Future of Mifepristone by Winifred Nathan

Today is the one year anniversary of the Dobbs decision.

The alarm grows louder. How far will the antiabortion lobby restrict women’s reproductive health care before they are satisfied? If they successfully secure a complete abortion ban, will they stop? Or will they go on to control women’s dress, education, travel, etc.?

Reportedly, Dobbs v Jackson overturned Roe v Wade so the states could set the legal boundaries of abortion through the democratic process. But on November 18, 2022, the US District Court of Northern Texas delivered Alliance for Hippocratic Medicine et al. v US Fodd and Drug Administration et al., a decision that stops medical abortion in all fifty states by ending FDA approval of mifepristone. The Supreme Court has stayed (paused) the Texas order as the appeal works its way to their docket. Mifepristone continues to be available, but for how long? Will the Supreme Court eventually side with the plaintiffs?

We see on the evening news Iranian women protesting the death of Mahsa Amini, murdered by the “morality police” because she fell short of dress restrictions. In the seventies, Iranian women wore miniskirts. What happened? The answer, holders of extreme religious views changed the laws. Can that happen here? We learn in civics class that our Constitution stands for the separation of Church and State, but can extremists manipulate freedom of religion? Roe v Wade did not make abortion mandatory. If your faith says human life starts with conception, you can choose not to have an abortion. But extremists don’t stop there. They want the law to outlaw all forms of abortion for everyone forcing their religious view on all of us. 

If the Supreme Court dismisses the Texas case, I’ll relax (at least a little). The Court could do this based on standing. (Standing is the ability of a party to bring a lawsuit in court based upon their stake in the outcome.) At great length, the Texas Court discusses standing, perhaps revealing how tenuous the complainants’ standing is? I view the complainants in the Texas case as doctors and national medical associations with an agenda. They claim “alleged severe effects from chemical abortion can overwhelm the medical system placing enormous pressure and stress on doctors during emergencies and complications.” My response: a meta-analysis of 87 clinical trials showed that medication abortion is safe, with serious complications requiring hospitalization (for vaginal bleeding, pelvic pain, or infection) occurring in less than .3% of patients. Approximately .1% of patients needed a blood transfusion. Complications in these percentage ranges will not overwhelm the medical system.

Further, pregnant women who don’t abort will continue to require medical care, some developing “severe effects.” A study by the National Institute of Health found pregnancy-associated mortality rate among women who delivered live babies was 8.8 deaths per 100,000 live births. The mortality rate related to induced abortion was 0.6 deaths per 100,000 abortions. 

Does a bias emerge demonstrating that the complaining medical professionals want to exclude medical abortion patients for an unstated reason? Is the elephant in the room religious beliefs?

For me, the vocabulary of the decision by design is deceptive. I believe it hides the religious motivation of the complainants and as well the Texas court. Speculation of when the soul enters the developing embryo transforming it into human life, is absent. This question is avoided by merging all stages of development of the fertilized egg. The embryo and its subsequent changes are, for them, an “unborn child.” An embryo in fact is not an unborn child, but equating an embryo with an unborn child conveniently negates dealing with the question of when human life begins. 

In footnote 1, Robert P. George and Christopher Tollefsen are cited as the authority for using the term unborn child in the decision regardless of the fetal stage of development under discussion. These are the same men who came up with the personhood argument for all stages of pregnancy. In their book Embryo, an embryo is an unborn child because “an entity must possess a developmental program (including both its DNA and oriented toward developing a brain and central nervous system.” The program begins at conception; therefore, so does personhood according to George and Tollefsen. 

The male role in reproduction may explain how men (and patriarchal religion) become confused about the difference between an embryo and an unborn child. The only action required of a man to become a father is to fertilize the female egg. Once there is an embryo, he can disappear. On the other hand, a woman, after conception, faces nine months of pregnancy and active participation in the baby’s birth. She is unlikely to equate an embryo with an unborn child. Any woman who has given birth knows there is a difference between an embryo that has taken up residence in her uterus and a six to nine-pound unborn baby nine months later making gymnastic moves while she is trying to sleep. 

An example of how the manipulation of language can change the response to imagery is the Texas decision referring to the termination of medical abortion as starvation. Really, can an embryo experience hunger? 

To bolster its decision, the Texas court cites studies and cases to show that women can suffer adverse psychological effects from abortions. I can agree that, typically, there is no happy ending to abortion, regardless of the procedure elected. There may be relief, but joy is unlikely. 

No woman sets a goal of becoming pregnant so she can experience having an abortion. 

All women who seek an abortion should be considered sincere in their decision and worthy of support. The last thing needed is criticism and guilt. Support can significantly help reduce any adverse psychological effects of an abortion. 

If the antiabortion lobby truly wants to end abortions, they could work to change the conditions that motivate women to seek abortions. Limitations on access to abortion should not be a front for gaining control of women’s lives.

BIO Winifred Nathan: Like E. Jean Carroll, I am a member of the Silent Generation. I was born during the Great Depression and am a child of WWII. Occasionally, I break the silence and publish articles about everything from making a piñata to Marshall McLuhan and the Gospel of John. I have three degrees: BA with majors in philosophy and sociology, MSW, and JD. My resume includes sworn police officer, social worker, psychotherapist, and attorney. Three children and two husbands (deceased) have added to the adventure of my long life.