As an OB/GYN, I know that medical abortion is safe, widely used, and effective. Women’s rights, family formation and abortion are recognized in many international human rights documents. The United Nations Human Rights Treaty of 1966 states that all human beings have the right to the highest attainable standard of health. The ability for someone to choose when and whether to have a child is fundamental to the framework of reproductive justice and is of paramount importance in protecting the health of an individual and a family. Family formation is also closely related to economic and social well-being and contributes to general health. Globally, unsafe abortions are responsible for 4 to 13 percent of maternal deaths. The World Health Organization recognizes that access to safe and timely abortion is an essential public health measure that reduces maternal morbidity and mortality. In other words, targeted policies that threaten access to abortion violate human rights.
Medical abortion is the most common method of terminating a pregnancy in the United States. Although abortions can only be performed with misoprostol, the most effective regimen combines mifepristone and misoprostol. Mifepristone has been approved by the Food and Drug Administration (FDA) for termination of pregnancy and for use up to ten weeks into pregnancy for over two decades. Mifepristone is also used to treat miscarriage, meaning reducing access has consequences beyond abortion. Despite long-term safety data, the FDA regulates mifepristone heavily because, unlike any other form of healthcare, abortion treatment is politicized. In January 2023, the FDA eased restrictions on mifepristone by removing the requirement that only certified providers be able to administer the drug to patients. Now pharmacies can stock and dispense mifepristone for prescription patients. Expanded access is particularly important for those living in rural and legally restricted settings, as they are already disproportionately impacted by barriers to supply.
A recent court case filed in Texas could potentially reverse that progress. The case was strategically submitted by anti-abortion groups to be reviewed by Trump-appointed Judge Kacsmaryk, known for his conservative views. The clear intent of this lawsuit is to strategically influence a judge who is likely to rule in a way that restricts access to mifepristone, and consequently the most effective form of medical abortion.
The United Nations Universal Declaration of Human Rights (UDHR) states: “All are equal before the law and are entitled to equal protection of the law without discrimination.” Mifepristone is used almost exclusively for reproductive health, and the manipulation of access to it Drugging for religious or political reasons is a clear violation of the UDHR as it targets people who may become pregnant. Such discrimination threatens the right to life, health and privacy of persons with reproductive capabilities. In addition, regimens containing only misoprostol increase the likelihood of side effects such as nausea, vomiting, diarrhea, fever, chills, abdominal cramps, and incomplete abortion. Exposing people unnecessarily to less effective treatment with more side effects is cruel, unethical and violates international human rights treaties.
Americans are desensitized to the endless onslaught of political attacks on reproductive rights, but we must not become complacent. So what are actionable ways we can improve reproductive health in the future? First, we must continue to educate people about the facts of abortion treatment: targeting mifepristone will not make medical abortion impossible, but it will force people to rely on a less effective option with more side effects. Second, we must support organizations dedicated to promoting reproductive rights. Abortion funds, for example, are community-based organizations that provide financial and social support to people regardless of the political landscape. Finally, we must vote for people who reflect the diversity of this country and commit to upholding reproductive rights at the state and federal levels.
Religious and cultural ideologies masked as politics trivialize reproductive health care and reduce the physical, mental, and emotional impact of forced pregnancy. As a country, we need to go beyond politics and recognize that reproductive health is a human rights issue. It’s time to reverse the onslaught on reproductive health.
Catherine Hennessey is an obstetrician and gynecologist.