Wednesday, South Dakota Governor Kristi Noem signed into law that would make the state one of the most difficult places to obtain medication abortion. The new law, which has not yet taken effect (it’s dependent on a federal court case’s outcome), would require those seeking a pharmaceutical abortion to visit a physician three times, even though physician visits are not medically necessary to have a safe medication abortion, and are also not required by the FDA to obtain a prescription for the medication.
The law would require patients first to be screened, then have to wait three days before getting the first dose of the drug. To get the second dose of the drug, the patient would have to go back to the doctor. The doses are typically taken within a day or two of one another, and in most cases, patients get both doses and manage the abortion at home if they are prescribed the drug by an in-person doctor.
The law also makes it a Class 6 felony for a person “practicing medicine without a state license to prescribe the drugs for a medication abortion,” per CNN. That could be a specific aim at programs like Aid Access, which mails abortion medication to those in need in every state.
Further complicating matters is that pharmaceutical abortion is only available prior to the 11th week of pregnancy. Many people do not realize they are pregnant until around the six to the eight-week point, meaning three physician visits are required in the approximately one-month span between detection and the medication’s gestational cut-off – an unreasonable requirement for most pregnant people to be able to meet, especially if, say, their doctor’s office is fully booked when they realize they are pregnant.
South Dakota is the latest in a string of states attempting to limit access to abortion medications. In response to the Covid-19 pandemic, the FDA lifted physician visit requirements, allowed telehealth visits, and permitted abortion medications to be mailed to patients, a temporary measure that was made permanent in December.
On the heels of the FDA change, lawmakers in 20 states quickly drafted bills that would limit availability and ease of access to the medications. Legislators in Georgia, Kentucky, Louisiana, Maryland, Minnesota, Missouri, Nebraska, Ohio, South Dakota, and Tennessee introduced bills that would ban mail receipt of the medications and require in-person pick up at a medical facility. Residents of South Dakota would be required to take the medication in the presence of a medical professional.
Iowa, Massachusetts, Minnesota, and Missouri lawmakers introduced bills that would revoke the ability for patients to seek telehealth consultations and require at least one in-person physician visit. And in Iowa, Massachusetts, Minnesota, and Missouri, lawmakers have proposed total bans on the use of abortion medications, which account for half of all abortions and have been approved by the FDA for over 20 years and are recommended by the American College of Obstetricians and Gynecologists (ACOG).
More than half of abortions in 2020 were medication abortions. At present, 26 states are poised to ban abortion outright if the landmark Roe vs. Wade decision is overturned this summeras many experts believe it will be, dramatically limiting family planning options for US families and sending countless people in search of dangerous black market abortions.
Despite the current anti-choice political climate in many states, organizations are working to provide abortion medications to those who are unable to obtain them in their home states.
Aid Access, an abortion advocacy group, mails abortion medications to all 50 states, ensuring that those who live in states with abortion bans have access to necessary medical treatment and family planning. Services like the ones Aid Access provides also mean that people can keep medications on hand in case of future need in areas where abortion services have or are likely to become significantly more difficult, or even illegal, to obtain.