New Obstacles to Safe Abortion in the US

Published in El Espectador
(Colombia) on 12 April 2023
by Catalina Ruiz-Navarro (link to originallink to original)
Translated from by Patricia Simoni. Edited by Michelle Bisson.
The most recent chapter in U.S. abortion wars involves a safe drug for early abortion: mifepristone. Ideally, medication-induced abortion uses both mifepristone, which acts to terminate the pregnancy, and misoprostol, which acts to initiate contractions and expel the embryo.

In Latin America, both drugs have been central to the struggle for the right to choose for decades.

In some countries, one of the strategies used by anti-choice groups has been to ban mifepristone; misoprostol, however, has many other uses and thus has been more difficult to ban. As a result, in certain cases abortions are performed with misoprostol alone, and it remains a fairly safe and effective method.

Until now in the U.S., both drugs have been legal, with Food and Drug Administration approval. But last week, two federal judges issued rulings — one banning mifepristone, and one supporting its use. Now one of those legal limbos is in play, and that is where the U.S. justice system comes in.

On the one hand, Matthew J. Kacsmaryk, a conservative judge in Texas — appointed by Donald Trump, of course — dared to question the FDA: “But here, FDA acquiesced on its legitimate safety concerns — in violation of its statutory duty — based on plainly unsound reasoning and studies that did not support its conclusions,” he said in his ruling, in which he also stated that mifepristone is "unsafe,” basically because it can produce an abortion even if it poses no risk to the pregnant woman.

And this raises the issue regarding who has the last word in determining the safety of a drug? A judge? Or an agency that specializes in making such determinations?

On the other side of the debate, U.S. District Court Judge for the Eastern District of Washington Thomas Rice reiterated what has been known for more than two decades: Mifepristone is completely safe.

These legal battles have already begun to have consequences. For example, Walgreens, one of the largest of the chain pharmacies in the U.S., announced that it will stop offering mifepristone in 21 states.*

One truth at the root of this problem is that these conversations about medical abortion are relatively new to public discourse in the U.S. That's what happens when you've had a guaranteed right to abortion for decades. In addition, repercussions from the fall of Roe v. Wade last year were even greater because no contingency plans appeared to be in place if that were to happen.

You might have asked us, the feminists of Latin America! We would have told you long ago that it was essential to guarantee future access to mifepristone and misoprostol. We would have told you that people should be educated about their use so they would not become negatively targeted as "satanic pills used to kill.”

Nationalistic discourse in the U.S. that allows it to see itself as the most just and progressive country — the utopian future in the present — leaves many strategic gaps, even among activists with the best of intentions. And this is evident when one sees the immense ground that anti-rights groups have gained in less than a year.

One hopes that reproductive rights groups will be able to resist and bounce back, for although it seems that when we look at the U.S. we are looking at our past, this will undoubtedly have future repercussions in Latin America.

*Editor's note: Although this article was accurately translated, Watching America has been advised by Walgreens that it does not currently dispense mifepristone in any location, did not make a decision "to stop offering" the medication, and plans to dispense mifepristone in any jurisdiction where it is legal to do so.


El último capítulo en las guerras del aborto en Estados Unidos tiene que ver con un medicamento muy importante para practicar abortos seguros y oportunos: la mifepristona. El aborto con medicamentos usa, en condiciones ideales, mifepristona, que sirve para terminar el embarazo, y misoprostol, que sirve para generar contracciones y expulsar el embrión. Ambos medicamentos han sido centrales en la lucha por el derecho a decidir en Latinoamérica desde hace décadas, y una de las estrategias de los anti-derechos ha sido precisamente prohibir la mifepristona en algunos países, ya que el misoprostol, como tiene muchos otros usos, ha sido más difícil de prohibir. Como resultado, en algunos contextos se practican abortos solo con misoprostol, y este sigue siendo un método bastante seguro y efectivo.

Hasta ahora ambas pastillas han sido legales en Estados Unidos y están aprobadas por la Administración de Alimentos y Medicamentos (FDA en inglés). Pero la semana pasada dos jueces federales fallaron uno en contra y el otro a favor de la prohibición de la mifepristona, y ahora están en uno de esos limbos legales en los que con tanta facilidad cae el sistema de justicia gringo. Por un lado, Matthew J. Kacsmaryk, un juez conservador en Texas, nombrado por Trump, por supuesto, se atrevió a cuestionar a la FDA: “en este caso, la FDA renunció a sus legítimas preocupaciones de seguridad —en violación de su deber legal— basándose en un razonamiento llanamente infundado y estudios que no apoyaban sus conclusiones” dijo en su fallo, en donde también afirma que la mifepristona es “insegura”, básicamente porque puede producir un aborto, aunque no represente riesgos para la gestante. Esto genera otras tensiones en los discursos de autoridad, pues ¿quién tiene la última palabra para determinar la seguridad de un medicamento? ¿Un juez o la organización especializada en hacerlo? Por otro lado, Thomas Rice en Washington reiteró lo que ya se sabe desde hace más de dos décadas: que la mife es totalmente segura. Estas batallas legales ya empezaron a tener consecuencias. Por ejemplo, una de las farmacias de cadena más extendidas en Estados Unidos, Walgreens, anunció que dejará de ofrecer la mifepristona en 21 estados.
Algo que está en la base de este problema es que estas conversaciones sobre el aborto con medicamentos son relativamente nuevas para la opinión pública en Estados Unidos. Es lo que pasa cuando has tenido el derecho a abortar garantizado por décadas. Y es que las repercusiones de la caída de Roe v. Wade el año pasado se hicieron más grandes porque parece que no había planes de contingencia por si algo así llegara a pasar. ¡Nos hubieran preguntado a las feministas latinoamericanas! Les habríamos dicho, desde hace rato, que era indispensable garantizar a futuro el acceso a la mifepristona y el misoprostol, y que se debía educar a las personas sobre sus usos, para que no terminaran siendo estigmatizadas como “las pastillas satánicas que sirven para matar”. Ese discurso nacionalista de Estados Unidos, que los hace verse como el país más justo y progresista, el futuro utópico en el presente, deja muchos vacíos estratégicos incluso en los y las activistas mejor intencionadas, y esto se nota en el inmenso terreno que han ganado los grupos anti-derechos en menos de un año. Ojalá, entonces, que los grupos a favor de los derechos reproductivos puedan resistir y remontar, pues, aunque parece que cuando vemos a Estados Unidos estamos mirando al pasado, esto, sin duda, tendrá repercusiones en Latinoamérica en el futuro.
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