Anti-abortion demonstrators listen to President Donald Trump’s speech at the 47th annual March for Life on January 24, 2020 in Washington, DC.
Olivier Doulieri | AFP | Getty Images
This week, voters in seven out of 10 states approved ballot measures guaranteeing abortion rights, a popular question This helps drive Americans to the polls.
but elected president Donald TrumpHealth policy experts warned that early Wednesday’s victory could make surgery more fragile and uncertain across the United States, leaving many women’s reproductive health hanging in the balance.
Trump’s stance on abortion has been fairly vague, recently saying he would Not supported federal ban and wants to leave the issue to the states. But Trump and his federal appointees can further restrict abortion at the federal level through methods that do not require Congress to pass new legislation.
“The more restrictions we place on abortion over the next four years, the worse health outcomes are going to be,” said Katie O’Connor, senior director of federal abortion policy at the National Women’s Law Center. “People are suffering and dying needlessly.”
In the two years since the Supreme Court ruling, abortion access in the U.S. has been in a state of flux Overturning Roe v. Wade and ended federal constitutional procedural rights — a decision Trump has taken credit for since reorganizing the court. As of last year, More than 25 million women People aged 15 to 44 live in states with stricter abortion restrictions than before the court’s 2022 ruling, according to PBS.
Experts say the Trump administration’s further crackdown on abortion could harm the health of many patients, especially those with low or low incomes. people of colorthere is danger.
“As long as our government is not fully committed to providing access to abortion to everyone who seeks it, there will be confusion and confusion on the ground about what is legal and what is available,” O’Connor said. “This will exacerbate our The ongoing health care crisis when it comes to abortion.”
It’s unclear what action Trump will take on this issue. There is little public support for Congress to pass a nationwide abortion ban, according to one person. polling June conducted by The Associated Press-NORC Center for Public Affairs Research. At least 70% of Americans oppose a federal ban on abortion or a ban on abortion within six weeks.
Experts say if Trump does decide to restrict access, it could include limiting use medical abortionespecially when it is administered via telemedicine or delivered by mail.
In the United States, medications are the most commonly used method of terminating pregnancy, accounting for 63% of abortions in the United States Last year, according to a March study by the Guttmacher Institute, a pro-life research group.
The Trump campaign did not immediately respond to a request for comment.
The decades-old Comstock Act
Julie Kay, co-founder and executive director of the Telemedicine Abortion Coalition, said the Trump administration could severely limit or ban medical abortion by enforcing its interpretation of the long-defunct Comstock Act.
The act, passed in 1873, made it a federal crime to mail or receive drugs or other materials used for abortion. It has not been widely enforced for decades.
The National Women’s Strike held a protest outside the U.S. Supreme Court in Washington on Monday, June 24, 2024, to mark the second anniversary of Dobbs v. Jackson, the Supreme Court’s decision that overturned Roe v. Wade.
Bill Clark | Cq-roll Call Inc. | Getty Images
The Trump administration could use the bill to block the transportation and distribution of abortion pills and any medical equipment used in abortion procedures, such as dilators and suction catheters, thereby preventing doctors from performing abortions in hospitals, said Kelly Dieter, the agency’s research director. Kelly Dittmar said.
To implement the bill, Trump would have to appoint an anti-abortion U.S. attorney general, which would require Senate confirmation.
The Biden administration insists the provisions of the Comstock Act are outdated. Trump said in August he has no plan Enforcement of the Comstock Act.
But anti-abortion advocates and people in Trump’s close circle, including his running mate, Vice President-elect J.D. Vance, have urge on the contrary. Some of Trump’s former advisers, writing in Project 2025, a conservative policy blueprint, also support using the Comstock Act to restrict abortion pills. So does every major anti-abortion organization in the country.
O’Connor noted that any enforcement efforts would likely be met with legal objections.
The issue could eventually make its way to the Supreme Court, where justices are open to the idea that the Comstock Act might ban abortion. Earlier this year, Justices Samuel Alito and Clarence Thomas Called repeatedly In cases regarding medical abortion, the Comstock Act was cited during oral argument.
Appoint anti-abortion activists to key agency roles
Trump could also appoint anti-abortion leaders to take control of key federal agencies that can use executive power to severely restrict or ban abortion procedures in the United States, including the Department of Health and Human Services, the Food and Drug Administration and the Justice Department.
Kelly Baden, associate dean for policy at the Guttmacher Institute, said of the Supreme Court’s decision in Dobbs v.: “In the post-Dobbs era, These institutions play an important role in clarifying or protecting as much as possible the right to abortion.
Trump and his political appointees at the FDA could direct the agency to severely limit or potentially eliminate the use of mifepristone, one of two drugs used in common medical abortion options.
In 2023, anti-abortion doctors launched a legal battle with the FDA over its more than two decades of approval of the drug. In June, the Supreme Court unanimously approved fired The challenge to mifepristone and on the side of the Biden administration means the commonly used drug remains widely available.
Mifepristone and misoprostol pills are pictured on Wednesday, October 3, 2018, in Skokie, Illinois.
Erin Hooley | Chicago Tribune | Tribune News Service | Getty Images
But Trump’s FDA appointees may push to roll back some of the changes made between 2016 and 2021 that expanded the use of mifepristone. This may include reinstating the requirement for in-person dispensing of mifepristone, which would Effectively eliminate Get your pills via telemedicine.
Telemedicine has become an increasingly common way to obtain abortion bills, accounting for nearly one in five in the final months of 2023, according to statistics. a research project Published in May by Planned Parenthood.
Alina Salganicoff, senior vice president and director of women’s health policy at KFF, a health policy research organization, said limiting telemedicine as an option would have an “incredible chilling effect” on abortion.
“We may see that in states where abortion is banned, more people have to travel and it takes longer to get care, and more people may not actually be able to get an abortion in person because of the difficulty of accessing it,” she said. Get medical care.
The new FDA leaders may also try a more extreme approach: revoking mifepristone’s approval entirely. Experts say both strategies ignore important scientific research demonstrating that mifepristone is safe and effective for use in the United States.
trump card vaguely suggest In August, he did not rule out instructing the FDA to revoke mifepristone’s authorization. A few days later, Vance trying to walk back these remarks.
Trump’s comments appeared to be a shift from his stance in June, when the former president said during a CNN debate that he “would not block” the use of mifepristone.
Restore old rules, break Biden’s rules
At the very least, Trump could reinstate some of the policies he implemented during his first term that made abortion more difficult to obtain and undermined some of the Biden administration’s efforts to expand abortion services.
Rep. Lois Frankel, D-Fla., left, points to states where reproductive rights are restricted, as Rep. Joyce Beattie, D-Ohio, and Rep. Joe Ness, D-Colorado, take photos during a reproductive rights news conference. The ceremony will take place at the U.S. Capitol on Wednesday, May 8, 2024.
Bill Clark | Cq-roll Call Inc. | Getty Images
Trump may reinstate the so-called domestic gag rule that he implemented in 2019 and was revoked by the Biden administration in 2021.
The rule prohibits providers in federally funded Title X family programs from referring patients for abortion care or providing counseling that includes abortion information. Title X is a decades-old program that provides family planning and preventive health services to patients, especially low-income individuals.
Guttmacher’s Baden said the rule “destroyed” Title X’s network of family planning clinics and limited its ability to serve low-income patients. She said the clinics are “still recovering from this.”
“I don’t think there’s any reason to think he won’t reinstate that rule within the first 100 days,” Baden said.
Baden said the Trump administration may also quickly rescind some of Biden’s executive orders, memos and other efforts to protect and expand access to reproductive health services.
