“It’s just a scary thought, you know,” said Hannah, a 21-year-old-year senior at the University of Denver. “I was lucky to be in Colorado.”
Hannah, referred to by a pseudonym due to privacy concerns, received a chemical abortion from a Denver abortion clinic in August 2022. The abortion pills, including Mifepristone, allowed Hannah to voluntarily miscarry the pregnancy in the safety and comfort of her own home.
“It [miscarrying at home] definitely did not ease the pain, but it just made, like, the emotional part of it, a lot more bearable,” Hannah said with a sigh.
Mifepristone in the Balance
For women and people with uteruses around the country, Mifepristone access is currently dangling around the gavel of a federal district judge in Amarillo, Texas. Judge Matthew Kacsmaryk, who was appointed by former President Donald Trump, is known for his conservative rulings and anti-abortion activism in the past. Now, he is tasked with evaluating a heated Mifepristone argument and reaching a decision: one that could sharply reduce access throughout the United States.
Since Mifepristone’s initial approval in 2000, the FDA has not listed major safety concerns or issues with the pill. But today, in a post-Dobb’s United States, abortion rights are no longer guaranteed federally and access is deteriorating around the country.
In this fierce fight involving Mifepristone, a coalition of anti-abortion activists, groups and doctors called the Alliance for Hippocratic Medicine (AHM) is leveraging the conservative Texas court and a Roe-free U.S. to ban federal access to Mifepristone.
How, many pro-abortion Americans ask, can federal Mifepristone access be threatened? The answer lies in the FDA approval of the drug.
The AHM claims in its legal argument that the FDA was never authorized to actually approve Mifepristone for the market, despite it being provided in the United States for over 23 years. This arguably tenuous claim resides on a subpart in the Federal Code of Regulations that allows the FDA to approve “certain new drug products that have been studied for their safety and effectiveness in treating serious or life-threatening illnesses.”
Integral to the AHM argument is this simple claim: pregnancy is not a serious or life-threatening illness, but rather a common condition that millions of women experience. Depending on Judge Kacsmaryk’s evaluation of the arguments, Mifepristone’s FDA approval could be revoked federally.
What is Mifepristone
According to the Food and Drug Administration, Mifepristone chemically induces abortions by blocking progesterone, a hormone necessary for pregnancy to continue. Mifepristone is commonly used in conjunction with Misoprostol, another chemical abortion pill, to increase the safety and effectiveness of abortions under 10 weeks of gestation.
When Mifepristone and Misoprostol are used together, the success rate of abortions is 99.6%, with major complications arising only .4% of the time, the FDA reports. When only Misoprostol is implemented, the FDA ensures safety; however, effectiveness dwindles in comparison – around 88% on average.
Since the advent of COVID-19 and increased telehealth practices, medication abortions have been on the rise. The Guttmacher Institute estimates that in 2020, 54% of all abortions in the U.S. were performed through medication. Here in Colorado, over 60% of all abortions are medically performed, demonstrating a higher reliance on the pills than the national average.
What’s more is that Colorado has already seen a precipitous rise in abortions from April 2022 to August 2022, largely due to out-of-state patients traveling to access abortions. The Society of Family Planning reports that there was a 33% increase during this time frame – a percentage that continues to climb.
Colorado and Codified Abortion Rights
After the U.S. Supreme Court’s landmark decision overturning Roe v. Wade, federal abortion rights became a relic of the past for Americans. However, in Colorado and many other Democrat-leaning states, legislation has protected reproductive rights within the bounds of state borders.
In April 2022, Colorado Governor Jared Polis signed the Reproductive State Equity Act into law, which permanently ensured a right to refuse or accept contraception and the right to abortions for Coloradoans. For many, this was a monumental victory for reproductive rights.
Now as Mifepristone’s access teeters in Texas federal court, Coloradans are gearing up for reduced access to abortion resources.
“What would happen here [is] we would see definitely an impact of people being able to make a decision to use one of the safest medications out there in the market,” says Aurea Bolaños Perea, the strategic communications director at the Colorado Organization for Latina Opportunities and Reproductive Rights (COLOR). “We will definitely see an impact immediately; people trying to rush to the clinic to try and get the medication before it is actually taken off of stands.”
COLOR, a non-profit that advocates for reproductive justice, has already started to see the effects of diminishing abortion access across the country, even here in Colorado. Bolaños Perea points out that increased traffic among Colorado abortion clinics can lead abortion seekers in rural areas, especially Latinx people with language barriers, to deceptive clinics with anti-abortion values.
In response to the ever-changing abortion climate, COLOR has created new resources for underrepresented women in Colorado, including the only Spanish reproductive rights radio show in the country. They also made an effort to go into underrepresented communities, especially those with young people and language barriers, when the Dobbs decision leaked to provide assurance and resources for Coloradans.
Colorado Abortion Opposition
Even in Colorado, where around 67% of the overall population and 74% of college students support the right to abortion, opposition is still prevalent. For many anti-abortion activists, health and safety concerns alongside religious convictions motivate public opinion and action.
“Abortion has a very bad effect on people’s mental health; both the mother and the father,” says Ana Lopez Muñiz, a third-year student at the University of Denver. “It has distinctive physical, social and psychological side effects that differ from any other medical procedure.”
Muñiz, like the plaintiffs in the Texas federal abortion pill case, often cites health and safety concerns for both parents. Although the Alliance for Hippocratic Medicine has been heavily criticized for its legal argument, some healthcare providers and researchers still have concerns.
A study published by the Charlotte Lolizer Institute found that abortion-related emergency room visits increased by over 500% from 2002-15 in the U.S. Still, critics of these statistics and depictions cite overall chemical abortion safety statistics and a correlation surrounding increased abortion pill usage, not causation.
The Future For Colorado
As the national abortion debate rages on and new legislation dictates abortion access, the state of Colorado will remain a place to obtain a legal, safe abortion. Despite Mifepristone’s potential removal from US markets, Misoprostol will still remain a safe and secure option for not just Coloradans, but those around the nation.
Colorado abortion activists, non-profits and providers remain stalwart and stable for those in need of reproductive healthcare. Organizations, such as COLOR are continuing to promote legislation and lobby for vulnerable and at-risk Coloradoans.
“It may be hard, but it’s not going to be impossible, because people like us have been in this movement for long enough to know that not everything is impossible,” says Bolaños Perea with determination.
For those like Hannah, young, single adults with full futures ahead, Colorado abortion access ensures the freedom to choose for oneself. That freedom, however, is not without fear. Hannah and countless others like her face mounting legislation throughout the United States. For the countless not in Colorado, the right to choose, like Mifepristone access, is left to the courts and lawmakers.
“I remember feeling guilty for the women who were in my position in other states, who aren’t as lucky as I am,” Hannah said. “The fact that it could just keep getting more unlucky for them” she pauses, “is a scary thought.”
