Sunday, May 19, 2024

Republican Forced-Birth / Forced-Pregnancy Operatives are Combining Surveillance of Women's Health Care with the Long Discredited War on Drugs to Try to Force Women to Obey Their “Biblical” Strictures

1). “Abortion, Every Day (5.17.24): The GOP is finding more ways to track abortion patients”, May 17, 2024, Jessica Valenti, Abortion, Every Day, at < https://jessica.substack.com/p/abortion-every-day-51726 >.

2). “Louisiana Aims To Criminalize Abortion Pills, Echoing Project 2025 Blueprint: A Republican effort to reclassify 2 abortion drugs as Schedule IV dangerous controlled substances could imprison women for unprescribed possession. Project 2025 plans similar tactics nationally”, May 14, 2024, Ahmed Baba, Ahmed Baba's Newsletter, at < https://www.ahmedbaba.news/p/louisiana-aims-to-criminalize-abortion >.

3). “Louisiana may reclassify drugs used in abortion as controlled dangerous substances”, May 17, 2024, Rosemary Westwood, WWNO, at < https://www.npr.org/sections/health-shots/2024/05/17/1251965020/louisiana-may-reclassify-drugs-used-in-abortion-as-controlled-dangerous-substanc >.

4). Copy of Letter sent and signed by 270 Louisiana Physicians to State Senator Pressly; commenting on his sponsorship of Senate Bill 276< https://x.com/rosiewestwood/status/1788281803532300710/photo/1 >

5). “The anti-abortion plan ready for Trump on Day One: The stakes of the election go far beyond whether a GOP president signs a bill banning the procedure”, Jan 29, 2024, Alice Miranda Ollstein, Politico, at < https://www.politico.com/news/2024/01/29/trump-abortion-ban-2024-campaign-00138417 >.

~~ recommended by dmorista ~~

Introduction by dmorista: The Forced-Birth / Forced-Pregnancy Operatives are now trying to use a couple of newer stratagems to make women who choose to use Mifepristone / Misoprostol abortions into felons, subject to heavy penalties of monetary fines and imprisonment, and at the most extreme the death penalty (6 states, South Carolina, Louisiana, Texas, Kentucky, Oklahoma, and Arkansas) at least have had bills introduced in their State Legislatures that would make obtaining an abortion murder, including medication abortions, with the death penalty a possible sentencing option). This is taking place along with an increase in states demanding that physicians record a wide variety of information about women who obtain abortion or reproductive health care. And in addition forced-birth / forced-pregnancy operatives are making sneaky moves to obtain information on women's health care, internet usage, phone apps that include menustration apps, and other private personal information. This is a dangerous combination extensive files kept on women and harsh drug-war laws that are being incorrectluy applied to classify Mifepristone / Misoprostol as Schedule 4 Dangerous Drugs, the classification that includes heroin. The Great Jessica Valenti has written, in Item 1)., “Abortion, Every Day (5.17.24): ….” that:

Attacks on Privacy

Let’s talk about Louisiana Republicans’ efforts to classify abortion medication as a controlled substance. I’ve covered this a bit already, but New Orleans public radio station WWNO flagged something I can’t believe I didn’t put together earlier: controlled substances are trackable in a state database:

“ 'The state database allows any doctor or pharmacist to look up the prescription history of his or her patient. The data is also accessible by the Louisiana State Board of Medical Examiners, which licenses physicians and other providers, and by law enforcement agencies with a warrant.'

OF COURSE. This is what I’ve been banging on about for months: anti-abortion groups are hyper-focused right now on data, tracking, and attacking patient privacy. (Both for criminalization purposes and to have a chilling effect on those seeking care.)

And remember, Republicans’ move in Louisiana comes at the same time that the GOP and anti-abortion groups in Indiana are working to make women’s abortion reports public records, and as Republican Senators propose legislation that would enable them to harvest pregnant women’s information. None of that is a coincidence.

In the States

Sticking with Louisiana for a moment: There’s more than just privacy issues at play if abortion medication is labeled a controlled substance. That classification is meant for drugs that are habit-forming—so the way that doctors and nurses handle the medication would have to change. The pills would be locked away at hospitals, for example, making them harder to get in emergencies when someone is hemorrhaging after giving birth.

And in news that will shock no one, anti-abortion groups in Louisiana are using the protection of teen girls as an excuse for their attack on the medication. Sarah Zagorski of Louisiana Right to life told WWNO, 'We've had pregnancy centers email us with many stories of minors getting access to this medication.' They want voters to think they’re just protecting vulnerable girls—even as they vote to force them into childbirth.”

And one of Valenti's many excellent commenters posted this, I cannot vouch for its accuracy but..... :


Lee 5 hrs ago:

MD here. I love your work. I keep posting this. It is hard to take in. War on women is blending with war on drugs. 3 states have laws that require a subpoena or warrant for full access to all prescription records. Flimsy even then. The other states’ law enforcement, DEA, & any healthcare have open access to what you’re taking & will make of it what they can. They don’t need a reason to look. LE has been documented setting people up for bogus traffic stop & search & then arrest based on legal substances. If your zip code is different than your physician’s zip code or pharmacy, that’s suspicious, and you will likely be fired as a patient so the physician or pharmacist isn’t arrested. Rural residents automatically fail that screening. This has resulted not only in the deaths of patients from withdrawal of substances used to treat their seizures (and everything else you can imagine), but also heart failure from untreated pain (yes, that happens), and the list goes on. All prescriptions, not just controlled. This invasion of privacy is allowed based on the lie that overdoses are caused by prescribed medications to patients and policing them will stop overdoses. It violates human rights. Physicians have had all assets seized before trial, been imprisoned for years, and later exonerated and released, but they get nothing back including their license. The thought leader in pain treatment (actually a dirty psychiatrist paid by legal firms) says pain is a spiritual problem. Everything that requires a stimulant (narcolepsy, ADHD, etc.) will be next, along with hormones (endometriosis, birth control, menopause, pregnancy, fertility, abortion). Unless we get educated and demand this shit stop. There will always be some people harmed by medications and those who abuse systems. We need to address that of course. Currently, the war on drugs is ignoring cartels because they can make a lot of money safely off docs, patients, and drug companies. They can even involuntarily commit pain patients for long term inpatient substance abuse care. I don’t want to think where this goes for women.” (Emphasis added)

Valenti links to previous articles she posted that have discussed the women's privacy and medical data collection issues, this excerpt below is from one such article:

Indiana Attorney General Todd Rokita says that abortion reports aren’t medical records, and that they should be available to the public in the same way that death certificates are. While Rokita pushes for public reports, New Hampshire lawmakers are fighting over a Republican bill to collect and publish abortion data, and U.S. Sen. Tommy Tuberville has introduced a bill that would require the Department of Veterans Affairs to collect and provide data on the abortions performed at its facilities.

Just last week, Kansas Gov. Laura Kelly vetoed legislation that would have required abortion providers to ask patients invasive and detailed questions about why they were getting abortions, and provide those answers in a report to the state. (BTW unfortunately that veto was overidden a couple of weeks ago, dm)

All of these moves are part of a broader strategy that weaponizes abortion data to stigmatize patients and to prosecute providers. And while most states have some kind of abortion reporting law, legislators are increasingly trying to expand the scope of the data, and use it to dismantle women’s privacy.

Rokita’s ‘advisory opinion’, for example, argues that abortion data collected by the state isn’t private medical information and that in order to prosecute abortion providers, he needs detailed reports to be public. ….

Rokita — best known for his harassment campaign against Dr. Caitlin Bernard, the abortion provider who treated a 10-year-old rape victim — is furious over the change. He says the only way he can arrest and prosecute people is if he gets tips from third parties, presumably anti-abortion groups that scour the abortion reports for alleged wrongdoing. He wants the state to either restore public individual reports, or to allow his office to go after abortion providers without a complaint by a third party. (Meaning, he could pursue investigations against doctors and hospitals without cause.)

Most troubling, though, is his insistence that women’s private abortion information isn’t private at all. Even though individual reports could be used to identify patients, Rokita claims that the terminated pregnancy reports [TPRs] aren’t medical records, and that they 'do not belong to the patient.' ”

(See, “Killing Confidentiality: The GOP wants women's abortions to be public record”, Apr 18, 2024, Jessica Valenti, Abortion, Every Day, at < https://jessica.substack.com/p/killing-confidentiality >)

In Item 2)., “Louisiana Aims To Criminalize Abortion Pills, ….”, Ahmed Baba points out that: “Project 2025 has a section of its 920-page Mandate For Leadership dedicated to abortion pills. ….

Abortion pills pose the single greatest threat to unborn children in a post-Roe world. The rate of chemical abortion in the U.S. has increased by more than 150 percent in the past decade; more than half of annual abortions in the U.S. are chemical rather than surgical.
The abortion pill regimen is typically a two-part process. The first pill, mifepristone, causes the death of the unborn child by cutting off the hormone progesterone, which is required to sustain a pregnancy. The second pill, misoprostol, causes contractions to induce a delivery of the dead child and uterine contents, usually into a toilet at home. ….

Mail-Order Abortions. Allowing mail-order abortions is a gift to the abortion industry that allows it to expand far beyond brick-and-mortar clinics and into pro-life states that are trying to protect women, girls, and unborn children from abortion. The FDA should therefore:

Reverse its approval of chemical abortion drugs because the politicized approval process was illegal from the start. …. Furthermore, at no point in the past two decades has the FDA ever acknowledged or addressed federal laws that prohibit the distribution of abortion drugs by postal mail; to the contrary, the FDA has permitted and actively encouraged such activity.

Now that the Supreme Court has acknowledged that the Constitution contains no right to an abortion, the FDA is ethically and legally obliged to revisit and withdraw its initial approval,” (See, Mandate for Leadership, The Conservative Promise: Project 2025 Presidential Transition Project, 2023, Edited by Paul Dans & Steven Groves, pp 457-458, The Heritage Foundation, at < https://static.project2025.org/2025_MandateForLeadership_FULL.pdf >)

Baba goes on to point out that, “They’re also urging the EPA to re-classify the chemicals in the abortion pills as a “forever chemical” to place more robust regulations on it.

That’s not all. They want to use the Federal Trade Commission to prosecute virtual clinics that prescribe abortion pills in states with abortion restrictions.

Now, this is where it gets taken up a notch. They plan on using the archaic Comstock Act from 1873 in an attempt to not only criminalize abortion pill access but to potentially criminalize abortions generally.”

Item 3)., “Louisiana may reclassify drugs ….”, is a good account of the situation in Louisiana, from WWNO a public radio station in New Orleans. I posted “Item 4)., Copy of Letter sent and signed by 270 Louisiana Physicians ….” so any interested reader can see the actual letter those physicians sent to State Senator Pressly (that he ignored preferring to talk with doctors who are forced-birth / forced-pregnancy advocates). Jessica cited Item 3 in her discussion.

Finally Item 5)., “The anti-abortion plan ready for Trump on Day One: ….”, provides a good discussion of the plans some in the Trump Campaign and at Project 2025 have to criminalize abortion and attack the proponents of legal and easily available Abortion access and Reproductive Health Care access.

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Abortion, Every Day (5.17.24)

Click to skip ahead: In Attacks on Privacy, what Louisiana Republicans are really working towards. In the States, news from Louisiana, Iowa, South Carolina, Georgia and more. In Ballot Measure Updates, abortion will be on the ballot in South Dakota—but not without a fight from Republicans. In the Nation, a look at what happens to our data if Comstock is used to target abortion pills. And in 2024 news, Trump is still using dangerous anti-abortion rhetoric.

Attacks on Privacy

Let’s talk about Louisiana Republicans’ efforts to classify abortion medication as a controlled substance. I’ve covered this a bit already, but New Orleans public radio station WWNO flagged something I can’t believe I didn’t put together earlier: controlled substances are trackable in a state database:

“The state database allows any doctor or pharmacist to look up the prescription history of his or her patient. The data is also accessible by the Louisiana State Board of Medical Examiners, which licenses physicians and other providers, and by law enforcement agencies with a warrant.”

OF COURSE. This is what I’ve been banging on about for months: anti-abortion groups are hyper-focused right now on data, tracking, and attacking patient privacy. (Both for criminalization purposes and to have a chilling effect on those seeking care.)

And remember, Republicans’ move in Louisiana comes at the same time that the GOP and anti-abortion groups in Indiana are working to make women’s abortion reports public records, and as Republican Senators propose legislation that would enable them to harvest pregnant women’s information. None of that is a coincidence.

If you have information about anything happening in your state around data, privacy, or abortion reports, please contact me.

In the States

Sticking with Louisiana for a moment: There’s more than just privacy issues at play if abortion medication is labeled a controlled substance. That classification is meant for drugs that are habit-forming—so the way that doctors and nurses handle the medication would have to change. The pills would be locked away at hospitals, for example, making them harder to get in emergencies when someone is hemorrhaging after giving birth.

And in news that will shock no one, anti-abortion groups in Louisiana are using the protection of teen girls as an excuse for their attack on the medication. Sarah Zagorski of Louisiana Right to life told WWNO, “We've had pregnancy centers email us with many stories of minors getting access to this medication.” They want voters to think they’re just protecting vulnerable girls—even as they vote to force them into childbirth.

South Carolina judge has rejected a challenge to the state’s 6-week abortion ban, allowing the law to be enforced as it is. Planned Parenthood South Atlantic has brought multiple suits challenging the law, specifically around its definition of fetal heartbeat. Here’s a backgrounder I did on the issue in February, but the short version is this: There’s no heartbeat at 6-weeks of pregnancy because there’s no heart yet. And so Planned Parenthood South Atlantic wanted the courts to allow abortion until the 9th week of pregnancy, which is when most of the primary parts of the eventual heart have formed.

While 6 weeks vs. 9 weeks may seem like not a very big difference, I always think of this vital point made by South Carolina abortion advocates: The difference between a 6-week ban and a 9-week ban is the difference between doctors turning away half of their patients, or 90% of them.

Also in South Carolina, state Rep. April Cromer is running for reelection—and away from her anti-abortion voting record. The Republican posted a video attacking her opponent, saying they “stooped so low as to say I want to punish and even kill women who have an abortion.” Feigning offense, she continued, “I have never and would never advocate for punishing women.”

It seems that Cromer is for getting that she co-sponsored legislation last year that would have made having an abortion punishable by the death penalty! Incredible. (Abortion, Every Day was the first to break the news about the bill, which didn’t end up going anywhere thanks to the ensuing public outrage.)

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The Georgia Supreme Court race is becoming all about abortion: Former U.S. Rep. John Barrow, who launched a long-shot campaign against Justice Andrew Pinson, has made abortion rights a centerpiece of his run. That focus on abortion, however, has drawn some ire from Republicans, who say he’s violating the state’s judicial code of ethics.

First, the Judicial Qualifications Commission sent Barrow a letter, issuing a warning against his repeated comments about supporting abortion rights, specifically mentioning how “emphatically” he was talking about the issue. Barrow then sued the commission in federal court, making the letter public; yesterday a judge dismissed that lawsuitFrom Barrow:

“I’ve never declared how I would rule in a case, but I have not hesitated to say what I believe the law is in this matter because that’s what people have a right to know. If you can’t talk about what the election is all about, what’s the point of having an election in the first place.”

Abortion has been a top issue in a several state Supreme Court races recently —like Wisconsin and Pennsylvania, where we saw record amounts of money spent on campaigns.

It’s been over a year since Iowa Attorney General Brenna Bird stopped funding for emergency contraction for rape victims. Katy Rasmussen, a nurse with the Sexual Assault Nurse Examiner (SANE) program, told the Iowa Starting Line, “I think we all feel pretty strongly that this is not a cost that we want to pass along to our patients.”

Still, Bird has refused to budge. She even stood by the decision to make rape victims pay for their own care even after finding out that the majority of victims serviced by the funding were childrenAs I’ve pointed out so many times before, this is how they ban birth control—a little at a time, starting with the most vulnerable among us.

This stinks: The Amarillo city council in Texas is going to have to consider an anti-abortion ordinance after activists gathered enough signatures tto force the issue. Originally, Amarillo leaders declined to hop on the ‘abortion trafficking’ bandwagon (multiple Texas counties have made it illegal to help someone leave the state for an abortion or to use county roads on the way out). But the Texas Tribune reports that the city validated 6,300 signatures, enough to make the council to hear out the issue.

And in the last bit of state news, another sign that Republicans are terrified of abortion rights: Maryland Republican Larry Hogan, a former two-term governor, is now saying he is “pro-choice” in order to preempt any Democratic attacks about abortion as he runs for U.S. Senate.

It’s a remarkable statement, really, considering that the Catholic Republican has previously ducked talking about the issue and, while governor, vetoed a law to expand abortion access. “I support restoring Roe as the law of the land,” Hogan said. “I’ll continue to protect the rights of women to make their own reproductive choices just like I did as governor for eight years.” Sure you will.

Hogan’s opponent, Democrat Angela D. Alsobrooks, said, “Larry Hogan has already shown us and told us that he’s not going to protect abortion rights…And the Republicans he’d be joining in the Senate have made their agenda crystal clear.”

Quick hits:

Ballot Measure Updates

Abortion will be on the ballot in South Dakota this November. Secretary of State Monae Johnson reported yesterday that abortion rights activists collected enough valid signatures to put the issue in front of voters.

Dakotans for Health released a statement celebrating the ballot measure being certified, saying that “the people of South Dakota, not the politicians in Pierre, will be the ones to decide whether to restore Roe v. Wade as the law of South Dakota.”

The measure would protect abortion rights through the first trimester of pregnancy. The government could limit abortion in the second trimester as it relates “to to the physical health of the pregnant woman.” In the third trimester, abortion would be allowed to save a patient’s life.

And while that’s certainly better than what South Dakota has now—which is a total ban—you know how I feel about restrictions in ballot measures. Obviously, I have a tremendous amount of respect for the activists on the ground who are working to restore any kind of access. I don’t live in South Dakota; I don’t know what it’s like to do this work there. I don’t know what it’s like to push for a ballot measure in Missouri or Florida, either. But I’m extremely concerned that measures including these kinds of limitations are effectively enshrining restrictions—and leaving some of the most vulnerable people out.

All that said, none of that changes the horrific attacks on democracy we’re seeing from Republicans in these states. South Dakota anti-abortion groups, for example, plan to bring forward a legal challenge—and it was just yesterday that I told you about their (very sketchy) efforts to invalidate the measure.

Activists have been impersonating government employees in calls to voters, pressuring them to remove their names from the petition as part of their “Take Off My Name” campaign. (Republicans were able to pass a law that would allow the measure to be invalidated if they get enough people to withdraw their signatures.) Incredibly, South Dakota Attorney General Marty Jackley’s office announced that an investigation found no evidence of criminal wrongdoing.

Speaking of anti-abortion ballot measure bullshit, this made me so angry. A group of anti-choice groups in Florida are coming together to try to stop Amendment 4, and they’re calling themselves “Do No Harm Florida.” The fact that they’re adopting the language of doctors who care about their patients is just beyond the pale—especially given the horror stories that are coming out every day from states with abortion bans.

Meanwhile, Minnesota lawmakers were expected to vote today on the Equal Rights Amendment, which would protect abortion rights in the state constitution—but they tabled the issue (again). Abortion is legal in the state, but multiple pro-choice states are pushing ballot measures as an extra layer of protection.

In Missouri this week, Democrats beat back an effort by Republicans to raise the standards on ballot measures by engaging in a 50-hour filibuster. Following in the footsteps of Ohio Republicans, who held a failed special election to raise ballot measure standards, the Missouri GOP wanted to require that constitutional amendments pass with five out of eight congressional districts as opposed to a simple majority. I’m glad that Democrats were able to hold them back, but as we’ve seen in multiple states—we can expect the attacks on democracy to continue.

Quick hits: Arizona abortion rights activists are fighting back against anti-choice myths. Teen Vogue on the ballot measure in Florida, and NY1 on the abortion rights amendment that was tossed by a New York judge. Finally, today was the last day of the legislative session in Maine, which means that the proposed abortion rights amendment, which failed to get the 2/3 support needed, will not go forward.

In the Nation

Let’s get back to Republican attacks on privacy. Nicole Gill, executive director of Accountable Tech, has an important (but terrifying) piece at Fast Company about what would happen to our private data if the Comstock Act is enforced to ban the shipping of abortion medication. It’s a must-read.

Gill points out that major tech companies are already putting abortion seekers at risk “by collecting, storing, and selling as much user data as possible.” Around this time last year, in fact, I wrote about Accountable Tech’s work testing Google’s promises to stop collecting users’ abortion-related data. What they found then is similar to what they found in January of this year: that Google was still holding onto data. (Even searches for terms like “Planned Parenthood” were being stored.)

If Comstock is used to stop the mailing of abortion medication—which we know now accounts for 63% of abortions and thousands of red-state abortions a month—the situation gets even more dire:

“That means thousands of women would be forced to travel for abortion—often out of state—with many of them turning to GPS tools like Google Maps to find and navigate to far-away clinics. And the more of this personal location data Big Tech companies collect, the more data they will have to turn over to law enforcement under subpoena.”

Scary stuff. Meanwhile, I appreciated this reminder from Talking Points Memo that one of conservatives’ criminalization strategies is to oust any state or local prosecutors that decline to prosecute abortion cases. This is a tactic I’ve been tracking since Roe was overturned—from Florida Gov. Ron DeSantis firing of a state attorney to Texas laws allowing for the removal of DAs via citizen petitions.

This week, the Public Rights Project and Local Solutions Support Center released a report showing just how bad those attacks on prosecutors have gotten. The groups outline some of the lawsuits brought on the issue and the (many) bills that are being advanced in states eager to punish state attorneys who don’t get with the Republican program.

In a release, Public Rights Project CEO Jill Habig says that the legislative trend has not stopped, “in fact it’s only accelerating.” For more on this tactic, check out Abortion, Every Day’s year-end roundup on criminalization.

Finally, thanks to The New York Times for quoting my piece about Harrison Butker’s misogynist commencement speech. They even included my favorite line!

Quick hits:

2024

Steve Benen at MSNBC points out that Donald Trump still hasn’t said what he thinks about using the Comstock Act to ban the shipping of abortion medication. The disgraced former president promised in his recent interview with TIME magazine that he’d be “releasing” his opinion on the issue and making a “big statement” within the next two weeks. It’s been two weeks, and we haven’t see any announcement—big or small.

“The whole point of the deceptive two-week trick is to push off inconvenient questions indefinitely,” Benen writes.

Speaking of Trump. He keeps repeating the dangerously false claim that Democrats are allowing babies to be “executed” after birth. Is any Republican going to speak up about it? Why aren’t reporters asking GOP leaders what they think about this rhetoric? It’s going to get someone hurt or killed. After all, we’ve seen it happen before.

Quick hits: Roll Call on Vice President Kamala Harris taking the lead on abortion rights. And even Fox News’ polls show that abortion is important to voters.

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Louisiana Aims To Criminalize Abortion Pills, Echoing Project 2025 Blueprint

Donald Trump said he would leave the issue of abortion to the states. This is what that looks like.

Republican lawmakers in Louisiana are undertaking a new legislative effort to reclassify the abortion-inducing drugs mifepristone and misoprostol as Schedule IV controlled dangerous substances and prosecute any unprescribed possession of them. The reclassification would place these abortion drugs in the same category as cocaine, heroin, and methamphetamine.

Abortions are already banned entirely in Louisiana, with no exceptions for rape or incest. Louisiana had the fifth-highest maternal mortality rate of any state in the country between 2018-2021, according to KFF. These kinds of policy pursuits will only make that death rate higher.

The amendment to SB 276 was sponsored by Republican State Senator Thomas Pressly. If a person is caught with an abortion pill without a prescription, the amendment would make it a felony punishable by up to five years in prison, according to CNN’s analysis.

Over 270 doctors, healthcare providers, and other medical experts signed a letter expressing concern over Senator Pressly’s amendment.

The letter declares that “neither mifepristone nor misoprostol have been shown to have any potential for abuse, dependence, public health risk, nor high rates of adverse side effects.” The medical experts went on to state that the bill creates “the false perception that these are dangerous drugs that require additional regulation.”

The abortion pill amendment faces a vote for final approval on June 3.

Currently, both mifepristone and misoprostol are FDA-approved, can be prescribed online, and can be mailed to those seeking abortion care. According to the Guttmacher Institute, medication-induced abortions account for 63% of abortions across the United States.

It’s that statistic that has made abortion pills a prime target for anti-abortion Republicans. While Trump has dubiously claimed that he won’t sign a national abortion ban, his allies in Project 2025 are plotting other ways he can target abortion access. And some of them are along the very same lines as this Louisiana bill.

Project 2025 calls on a future Trump administration to force the FDA to revoke approval of the abortion drugs mifepristone and misoprostol. They want the FTC to prosecute virtual clinics that prescribe abortion pills and the EPA to classify chemicals found in abortion drugs as “forever chemicals.” They also cite the use of the archaic Comstock Act to restrict and criminalize abortion pill access and, in an extreme interpretation of the law, restrict all abortions at the federal level through bans on mailing abortion-related material.

Let’s take a look at how the architects of many of Trump’s second-term agenda items are planning to target abortion pills nationwide.

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How Project 2025 Plans To Target Abortion Pills


Screens
Screenshot from Donald Trump’s video statement on abortion - Monday, April 8, 2024 (Truth Social)hot from Donald Trump’s video statement on abortion - Monday, April 8, 2024 (Truth Social)

The 100 right-wing groups at Project 2025, led by the Heritage Foundation, have outlined exactly how Trump can bypass Congress and exploit executive power to unilaterally restrict abortion access nationwide.

One of Project 2025’s most distributing anti-abortion proposals, and most easily accessible to the next Republican president, is how they plan to restrict abortion pill access.

If you’re unfamiliar with Project 2025, it’s essentially a playbook culminating in an authoritarian plot that plans to replace tens of thousands of civil servants with GOP loyalists and effectively turn the federal government into a tool of the far-right.

Project 2025 has a section of its 920-page “Mandate For Leadership” dedicated to abortion pills. On page 458, Project 2025 goes into detail about why they want to target these abortion pills. It specifically calls out mifepristone and misoprostol:

“Abortion pills pose the single greatest threat to unborn children in a post-Roe world. The rate of chemical abortion in the U.S. has increased by more than 150 percent in the past decade; more than half of annual abortions in the U.S. are chemical rather than surgical.

The abortion pill regimen is typically a two-part process. The first pill, mifepristone, causes the death of the unborn child by cutting off the hormone progesterone, which is required to sustain a pregnancy. The second pill, misoprostol, causes contractions to induce a delivery of the dead child and uterine contents, usually into a toilet at home".”

Project 2025 goes on to give specific instructions to the FDA on how they should regulate abortion drugs. They call on the FDA to revoke its approval of mifepristone and misoprostol and end its distribution in the market. And if the FDA disagrees, they want the next Trump Administration’s Health and Human Services Secretary to override the FDA’s approval of the drug - a power the HHS Department has.

They’re also urging the EPA to re-classify the chemicals in the abortion pills as a “forever chemical” to place more robust regulations on it.

That’s not all. They want to use the Federal Trade Commission to prosecute virtual clinics that prescribe abortion pills in states with abortion restrictions.

Now, this is where it gets taken up a notch. They plan on using the archaic Comstock Act from 1873 in an attempt to not only criminalize abortion pill access but to potentially criminalize abortions generally.

The Comstock Act bans “mailing obscene or crime-inciting matter.” What it considers crime-inciting material is “lewd or lascivious material,” including an “instrument, substance, drug, medicine, or thing” or “article or thing designed, adapted, or intended for producing abortion.” The law is currently being invoked in a case before the Supreme Court seeking to force the FDA to take mifepristone off the market.

The law was made irrelevant by Roe. v. Wade, but with that ruling overturned, Republicans have been eager to use it to criminalize the mailing of abortion material. Project 2025 calls for the next Republican Justice Department to enforce the Comstock Act. This could be enforced not just in states where abortion is banned but everywhere in the country.

The law could be used against drug companies, distributors of abortion pills, doctors, and women who receive abortion material. Mary Ziegler, law professor and a Guggenheim Fellow, wrote a piece in The New York Times that detailed how this could play out:

Project 2025’s road map argues that a Republican Justice Department should enforce Comstock “against providers and distributors” of abortion pills. A Trump administration could follow through on these plans by prosecuting doctors and drug companies anywhere in the country: The Comstock Act, as a federal law, could be read to override state protections for abortion rights.

Some key abortion opponents, like the former Texas solicitor general Jonathan Mitchell, argue that Comstock should be interpreted as an effective ban on all abortions because every procedure that takes place in the United States relies on some item placed in the mail, from a surgical glove to a curet. Mr. Mitchell and his allies read the law to exclude explicit exceptions for the life or health of the patient.

Understood in this way, the law could punish women who receive abortion-related items or information using the Postal Service or another carrier or even websites.

The Biden Administration’s Justice Department pushes back on this interpretation, arguing that the Comstock Act “does not prohibit the mailing of certain drugs that can be used to perform abortions where the sender lacks the intent that the recipient of the drugs will use them unlawfully. Because there are manifold ways in which recipients in every state may lawfully use such drugs, including to produce an abortion, the mere mailing of such drugs to a particular jurisdiction is an insufficient basis for concluding that the sender intends them to be used unlawfully.”

Trump-appointed judges have ruled in favor of the right-wing interpretation, leading to uncertainty about how this could be ruled on in the future.

The Supreme Court ruling on abortion pill access is expected to come this Summer. We’ll see how they interpret the Comstock Act. This will prove vital to indicating whether this Supreme Court would uphold a second-term Trump’s attempts at banning abortion pills nationwide, or worse, abortion itself.

The bottom line is this: If Donald Trump is re-elected, we’re very likely going to see attempts to restrict abortion pills nationwide. It’s outlined in the second term agenda of the allies currently screening and training staff for a second Trump administration. Trump can say whatever he likes, but he said he was “proud” of his role in overturning Roe v. Wade. We shouldn’t be surprised if he implements anti-abortion measures nationwide along the lines of what his allies have outlined for him.

We need to keep informing Americans about these plans. A lot is at stake this November.

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Louisiana may reclassify drugs used in abortion as controlled dangerous substances

Mifepristone and misoprostol inside a Planned Parenthood clinic in Fairview Heights, Ill. in 2021. The drugs are used after miscarriage and for bleeding and other obstetrical procedures and problems. In combination, they can also induce an early abortion. Lawmakers in Baton Rouge are considering a bill to reclassify the medications as controlled dangerous substances.

Jeff Roberson/AP

Louisiana lawmakers are considering adding two drugs commonly used in pregnancy and reproductive health care to the state's list of controlled dangerous substances, in a move that has alarmed doctors in the state.

Mifepristone and misoprostol have many clinical uses, but one FDA-approved use is to take the pills to induce an abortion up to ten weeks gestation.

KFF Health News logo

This story was produced in partnership with KFF Health News.

The bill moving through the Louisiana legislature would list both medications as Schedule IV drugs under the state's Uniform Controlled Dangerous Substances Law, creating penalties of up to 10 years in prison for anyone caught with the drugs without a valid prescription.

It's the latest move by anti-abortion advocates trying to control access to abortion medications in states with near-total abortion bans, such as Louisiana. If passed, the law would be the first of its kind, opening up a new front in the state-by-state battle over reproductive medicine.

A Supreme Court abortion pill case with potential consequences for every other drug

A Supreme Court abortion pill case with potential consequences for every other drug

Republican-controlled states have passed various laws regulating medication abortion in the past, said Dr. Daniel Grossman, an OB-GYN and reproductive health researcher at the University of California San Francisco.

But after the Dobbs decision in 2022, scrutiny of medication abortions escalated even more as clinics in certain states shuttered completely or were forced to stop offering in-clinic procedures.

"It's not surprising that states are trying everything they can to try to restrict these drugs," Grossman said. "But this is certainly a novel approach."

More than 250 OB-GYNs, emergency, internal medicine and other physicians from across Louisiana have signed a letter to the bill's sponsor, Republican state senator Thomas Pressly, arguing the move could threaten women's health by delaying life-saving care.

"It's just really jaw-dropping," said Dr. Nicole Freehill, a New Orleans OB-GYN who signed the letter. "Almost a day doesn't go by that I don't utilize one or both of these medications."

Mifepristone and misoprostol are routinely used to treat miscarriages or stop obstetric hemorrhaging, induce labor, or prepare the cervix for a range of procedures inside the uterus, such as inserting an IUD or taking a biopsy of the uterine lining.

Proposal added as amendments

The proposal passed out of an Apr. 30 Louisiana House Administration of Criminal Justice committee hearing as amendments to Pressly's original bill creating the crime of "coerced criminal abortion" — where someone "knowingly" gives abortion pills to a pregnant woman to cause or attempt to cause an abortion "without her knowledge or consent."

Pressly's sister, Catherine Pressly Herring, testified during the hearing that she was given abortion drugs without her knowledge by her former husband. Pressly said his sister's story prompted the legislation.

In a statement, state Sen. Pressly explained he added the new amendments to "control the rampant illegal distribution of abortion-inducing drugs." He did not respond to NPR's requests for comment.

"By placing these drugs on the controlled substance list, we will assist law enforcement in protecting vulnerable women and unborn babies," Pressly wrote.

Access to a key abortion drug is in legal limbo. Here's how medication abortion works

Access to a key abortion drug is in legal limbo. Here's how medication abortion works

Louisiana Right to Life, the state's most powerful anti-abortion group, helped draft the bill. Claims that rescheduling the drugs could harm women's health represent "fearmongering," said communications director Sarah Zagorski.

The real problem, she says, is mifepristone and misoprostol are too accessible in Louisiana, and are being used to induce abortions despite the state's ban.

"We've had pregnancy centers email us with many stories of minors getting access to this medication," Zagorski said. "That's just going to create an epidemic in Louisiana of minors and women and putting the public health at risk."

Studies have shown a spike in people ordering abortion pills online to give themselves abortions in states with restrictive abortion bans.

Despite state bans, abortions nationwide are up, driven by telehealth

Despite state bans, abortions nationwide are up, driven by telehealth

In the Louisiana committee hearing, anti-abortion advocates stressed the bill would still allow physicians to dispense mifepristone and misoprostol for lawful medical care, and that women who give themselves abortions using the medications would be exempted from criminal liability.

"Under this law, or any abortion law, in Louisiana, we see the woman as often the second victim," testified Dorinda Plaisance, a lawyer who works with Louisiana Right to Life. "And so Louisiana has chosen to criminalize abortion providers."

Move "not scientifically based," doctors say

The Drug Enforcement Agency as well as individual states have the power to list drugs as controlled dangerous substances.

State and federal regulations aim to control access to drugs, such as opioids, based on their medical benefit and their potential for abuse, according to Joe Fontenot, the executive director of the Louisiana Board of Pharmacy, the state agency that monitors drugs listed as controlled dangerous substances.

As in other states, Louisiana tracks those prescriptions in databases which include the name of the patient, the health provider who wrote the prescription, and the dispensing pharmacy.

Physicians need a special license to prescribe the drugs — in 2023, there were 18,587 physicians in Louisiana, 13,790 of whom had a controlled dangerous substance license, according to data from the Louisiana State Medical Society and the Board of Pharmacy.

"Every state has a prescription drug monitoring program. And they really are designed to identify prescription drug mills that are hocking fentanyl, and opioid painkillers," said Robert Mikos, a professor of law and drug policy expert at Vanderbilt University.

But what happened to Pressley's sister — being tricked into taking mifepristone or misoprostol — is a form of drug abuse, said Zagorski of Louisiana Right To Life, which is why the drugs should be more strictly controlled.

But Fontenot, of the Louisiana Board of Pharmacy, said that under Louisiana's law, abuse refers to addiction.

Despite bans in some states, more than a million abortions were provided in 2023

Despite bans in some states, more than a million abortions were provided in 2023

Dr. Jennifer Avegno, a New Orleans emergency physician and the director of the New Orleans Department of Health, agrees.

"There is no risk of someone getting hooked on misoprostol," Avegno said.

Under the bill, the two medications would be added to a list comprised of opioids, depressants, and stimulants.

"To classify these medications as a drug of abuse and dependence in the same vein as Xanax, Valium, Darvocet is not only scientifically incorrect, but [a] real concern for limiting access to these drugs," Avegno said.

Doctors worry the bill could also set a dangerous precedent for state officials who want to restrict access to any drug they consider dangerous or objectionable, regardless of its addictive potential, Avegno said.

Fears over delays in care

In their letter, doctors said the bill's "false perception that these are dangerous drugs" could lead to "fear and confusion among patients, doctors, and pharmacists, which delays care and worsens outcomes" in a state with high rates of maternal injury and death.

Standard pregnancy care is now dangerously disrupted in Louisiana, report reveals

Standard pregnancy care is now dangerously disrupted in Louisiana, report reveals

The increased scrutiny could have a state-wide chilling effect and make doctors, pharmacists and even patients more reluctant to use these drugs, the doctors wrote in their letter.

The state database allows any doctor or pharmacist to look up the prescription history of his or her patient. The data is also accessible by the Louisiana State Board of Medical Examiners, which licenses physicians and other providers, and by law enforcement agencies with a warrant.

"Could I be investigated for my use of misoprostol? I don't know," said Freehill.

Pharmacists could be even more reluctant to dispense the medications, Freehill said — exacerbating a problem she and other OB-GYNs have already been dealing with since Louisiana banned nearly all abortions. That could leave patients miscarrying without timely treatment.

"They could be sitting there bleeding, increasing their risk that they would have a dangerous amount of blood loss" or risking infection, she said.

Medical residents are starting to avoid states with abortion bans, data shows

Medical residents are starting to avoid states with abortion bans, data shows

Already, Freehill now routinely phones in every prescription for misoprostol when her patients are miscarrying so she can explain to the pharmacist why she's prescribing it — something that won't be possible if it's made a controlled substance because those prescriptions have to be written on a pad or sent electronically.

In hospitals, the drugs would also have to be locked away, according to a midwife who works in New Orleans and asked not to be identified so she could speak on a sensitive topic. That could potentially cause delays getting the drug when a patient is hemorrhaging after childbirth.

Doctors worry some patients might be afraid to take the medications once they're listed as "dangerous," Avegno said.

In a written response to the Louisiana physicians who signed the protest letter, state Sen. Pressley said the doctors that he's spoken with feel the proposal "will not harm healthcare for women."

Criminalizing support for people giving themselves abortions

Louisiana's current abortion ban already makes it a crime to provide an abortion, including by giving someone medications used to induce abortion. And a 2022 law added up to 50 years in prison for mailing mifepristone or misoprostol.

Because the new proposal explicitly exempts pregnant women, opponents like Elizabeth Ling believe it is meant to isolate those women from others who would help them. Ling, a reproductive rights attorney at If/When/How, is particularly concerned about the prison penalties, which she believes are intended to frighten and disrupt underground networks of support for patients seeking the pills.

Pregnant patients might worry about ordering online or enlisting a friend to help obtain the pills: "Is my friend who is simply just providing me emotional support going to somehow, you know, be punished for doing that?" Ling said.

The proposed regulation could also target people who aren't pregnant, but want to order abortion pills online and stock them in case of a future pregnancy, a tactic has become increasingly popular in states with abortion bans.

In a written response to the Louisiana physicians who signed the protest letter, state Sen. Pressley made it clear he intends to push the bill forward. The bill awaits a full floor vote in the state House, and then would need to be reconciled with a Senate version. If it passes before the legislature adjourns on June 3, it's expected to be signed by Republican Governor Jeff Landry, an outspoken opponent of abortion rights.

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The anti-abortion plan ready for Trump on Day One

The stakes of the election go far beyond whether a GOP president signs a bill banning the procedure.

Pro-life demonstrators listen to former President Donald Trump as he speaks.

The sweeping plans indicate how much conservative activists see a potential Trump administration as an opportunity to restrict abortion nationwide. | Olivier Douliery/AFP via Getty Images

Anti-abortion groups have not yet persuaded Donald Trump to commit to signing a national ban if he returns to the White House.

But, far from being deterred, those groups are designing a far-reaching anti-abortion agenda for the former president to implement as soon as he is in office.

In emerging plans that involve everything from the EPA to the Federal Trade Commission to the Postal Service, nearly 100 anti-abortion and conservative groups are mapping out ways the next president can use the sprawling federal bureaucracy to curb abortion access.

Many of the policies they advocate are ones Trump implemented in his first term and President Joe Biden rescinded — rules that would have a far greater impact in a post-Roe landscape. Other items on the wish list are new, ranging from efforts to undo state and federal programs promoting access to abortion to a de facto national ban. But all have one thing in common: They don’t require congressional approval.

“The conversations we’re having with the presidential candidates and their campaigns have been very clear: We expect them to act swiftly,” Kristan Hawkins, the president of Students for Life, told POLITICO. “Due to not having 60 votes in the Senate and not having a firm pro-life majority in the House, I think administrative action is where we’re going to see the most action after 2024 if President Trump or another pro-life president is elected.”

The groups have had, at times, a fraught relationship with Trump, who appointed the Supreme Court justices who helped overturn Roe v. Wade but who has blamed the anti-abortion movement for electoral losses, criticized Florida’s six-week ban and favors exemptions for rape, incest and life of the mother. Yet the sweeping plans indicate how much conservative activists see a potential Trump administration as an opportunity to restrict abortion nationwide — including in states that have voted to protect access over the last two years.

The Heritage Foundation’s 2025 Presidential Transition Project — a coalition that includes Students for Life, Susan B. Anthony Pro-Life America and other anti-abortion organizations — is drafting executive orders to roll back Biden-era policies that have expanded abortion access, such as making abortions available in some circumstances at VA hospitals. They are also collecting resumes from conservative activists interested in becoming political appointees or career civil servants and training them to use overlooked levers of agency power to curb abortion access.

“We’re trying to do as much, now, of the future president’s work that we can,” Spencer Chretien, a former special assistant to Trump who now runs Project 2025, recently told a packed room at Students for Life’s annual DC conference. “We need our people, our pro-life conservative people across America, to get fired up and to know that help is on the way and that they have something to look forward to.”

The Biden campaign hopes its own voters are similarly fired up, and is highlighting the right’s policy plans as they draw a contrast between Trump and Biden and make abortion rights a leading issue in the presidential election.

“We’ve made such great progress here in the state of Michigan, and yet, it is precarious in the event that Donald Trump comes back to the White House because all that work could be undone,” Biden campaign co-chair and Michigan Gov. Gretchen Whitmer told POLITICO — referencing her state’s vote in 2022 to overturn a 1931 ban and enshrine abortion rights in the state constitution. “We cannot afford to have someone in the White House who is going to rip these rights away that we’ve been fighting so hard to protect.”

In a call with reporters earlier this month, campaign manager Julie Chávez Rodriguez pointed to Project 2025 as a particular threat — arguing that Biden’s policies to advance abortion rights would be in jeopardy if he loses in November and vowing to hammer the message until “every single voter knows it.”

“They have laid out an 887-page blueprint that includes, in painstaking detail, exactly how they plan to leverage virtually every arm, tool and agency of the federal government to attack abortion access,” she said. “Trump’s close advisers have actual plans to block access to abortion in every single state without any help from Congress or the courts.”

The Trump campaign did not respond to questions about its second-term plans for abortion.

But Project 2025, led by Trump administration alumni, along with other conservative activists close to the campaign, said they’re confident Trump would at the very least revive his first-term policies that Biden has since scrapped. That includes reimposing restrictions on domestic and international clinics that provide contraception and STD testing and rolling back access to abortion pills.

Rewriting the rules

The Title X family planning program provides free and subsidized contraception, STD screenings, prenatal care and other services to millions of low-income people around the country.

The Trump administration, in 2019, barred clinics that receive Title X funds from counseling patients about abortion or providing a referral for one, and required clinics that provided both abortion and family planning to construct physically separate facilities and maintain separate staff and finances.

Approximately one-quarter of Title X providers quit the network in protest of the rules, leaving the program with 1,000 fewer sites and 22 percent fewer patients served, according to HHS. Six states lost all Title X providers, while another six lost the vast majority, which the agency estimated led to as many as 181,477 unintended pregnancies.

The Trump rules also allowed faith-based centers that don’t provide or inform patients about their full range of contraceptive options and try to dissuade them from having an abortion to participate in the program and receive federal funding.

Should these policies return with abortion banned or restricted in nearly half the country, the effect could be far greater.

“You are talking about a population that by definition is very low-income and you’d be cutting them off from very basic health care services,” said Usha Ranji, the associate director for women’s health policy at KFF. “The risk of unplanned pregnancies is also completely different post-Dobbs. Title X funds have never been used for abortion services. But providers could once again be prevented from offering comprehensive counseling on all their options, including options that may not be available for great distances.”

Anti-abortion activists are also preparing for a future Trump administration to rescind all the policies Biden enacted that expanded access to both abortion pills and surgical abortions — including funding for military members who must travel across state lines for an abortion, the provision of abortions at VA clinics, the expansion of HIPAA privacy rules to cover abortions, and the availability of abortion pills by mail and at retail pharmacies.

“We need to undo all of those,” said Roger Severino, the Heritage Foundation’s vice president of domestic policy who drafted part of the Project 2025 playbook. Speaking at the Students for Life conference, he added the group is “working on those sorts of executive orders and regulations” that will roll back Biden policies and “institutionalize the post-Dobbs environment.”

Undoing many Biden actions would take several months, because the Trump administration would have to propose a new agency rule and allow for public comment before implementation. Several other items on anti-abortion groups’ policy wish list for a Trump administration would also require rulemaking.

Students for Life is pushing for the EPA to classify the chemicals in the abortion pill mifepristone as “forever chemicals” subject to stricter regulations, and to require any doctor who prescribes the pill to be responsible for collecting and disposing of the aborted fetus.

They also want the Federal Trade Commission to penalize and prosecute virtual clinics that prescribe abortion pills to people in states where they are banned.

Susan B. Anthony, an anti-abortion group spending tens of millions of dollars to elect conservative candidates this fall, wants the FDA to reimpose the requirement — lifted by the Biden administration — that abortion pills only be dispensed in-person by a doctor, and investigate non-fatal complications reported by patients who take the drugs. Others want the agency to go further and strip the two-decade-old approval of the pill, banning its sale nationwide.

These regulatory changes would likely face legal challenges. Many rules the Trump administration tried to enact were blocked in court because officials did not follow administrative procedure. But given that experience, the prep work being done by Project 2025 and other groups, and the additional judges appointed by Trump, they would likely have a better success rate in a second term.

“I would anticipate both the very aggressive use of executive authority to undermine access to abortion and a reliance on conservative-leaning courts to lock those executive actions in place,” said Chris Jennings, a health policy expert who worked in both the Clinton and Obama administrations. “Even people who think they’re safe because they live in blue states would lose access should that happen.”

Lawmaking by memo

A second Trump administration could make swifter and more sweeping changes by issuing guidance and interpretations of existing laws.

The Comstock Act, passed in the 1870s and named for an official who campaigned against everything from masturbation to women’s suffrage, bans mail delivery of any “lewd or lascivious material,” including any “instrument, substance, drug, medicine, or thing” that could be used for an abortion. The law remains on the books, though its scope has been narrowed by Congress and the courts — for example, it no longer can be used to stop mail delivery of contraception. Project 2025 is preparing for Trump to bring it back into force, cutting off access not only to the pills used in the majority of abortions but also to medical equipment used for abortions and other procedures, and allowing criminal prosecutions of both providers sending the drugs and patients receiving them.

“We believe the Comstock Act should be followed and abortion pills should not be sent through the mail — certainly that should be enforced,” Carol Tobias, the president of the National Right to Life Committee told POLITICO.


The Biden administration’s Justice Department issued a legal memo in December, 2022 arguing that the Comstock Act does not bar mail delivery of abortion medication unless the sender intends for it to be used illegally. But judges appointed by Trump have, since then, ruled the opposite, and GOP state attorneys general have cited Comstock to pressure major pharmacies not to carry the pills in their states.

Groups are also planning for a Trump administration to rescind Biden administration guidance requiring hospitals to offer abortions to patients experiencing medical emergencies regardless of state bans on the procedure — an issue the Supreme Court is set to consider this year.

“The Biden administration has reiterated that stabilizing care includes abortion services and providers need to provide it,” Ranji said. “That could be something the Trump administration could decide not to enforce and they would not even have to go through a rule-making process. They could just do it.”

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