The U.S. Supreme Court is expected to rule on a Mississippi abortion law next year. That law bans abortion after 15 weeks. A majority of Supreme Court justices signaled during oral arguments they might be willing to restrict or overturn Roe v. Wade and allow each state to determine the legality of abortion.
Since those arguments, the Food and Drug Administration made it easier for women to get abortion pills. Now both pro- and anti-abortion advocates are responding to the FDA’s ruling and the possibility that Roe v. Wade is nullified. In North Carolina, Planned Parenthood is already preparing for a world in which Roe v. Wade is struck down.
“We may have a bunch of patients flooding into one of our border clinics,” said Dr. Katherine Farris, the top doctor for Planned Parenthood South Atlantic. She thinks patients will come to North Carolina because 21 states — including South Carolina, Tennessee and Georgia — have laws to immediately ban or restrict abortion if Roe v. Wade is overturned.
“That may start creating difficulty for our local patients to get appointments there, so they might start traveling to mid-state clinics because they can get an earlier appointment,” Farris said.
Earlier this year, Texas passed a law that bans abortion after six weeks, and clinics in bordering states have been overwhelmed. Farris says a few Texans even came to Planned Parenthood clinics in North Carolina. Now, she’s preparing for more to come if the Supreme Court rules that states will decide if abortion is legal.
“We’re making sure that we have support staff, nursing staff, physicians,” Farris said. “We’re making sure that our buildings can handle more. We’re making sure that our call center and our online scheduling system can handle more requests.”
Perhaps because it was anticipating a Supreme Court ruling, the FDA changed its rules to make it easier for women in the first 10 weeks of pregnancy to get a prescription for abortion-inducing drugs. When the pandemic started, it temporarily allowed women to get those pills in a telehealth visit instead of having to see a doctor in person. On Dec. 16, the agency made the change permanent. That will change things in many states.
But not everywhere.
“Unfortunately, no it’s not going to change anything in North Carolina,” Farris said. “We have to hand the patient the pill and watch them swallow it."
Like 18 other states, North Carolina currently requires an in-person visit to a doctor. But, there is a loophole. Kirsten Moore of the advocacy group Expanding Medication Abortion Access says women in North Carolina can drive to states like Virginia that don’t require an in-person visit. They can have a telemedicine appointment from anywhere in the state and receive pills by mail at a Virginia address.
“What they really said was we're going to take away the in-clinic distribution requirement,” Moore said, “and so mail order is clearly on the table.”
And, she said, it opens the door to some creative solutions.
“There’s a group in Minnesota called Just the Pill, and they are a mobile van," Moore said, “so they go around to different corners of the state, you know, where their clinics aren’t and meet up with folks there.”
Asked if a van could park right at the border of North Carolina and Virginia, Moore said, “In theory, yes.”
That doesn’t surprise Carol Tobias, the president of National Right to Life, which opposes abortion. Antiabortion pregnancy centers have already gone mobile. They drive to different cities, offering free ultrasounds.
“That ultrasound convinces a lot of women, 'Oh that’s my baby; I can’t kill that thing,” Tobias said. “So it doesn’t surprise me that the abortion industry would be basically doing the same thing."
But Tobias says the FDA’s decision and the possibility that Roe will be overturned, mean the battle to restrict abortion will increasingly move to the states.
“Actually bringing it home to the state may get more of the local voters involved,” Tobias said.
Politically divided states like North Carolina can expect newfound activism. But changing the law in North Carolina could be tough, Tobias said, because voters here are closely divided. They could elect an antiabortion supermajority legislature that bans abortion, only to see the ban undone if control of the legislature flips back in a following election.
“There may be states where the law does kind of bounce around for a little bit," Tobias said. "Things are going to be very fluid for a few years, but we will keep working even in those tough states.”
But first, the Supreme Court has to rule in the Mississippi abortion case.
