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The following is presented as part of The Columbian’s Opinion content, which offers a point of view in order to provoke thought and debate of civic issues. Opinions represent the viewpoint of the author. Unsigned editorials represent the consensus opinion of The Columbian’s editorial board, which operates independently of the news department.
News / Opinion / Columns

Ziegler: Antiabortion activists target pills

By Mary Ziegler
Published: January 13, 2025, 6:01am

The state of Texas filed a major lawsuit on Dec. 12 against a New York doctor who mailed abortion pills to a Collin County, Texas, woman, arguing that the doctor was practicing medicine without a Texas license and violating the state’s abortion ban. The suit raises messy legal questions about whether one state can haul a doctor abiding by the law in another state into its courts, or enforce a judgment if it wins. More than that, however, the suit is a window into the next battlefield over abortion rights — and how abortion pills and telemedicine are reshaping the politics of abortion in America.

The antiabortion movement’s endgame is establishing fetal personhood — the idea that life and constitutional rights begin at the moment sperm fertilizes an egg. But with blue states and many red states reaffirming a right to abortion, fetal personhood doesn’t seem like it’s going to come to pass anytime soon. In the meantime, abortion opponents have set their sights on shutting down access to abortion pills — mifepristone and misoprostol.

Here’s why: Medication abortion, also called chemical abortion, has made it difficult to enforce abortion bans in the states where they exist — indeed, even with Roe v. Wade reversed, studies show an increase in the number of abortions performed annually in the U.S. Abortion pills also make it harder to frighten doctors and harder to stigmatize the termination of pregnancy.

The Texas lawsuit is part of a much broader antiabortion strategy that will unfold in the new year. Besides targeting telemedicine and pills, antiabortion groups plan to pursue anyone who aids or abets abortion — for example, internet service providers that allow websites to provide information about abortion pills and where to get them. Other proposals copy a Louisiana law that designates safe and effective drugs used in abortion as “controlled substances.”

In addition to these maneuvers, look for abortion opponents to lobby the Trump administration to reinterpret the Comstock Act, a 19th-century obscenity law, to make it illegal to send anything used in abortions by mail. That could create the equivalent of a nationwide ban, which Congress so far won’t legislate and voters don’t want.

The Supreme Court decision overturning Roe has done nothing to end abortion battles; instead, it has given them new life. Fights over telemedicine consultations, mail-order access to abortion pills and FDA safety rules could make abortion bans far more effective, reshape the procedure in states that protect abortion rights and expand the power of one state to dictate policy in another.

Most important: If abortion opponents succeed in making abortion pills inaccessible, the stigma surrounding abortion may well increase, and access to the procedure decrease. That’s why antiabortion groups have been relentless in their pursuit of pills. Nothing less than Americans’ view of abortion itself is on the line.


Mary Ziegler is a law professor at the University of California Davis. Her latest book, “Personhood: The New Civil War Over Reproduction,” is scheduled for publication in April.

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