This Week in Abortion: From Chaos to Control
A collection of good reads, events from the week, and policy insights.
It’s only been a month since Trump’s inauguration—seriously, I checked. Trump and his crew, as planned, have thrown the country into chaos, pushing abortion access out of focus for many.
But, this shock-and-awe phase will eventually end and in its place will be a paradigm-shifting assault on abortion access. The good news is we know what’s coming and we can be ready.
Restrictions on Abortifacients
According to the Guttmacher Institute “medication abortion accounted for 63% of all US abortions in 2023.” So, it’s no surprise that anti-access forces are trying to get rid of mifepristone (Mife) and misoprostol (Miso). With new leadership in the Justice Department (DOJ) and the Federal Drug Administration (FDA), they have a chance to do so.
Comstock Shackles
After Dobbs anti-abortion forces tried using the defunct 1873 Comstock Act to block the distribution of abortion pills by mail, despite the Biden administration’s stance that the law was unenforceable. Now it looks like they have a willing federal partner.
As one of her first acts in office, Attorney General Pam Bondi praised a state-based criminal case against a New York doctor who allegedly mailed Mife and Miso to a Louisiana patient. Bondi told Louisiana officials “I would love to work with you [on the case].” If the Comstock hook is added with federal backing it will send a chill nationwide.
FDA Rollbacks
Trump’s FDA pick - Dr. Marty Makary - has used anti-abortion rhetoric in public appearances and it’s a fair bet that he’ll get on board with restricting access to medicated abortions. First, expect an effort to reinstate restrictions like requiring patients to make three visits to their doctor’s office to receive the drugs. In the long run, the FDA could also try to shut down access to Mife altogether. If emboldened, activists might even go after Miso (which currently has FDA approval as an ulcer medication) and emergency contraceptives like Ella.
The Hyde Hammer
The Hyde Amendment has prevented the U.S. government from funding abortion procedures for half a century. Even after Dobbs, the Biden administration never funded abortion procedures. Instead, it provided increased support for wrap-around services such as funding for family planning clinics, education, and hotlines. Oh, and ensuring a whole dozen military service families did not lose access to IVF treatments and abortion care because of their posting.
The Trump administration has already reversed these Dobbs-response programs, pulling funding out of the reproductive health ecosystem. It also reinstituted the “Mexico City Policy,” which prohibits international aid funding from going to organizations that perform abortions, even when the funding has nothing to do with abortions. To some extent, such moves are expected after a change in administration. But buckle up, cause things are going to get worse.
Along with its general pause on federal funding, the administration released a review template that includes the question: “Does this program promote or support in any way abortion or other related activities identified in the Hyde Amendment?”
The administration is doing a sweep using a broad interpretation of the amendment. As a result, the Mexico City Policy may start to become the Policy with clinics and even hospitals that provide abortions facing restrictions and funding cuts. We could also see programs that provide factual information about abortions pressured to reform or lose funding.
Difficult, Dangerous Times for Patients and Providers
Simply put getting an abortion is going to become more difficult and - depending on where you live - dangerous. On top of the pressures I’ve covered above, the Justice Department announced it will be curtailing enforcement of the “FACE Act,” which prevented protestors from harassing patients and staff at full-service family planning clinics. Underlining the point, the DOJ dismissed related cases and Trump issued pardons to 23 people convicted under the Act. The result will be emboldened protestors outside medical clinics getting into patients’ literal faces.
There is also a call for the federal government to force (by withholding funds) states to monitor and report data on abortion care including at a minimum “gestational age of the child, for what reason, the mother’s state of residence, and by what method.” Historically, most states have voluntarily provided this data and more to the Centers for Disease Control and Prevention. However, there is a growing concern that collecting such information today could “facilitate surveillance and criminalization of patients and providers.”
“The administration doesn’t have to pass or sign a national abortion ban to massively curtail access…People are scared, and these threats from the government and state officials are only creating additional misinformation and fear. And that’s the point. To keep us scared and in the dark.” Elizabeth Ling, If/When/How
The Rythm Method
What the anti-access, fertilization-is-life, community is really after is a culture shift, an anti-abortion, anti-IVF, anti-birth control wave that sweeps the nation.
The federal bureaucracy is being purged under the name of efficiency. Eventually, those employee and grantee numbers will start to tick back up, filled by fertilization-is-life, Trump loyalists ready to utilize the power of the federal purse to promote their cause.
“Voluntary” censorship is already a huge concern. We’ve seen accusations of social media censoring information about abortion pills. Now, the National Science Foundation is reportedly combing through grants for no-no words. As the administration digs in, we will see federal funding going to biased anti-abortion research rather than serious, scientific study of reproductive health. The icing on the cake will be an administrative state promoting the false idea that the rhythm method (ovulation tracking) is the best form of birth control.
This is not a fantasy or some conspiracy-minded rant. This is the very plan clearly outlined in Project 2025. The administration is following a playbook, including replacing qualified bureaucrats with sycophants and leaving international coalitions while signing onto an anti-abortion pact whose fellow signatories are small countries and authoritarian regimes.
“The CDC should eliminate programs and projects that do not respect human life and conscience rights and that undermine family formation. It should ensure that it is not promoting abortion as health care. It should fund studies into the risks and complications of abortion and ensure that it corrects and does not promote misinformation regarding the comparative health and psychological benefits of childbirth versus the health and psychological risks of intentionally taking a human life through abortion.” Project 2025
WTF! What can be done?
This is the part where I try to be positive. There are a lot of dedicated people out there doing great things. We are struck down, but not destroyed. (Oops, I went biblical.)
Legal Defense. Courts remain a critical line of defense, even as Trump tests their limits. Preservation of our democracy, the independent power of state governments, of courts, and (yes) of Congress is a basic requirement to ensure access to abortion continues.
States are preparing. States are adopting shield laws, moving towards constitutional amendments, and generally expanding access within their borders. This is part of the long and hard work that advocates do every day to protect access and scientifically grounded reproductive health in local communities.
The future favors access. The fertilization-as-life movement may look strong, but they have not won. Far from it. Even polls sponsored by anti-abortion groups like the Knights of Columbus find that 60% of Americans (and even 40% of Republicans) support some general access to abortion starting with allowing abortion during the first three months of pregnancy. (For a fun stats lesson, check out their negative presentation of the same data) The movement wants to eliminate any access to science-driven family planning. But, that is not where the world is, and they know it.
There is a lot of work ahead so don’t let the bad news overwhelm you. That’s what the Trump administration is banking on. There will be plenty to do in the coming months and years. Here are a few ways to act today:
Contribute to the legal defense. Check out this tracker of the various legal cases against Trump. The shortlist of organizations includes Doctors for America, National Council of Nonprofits, American Federation of Government Employees, and Association of American Medical Colleges. Other good orgs in the mix are Public Citizen, the Public Service Alliance, ACLU, and Democracy Forward.
Thank a federal employee. We need good people, who know how to do their jobs, to stay in them. So, give a public servant friend a call. It’ll be good for both of you.
If you got this far you are an f-ing champ! Tell us what’s on your mind. What are you most worried about for the coming months? What are you doing to stay focused and joyful?