South Dakota women get abortion pills from other states

SIOUX FALLS, SD (Dakota News Now) – The border between Republican-led South Dakota and Democratic-controlled Minnesota has become a flashpoint in the national fight over abortion rights, with online doctor visits and mail order orders blurring state lines. sovereignty and access of law enforcement agencies.

On one side is South Dakota Gov. Kristi Noem, who presides over some of the strictest abortion laws in the country and has been a staunch opponent of abortion since 2000, when the main drug, mifepristone, was approved by the state. has become more popular. Food and Drug Administration. According to the Guttmacher Institute, a reproductive health organization, medication abortions currently account for 54% of abortions in the United States.

On the other side is Julie Amaon, medical director of Just the Pill, a Twin Cities telemedicine abortion provider that has helped 110 South Dakotans in 2022 with online abortion consultations and prescriptions. Patients cross the border for a phone consultation and get a tracking number for their medication, which they receive a few days later and then return to South Dakota to pick up the medication.

South Dakota women were seeking abortions in South Dakota even before the Supreme Court’s decision to overturn the landmark Roe v. Wade decision in the summer of 2022 and access to reproductive services in South Dakota due to state laws that make the process more difficult and, in practice, difficult. is closed Covid-19 pandemic.

Now that the Supreme Court has struck down the federal constitutional right to abortion, leaving it up to the states to determine legality and access. South Dakota had a “trigger law” that went into effect in 2005, making it a Class 6 felony for anyone who “prescribes to any pregnant woman, or prescribes or procures for any pregnant woman,” a Class 6 felony. takes, except to save the life of the mother. The offense is punishable by two years in prison, a $4,000 fine, or both.

Just the Pill started as a nonprofit in 2020, mirroring the telemedicine model of Aid Access, an overseas provider that saw an increase in requests for abortion pills when states banned abortions. Charging $350 per patient, Just Pill saw about 1,300 patients in 2021 and plans to increase that number to more than 3,000 in 2022, using online pharmacies such as American Mail Order of Michigan and Honeybee Health of California.

“It’s always been a skeleton — it’s always where you live that matters if you can access care,” Amaon said in an interview with News Watch. “So nothing much has changed for us. Even before Roe collapsed, we were having people travel across state lines for care.”

The organization offers services not only in Minnesota, but Wyoming, Montana and Colorado, allowing residents from eastern and western South Dakota and North Dakota to receive out-of-state care. Of the 110 South Dakota residents who used the Just Pill in 2022, 65 traveled across the border to Minnesota, 41 to Wyoming, three to Montana and one to Colorado.

South Dakota Attorney General Marty Jackley told News Watch that his office is monitoring the situation and expects South Dakota laws to be followed.

The state prohibits abortion unless there is a valid and reasonable medical judgment that the abortion is necessary to preserve the life of the pregnant woman. South Dakota law focuses on the person providing the abortion service, not the woman terminating her pregnancy.

Asked if someone who provides telemedical abortion services to South Dakota residents in another state could be prosecuted in South Dakota, Jackley said it could happen, but he hoped the situation would not to increase to this extent.

“South Dakota law expressly prohibits anyone from purchasing or distributing abortion-inducing drugs,” he said. “If you aid or abet or actively participate in a criminal act, our reach may extend beyond state borders. Obviously, we don’t want to do that, but we’ve made our position very clear.”

The Food and Drug Administration made rule changes in January 2023 that expanded the availability of abortion pills at more pharmacies, and the FDA no longer requires women to pick up pills in person, reversing a rule that began during the COVID-19 pandemic. , finished.

Noem and Jackley responded in a Jan. 24 letter to South Dakota pharmacists that “pharmacies, including chain drug stores, are prohibited from purchasing and distributing abortion-inducing drugs for the purpose of inducing abortion and are subject to criminal prosecution within South Dakota.” are drawn. Dakota law.”

Along with 19 state attorneys general, Jackley signed a petition to national drugstores CVS and Walgreens from Missouri Attorney General Andrew Bailey citing the Comstock Act of 1873, which the letter says prohibits the use of the mail to send or receive any drug that “is used” prohibits. or applied for an abortion.”

In January 2023, the Office of the Legal Counsel of the Biden Administration asked the US Postal Service to interpret the Comstock Act, which states that sending drugs through the mail is not a violation if the sender does not know whether drugs are being used. illegal, the interpretation that Missouri AG’s letter called “strange”.

A lawsuit before a federal judge in Texas that invokes the Comstock Act and challenges the FDA’s approval of mifepristone could have far-reaching implications for abortion, the prescription process, and the legality of the drugs themselves.

“They’ve relaxed the requirements over and over again,” Denise Harl, senior counsel for the anti-abortion group Alliance Defending Freedom, which filed the lawsuit, told NPR. “That’s why mifepristone is now being given to women who have never even seen a doctor.”

Noem and Jackley both cited safety concerns with medication abortions, saying that if something goes wrong, such as heavy bleeding or an infection, emergency medical care won’t be available if a woman takes the medication at home. Criminal charges against a person who helped procure the drugs could be “much more serious” than a Class 6 felony if the woman was harmed as a result of taking the drugs to end a pregnancy, Jackley said.

“These are very dangerous medical procedures,” Noem said on CBS’ “Face the Nation” in June 2022. “We don’t believe it should be available because it’s a dangerous situation for those individuals without medical supervision.”

The Missouri AG’s letter, signed by Jackley, raised the issue of forced abortions and also cited a 2015 study that found medication abortions “are 5.96 times more likely to cause a first-trimester abortion .” But Amaon pointed to a study published in the medical journal Lancet Regional Health in 2022 that found a 98 percent success rate in terminating pregnancies for women who accessed abortion pills through a telemedicine provider, and the same percentage of patients who said they are satisfied with the experience. .

The first pill, mifepristone, works by blocking the hormone progesterone, which the body needs to keep pregnancy going. This process causes the thickening of the uterus to stop and the embryo to separate. The second drug, misoprostol, which is taken 24 to 48 hours later, causes the uterus to contract and the cervix to dilate, which expels the embryo.

“Once FDA approved [mifepristone in 2000]we had a lot of good data from Europe 20 years ago and now we have tons of good data [from the United States]especially from telehealth during a pandemic,” Amaon said. “It’s a safe drug with less than 2 percent bleeding or infection concerns, and we have a 24-hour hotline to help patients if they have these very rare concerns. , let’s check.”

– This article was produced by Dakota News Watch, a nonprofit online journalism organization. SDNewsWatch.org.

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