Enforcing Abortion Bans Is Much Harder Than Passing Them

Texas’ strict restrictions on abortion in the fall resulted in half of all abortions being performed at state clinics. The actual decrease in abortions is much less because so many women went to other states for treatment or simply used the readily available drugs at home to terminate their pregnancies.

Recent research shows that these workarounds significantly limited the law’s effectiveness. This finding highlights the formidable challenges facing opponents to abortion, even though the Supreme Court seems to be allowing states to limit the practice as much as they wish.

Texas law forbids abortion after detection of fetal cardiac activity. This is usually six weeks before the due date. According to the Texas Policy Evaluation Project, Texas clinics did 50 percent fewer abortions in September than the previous month, which was the start of the law’s first month.

However, there was a dramatic increase in the number of Texas residents seeking abortions elsewhere. This research group also counted 5,574 abortions outside of Texas that were performed by Texas residents between September and December. That’s more than 10 times as many as the total during 2019.

It’s close to two-thirds the total number of Texas abortions that are reported. This averages out at about 1,400 per month. This cross-border total is likely to be an underestimate, since it includes only 34 clinics across seven states.

Aid Access allows women from Texas to get misoprostol and mifepristone abortion pills abroad. It is based on prescriptions from a doctor from Austria. There was a significant increase in Texas requests. The February 25th report from the in JAMA Network OpenThe daily average jumped to 138 during the first week in September from 11 in the late 2020s and 2021.

The number of requests fell dramatically after the first week. However, it was still well above the baseline. They averaged 37 in September, then 30 in October, November and December. Between September 1, 2009 and December 31, 2013, Aid Access received over 4,500 requests in Texas, which is approximately 1100 per month.

We don’t know how many women obtained abortion pills from Aid Access. It is possible that there was overlap with women who eventually had to have abortions performed in another state. However, Aid Access is not the only place to get abortion pills. They can also be purchased online in Mexico or delivered by mail in other states (unlike Texas).

Food and Drug Administration approved misoprostol and mefepristone for use up to 10 weeks in a pregnant woman. It is likely to be popular in America, where approximately four-fifths (or more) of abortions are done at nine weeks.

The FDA lifted the long-standing requirement that abortion pills must be delivered in person. This opened the doors to home and telemedicine prescriptions. It is likely to speed up a trend that has been occurring for some time: According to preliminary data from the Guttmacher Institute which advocates abortion rights, “medication abortions” accounted in 2020 for 54%. This was an increase of 39%.

FDA considers abortion pills that are shipped to the United States from countries other than their own as unapproved and misbranded new drugs. Aid Access was warned by the FDA in 2019. They were not deterred.

State law may not allow drug-induced abortions to be performed even though they are approved by the FDA. Texas is one of the 19 states that have restrictions on abortions in medical settings. Recently, Texas made it a crime to provide the drugs unsupervised.

Even though self-managed abortions may be legal, that doesn’t mean they are impossible to stop. Because the pill is legal in almost all jurisdictions, it’s even harder than the challenges faced by the War on Drugs. This war has a record of success that should not be copied.

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