Don't Think Abortion is Under Attack?

A group of ProLifers protesting against abortion

According to research published by NARAL Pro-Choice America, while 61% of the millennial generation identifies as pro-choice, only 21% are "passionately active" on the issue.

Meanwhile, 40% anti-choice millennials say that "pro-life" values are critical for them. That intensity gap means that, when it comes to young people, the largest hurdle facing the pro-choice community isn’t winning the argument with anti-choice opponents — it’s convincing a generation born more than a decade after Roe that the argument around abortion still matters at all.

When it began its new term on Monday, the Supreme Court made overcoming that hurdle just a little easier by signaling that it would hear Cline vs. Oklahoma Coalition for Reproductive Justice — a case that would be the court’s first foray into the abortion fight since 2007 and its first ever ruling regarding medical abortions in the 40 years since Roe vs. Wade.

At issue in Cline is whether doctors have the right to adjust the dosage of medications used in drug-induced abortions according to the latest medical research, or whether they must rigorously follow the FDA’s original guidelines as stipulated by a 2011 Oklahoma statute.

Those original guidelines, published in 2000 when the drug was first approved, dictate that a patient receive 600 mg of Mifepristone followed two days later by a smaller dose of Misoprostol. However, in the 13 years since its original approval, doctors have found that 600 mg is roughly three times the amount necessary to safely and effectively induce an abortion, and according to the book Crow After Roe, adds roughly $200 to the cost of the procedure.

In short, with no basis in medicine, lawmakers are mandating an unnecessarily high dosage of abortion medication in order to purposely increase the cost of abortion procedures and restrict access in communities that are already particularly vulnerable: namely, the young, the low-income, and communities of color.

In addition to artificially hiking up the price of abortion services, these vaguely worded restrictions create a confusing terrain of legal liabilities around offering the medications, which means that many providers have stopped offering it to their patients at all. As providers fold to the threat of lawsuit, medical abortions become virtually unavailable in those states and women seeking abortions are forced into expensive and far more invasive surgical procedures. Non-coincidentally, thanks to TRAP laws that are shutting down clinics around the country, the number of providers offering surgical procedures is fewer than ever.

As Jessica Mason Pieklo, senior legal analyst at RH Reality Check, told PolicyMic, "Medication abortions are safe and relatively inexpensive, and have the additional benefit of being able to be proscribed via telmed, which means pregnant people who live hundreds of miles away from a clinic, let alone one that provides abortion, can have access to safe abortion care if they need it. As more and more states seek to close down clinics via TRAP laws, that kind of access is critical."

So, without ready access to medical abortions and with few if any clinics that will offer surgical procedures, the avenues by which women access their reproductive rights are being closed in on from both sides. As NARAL Pro-Choice America President Ilyse Hogue has said, the strategy of the anti-choice community is "to make Roe moot" even if it technically remains the law of the land.

Beyond direct issues of access, however, regulations like those at issue in Cline matter to our rising generation of millennials because they are laws designed specifically to climb within the courts as challenges to the protections guaranteed by Roe. While millennials born after Roe tend to take their access to abortion services for granted, these laws are written with the explicit intent of giving the Supreme Court an excuse to chip away at Roe and eventually (they hope) overturn it altogether.

According to Pieklo, Cline is "a test of a line of reasoning under an earlier case, Gonzales v. Carhart. That case upheld the so-called federal "partial birth abortion ban" and set the precedent for state's banning specific abortion procedures. If the Court does hear Cline, they will be considering a ban on medication abortions, procedures done in the earliest stages of pregnancy."

The Oklahoma Supreme Court has already declared the statute unconstitutional, saying that because "off-label" use of medication is common medical practice, the only reasonable intent of the law could be to limit access to abortion, a violation of the "undue burden" standard laid out in Planned Parenthood vs. Casey. But the conservative Roberts court has expressed an active interest in hearing the case and has requested clarifications from the Oklahoma Supreme Court about their opinion. If the court does decide to hear the case this term, they will be determining the extent to which state legislatures can legally curb abortion access in their states — not just late-term abortions, but standard early abortion medical procedures performed within the first nine weeks of pregnancy. 

So to the millennials who think there are no more feminist battles left to fight, to the 40% of millennials who are pro-choice but don’t think choice is a priority, and to the young people out there who assume their right to an abortion is settled law — pay close attention. Because whether the court decides to hear this case or one of the many similar cases that are climbing the courts behind it, the far-right has a shot at overturning  Roe vs. Wade if we do nothing to stop them.