As an OB/GYN, I know that medication abortion is safe, commonly used, and effective. Women’s rights, family building, and abortion are recognized in many international human rights documents. The United Nations’ 1966 Human Rights Treaty states that all people have a right to the highest attainable standard of health. The ability for someone to choose when and if they want to have a child is the basis of the Reproductive Justice framework and is paramount to protecting the health of a person and family. Family building is also intimately connected to economic and social well-being, contributing to overall health. Globally, unsafe abortions account 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 intervention that reduces maternal morbidity and mortality. In other words, targeted political action that threatens access to abortion violates human rights.
Medication abortion is the most common method of terminating a pregnancy in the United States. Although abortions can be done with misoprostol alone, the most effective regimen combines mifepristone and misoprostol. Mifepristone has been approved by the Food and Drug Administration (FDA) for pregnancy termination for over two decades and for use up to ten weeks in pregnancy. Mifepristone is also used for treatment of miscarriage, meaning that decreasing access has consequences beyond abortion care. Despite long-term safety data, the FDA highly regulates mifepristone because abortion care is politicized unlike any other form of health care. In January 2023, the FDA loosened restrictions on mifepristone by removing a requirement that only certified providers can give the medication to patients. Now, pharmacies can stock and dispense mifepristone for patients with a prescription. Expanded access is particularly important for those living in rural and legislatively restrictive environments since they are already disproportionately impacted by barriers to care.
A recent court case filed in Texas could potentially reverse this progress. The case was strategically filed by anti-abortion groups to be reviewed by Trump-appointee Judge Kacsmaryk, who is known for his conservative views. The clear intent of this lawsuit is to strategically leverage a judge who is likely to rule in a way that will decrease access to mifepristone and, subsequently, the most effective form of medication abortion.
The United Nations’ Universal Declaration of Human Rights (UDHR) declares, “All are equal before the law and are entitled without any discrimination to equal protection of the law.” Mifepristone is used almost exclusively for reproductive health, and manipulating access to this medication for religious or political gain is a clear violation of UDHR because it targets people who can become pregnant. Such discrimination threatens the right to life, health, and privacy of those with reproductive capability. Additionally, misoprostol-only regimens increase the likelihood of side effects such as nausea, vomiting, diarrhea, fever, chills, abdominal cramping, and incomplete abortion. Unnecessarily exposing people to less effective treatment with more side effects is cruel, unethical, and violates international human rights treaties.
Americans have become desensitized to the endless onslaught of political attacks targeting reproductive rights, but we cannot become complacent. So, what are actionable ways we can improve reproductive health moving forward? First, we must continue to educate people about the facts of abortion care: targeting mifepristone will not make medication 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 advancing reproductive rights. Abortion funds, for example, are community-based organizations that assist people monetarily and socially regardless of the political landscape. Lastly, we must vote for people who reflect the diversity of this country and pledge to uphold reproductive rights at the state and federal levels.
Religious and cultural ideology masked as politics trivialize reproductive health care and diminish forced pregnancy’s physical, mental, and emotional effects. As a country, we must move beyond politics and recognize reproductive health is a human rights issue. It’s time to reverse the assault on reproductive health.
This essay is cited in the KevinMD record on women’s health.
Catherine Hennessey is an obstetrician-gynecologist.
