nash, state director for the Guttmacher Institute, an abortion rights group. “And so it’s particularly concerning because this is a method that is safe and effective and can be easily provided through telehealth.”
This year alone, a half dozen states have passed laws targeting medication-induced abortion, according to Nash, and several others are advancing legislation. Arkansas, Arizona and Oklahoma enacted laws banning the mailing of mifepristone for abortions. Montana approved a measure effectively banning telehealth services for such abortions, as did Ohio, whose law is being challenged by Planned Parenthood in court.
Indiana passed legislation mandating that a patient take the first dose in the presence of a physician. The law also says abortion providers must tell patients that medication abortions can be reversed with progesterone — a claim the American College of Obstetricians and Gynecologists says is unsupported by science. That law is also being challenged by Planned Parenthood and other advocacy groups
The Texas Legislature, which passed a fetal “heartbeat bill” in May, is now expected to consider a bill to limit medication abortions once it reconvenes with a quorum for its special session. That measure also would ban the mailing of abortion pills and require doctors to examine a woman in person and ensure she’s no more than seven weeks pregnant before prescribing the medication.
Some of the recently passed measures also require women seeking medication abortions to receive pregnancy tests, ultrasounds and counseling. Meanwhile, about 20 states have laws preventing telehealth appointments for abortion pill prescriptions, and more than 30 restrict the health care providers who can write them, requiring they be doctors rather than physician assistants or nurses.
Oklahoma state Sen. Julie Daniels, who authored the medical abortion legislation, said at the time that the FDA’s moves to relax requirements for the pills prompted her to act. In addition to banning the mailing of abortion pills, the legislation…