Oklahoma Lawmakers Approve Near-Total Ban on Abortion
And A New War On Drugs. Abortion Pills, Once a Workaround, Are Now a Target. In advance of a Supreme Court decision, states are proposing new restrictions and heavier criminal penalties on medication abortion.
Lawmakers in Oklahoma on Tuesday approved a near-total ban on abortion, making it the latest Republican-led state to forge ahead with stringent abortion legislation as the Supreme Court weighs a case that could overturn Roe v. Wade later this year.
The measure, Senate Bill 612, would make performing an abortion “except to save the life of a pregnant woman in a medical emergency” a felony punishable by up to 10 years in prison and a fine of $100,000.
The Oklahoma House voted 70 to 14 to send the bill, which passed the Senate last year, to Gov. Kevin Stitt, a Republican whose office responded by noting that Mr. Stitt vowed in September to sign “every piece of pro-life legislation” that came to his desk.
If Mr. Stitt signs the bill, it would take effect on Aug. 26, according to the Senate clerk’s office.
Its passage came after Oklahoma became a major destination for women from Texas who were seeking abortions after that state enacted a law banning the procedure after about six weeks, a very early stage of pregnancy.
Representative Jim Olsen, a Republican from Roland, and the House author of the bill, said the measure was enacted in anticipation of a pending Supreme Court decision on a Mississippi law that bans abortions after 15 weeks of pregnancy.
If the court upholds that law, it could upend Roe v. Wade, the 1973 decision that established a constitutional right to abortion and that prohibited states from banning the procedure before fetal viability, or around 23 weeks.
From Florida to Idaho, Republican-led state legislatures have been operating as though Roe has already been struck down, advancing restrictions that aim to make abortion illegal in as many circumstances as possible.
“Obviously, I’m thrilled because we have the potential of seeing many lives of babies saved — part of that depends on future court rulings” like the one in the Mississippi case, Dobbs v. Jackson Women’s Health Organization, Mr. Olsen said.
He said the bill passed without any floor debate.
“Nobody debated and nobody asked any questions,” he said. “I was actually kind of shocked.”
Mallory Carroll, a spokeswoman for the Susan B. Anthony List, an anti-abortion group, said Oklahoma, as one of “the most pro-life states in the country,” was following other states in enacting laws to restrict abortion as much as possible.
Last year, after Texas passed its strict abortion ban, surgical abortions in the state dropped by half. Many women found a workaround: pills. The week the law took effect, requests for medication abortion shot up to 138 a day from 11 a day at just one service that delivers the pills by mail.
Anti-abortion lawmakers in the state were already on it. That same week, they passed another law making it a felony to provide abortion pills through the mail and requiring doctors to comply with new testing and reporting procedures to prescribe them.
Medication abortion is the new front in the nation’s five-decade-long fight, as both sides anticipate that by summer the Supreme Court could overturn or pare back the constitutional right to abortion established in Roe v. Wade.
Supporters of abortion rights, who argue that women should be able to make their own reproductive choices, see the pills as a workaround in states that have already moved to ban or severely restrict abortion. Women in those states would get abortions not in the back alleys of pre-Roe America, but via a post office box or a friend in a state where abortion remains legal, or from an online pharmacy in India.
To anti-abortion activists, who believe ending a pregnancy is murder, the pills are a back door to be locked shut with new restrictions and heavier criminal penalties. In the first three months of this year, legislators proposed more than 100 restrictions on medication in 22 states.
States such as Missouri are attempting to reach beyond their borders to stop their residents from going elsewhere to get an abortion, by pill or by surgery. Connecticut and California, meanwhile, are rushing to protect their citizens who might be penalized for helping women in restrictive states obtain the medication. One pill manufacturer has sued to stop a Mississippi law that requires the pills to be picked up and swallowed in a doctor’s office.
The F.D.A. had initially approved the use of mifepristone, the first of a two-pill regimen to terminate a pregnancy, in 2000, but required it to be provided in person. As the coronavirus pandemic pushed up demand for telemedicine, and in the face of a lawsuit from medical groups, the agency lifted a ban on obtaining the pills through a remote appointment with a doctor. It authorizes only a limited group of providers to prescribe the pills — which are taken 24 to 48 hours apart — and allows the medication to be used only in pregnancies up to 10 weeks.
In January, Americans United for Life, an anti-abortion advocacy group that publishes an annual playbook for like-minded legislators, declared legislation against medication abortion as the first among its most “pressing priorities” for 2022.
Already, 19 states prohibit pills from being prescribed by telemedicine or delivered through the mail. Nine additional states are proposing to do the same.
Many of the new bills layer criminal penalties on top of the existing prohibitions, on the assumption that women will procure the pills illegally.
In Texas, S.B. 8, which bans abortion after about six weeks, requires civilian enforcement, incentivizing citizens with bounties of at least $10,000 to sue anyone who helps a woman get an abortion. S.B. 4, the subsequent law against medication abortion, establishes a criminal violation for delivering the pills, making it a state felony punishable by $10,000 and up to two years in prison. A bill in Iowa would ban the distribution of the pills entirely, with punishments of $10,000 and up to 10 years in prison.
The American College of Obstetricians and Gynecologists says so-called abortion reversal, in which a woman takes the hormone progesterone after the first pill, is “not based in science” and is “unproven and unethical.” The Center for Reproductive Rights and medical groups have obtained preliminary injunctions against abortion reversal laws in three states, arguing that they violate the free speech of doctors by forcing them to provide what one judge called “misleading” information to patients.
Still, the legislation that passed last week in Kentucky says that “more than 1,000 lives have been saved” by abortion reversal. Under a Tennessee law temporarily blocked by an injunction, providers who refused to tell patients about it would face up to six years in prison and health centers would face a $10,000 daily fine if they refused to display signs telling women about the procedure.
Several new groups providing pills within the United States say they will send them only to women in places where pill delivery remains legal. These groups imagine more complicated scenarios: A woman in a state that bans abortion orders pills to a friend in a state that allows them, who then forwards her the package.
Dr. Jamie Phifer, the founder of Abortion on Demand, said she hoped the increasing use of telemedicine that the pandemic encouraged would also encourage acceptance of providing abortion pills that way.
Over the next months, the F.D.A. will establish rules to certify pharmacies that want to dispense medication abortion.
Ms. Rebouché, the law professor, said pill providers could argue that the F.D.A. rules pre-empt the new state restrictions. The manufacturer of generic mifepristone, GenBioPro, for example, argues that the Mississippi rules requiring abortion pills to be taken in a doctor’s office constitute an “impermissible effort by Mississippi to establish its own drug approval policy.”
