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    What Is Mifepristone and How Is It Used?

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    Mifepristone is one of two drugs used in a medication abortion. It is combined with a second drug, misoprostol, to end a pregnancy.Mifepristone blocks a hormone called progesterone that is necessary for a pregnancy to continue. Misoprostol brings on uterine contractions, causing the body to expel the pregnancy as in a miscarriage.In U.S. studies, the combination of these pills causes a complete abortion in more than 99 percent of patients, and is as safe as an abortion procedure administered by a doctor in a clinic. A variety of research has found that medication abortion has low rates of adverse events, and a study published in The Lancet in 2022 found that patients are generally satisfied with it.Growing evidence from outside the United States suggests that abortion pills are safe even among women who do not have a doctor to advise them.While the only F.D.A.-approved method in the United States is to use both pills, misoprostol can also end a pregnancy when used alone, and its availability was not affected by the ruling on mifepristone. Misoprostol — which is around 80 percent effective on its own, although it sometimes has to be taken more than once — is also prescribed to treat ulcers, and is available over the counter in many countries, including Mexico.The Food and Drug Administration has approved medication abortion for up to 10 weeks of pregnancy, while World Health Organization guidelines say it can be used up to 12 weeks at home and after 12 weeks in a medical office. The vast majority of abortions occur before 12 weeks.More than half of people who get legal abortions in the United States — and three-quarters in Europe — use medication abortion. During the Covid-19 pandemic, it became more common because patients wanted to avoid going to clinics in person, and a change in federal regulation made it easier for them to get prescriptions via telemedicine and to fill them in a pharmacy.Since nearly two dozen states banned or restricted abortion following the Supreme Court’s Dobbs ruling, some women in those states have turned to mail-order abortion pills instead. Clinicians in several states have mailed pills into states with bans, protected by so-called shield laws. And foreign nonprofit groups and entrepreneurs have shipped some women pills from overseas.The court’s decision does not influence the availability of the overseas pills, which operate outside the bounds of the legal U.S. health care system. More

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      Abortion Pills May Become Controlled Substances in Louisiana

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      A bill that is expected to pass would impose prison time and thousands of dollars in fines on people possessing the pills without a prescription.Louisiana could become the first state to classify abortion pills as dangerous controlled substances, making possession of the pills without a prescription a crime subject to jail time and fines.A bill that would designate the abortion pills mifepristone and misoprostol as Schedule IV drugs — a category of medicines with the potential for abuse or dependence — passed the state’s Republican-controlled House of Representatives on Tuesday by a vote of 63 to 29. Should the Senate follow suit, Gov. Jeff Landry, a Republican and a vocal opponent of abortion, is likely to sign the legislation into law.The measure — which would put abortion pills in the same category as Xanax, Ambien and Valium — contradicts the way the federal government classifies mifepristone and misoprostol. The federal Food and Drug Administration does not consider abortion pills to be drugs with the potential for dependence or abuse, and decades of medical studies have found both to be overwhelmingly safe.Under the legislation, possession of mifepristone or misoprostol without a prescription in Louisiana could be punishable with thousands of dollars in fines and up to five years in jail. Pregnant women would be exempt from those penalties; most abortion bans and restrictions do not punish pregnant women because most voters oppose doing so.“These drugs are increasingly being shipped from outside our state and country to women and girls in our state,” Attorney General Liz Murrill, a Republican, said in a statement on social media. “This legislation does NOT prohibit these drugs from being prescribed and dispensed in Louisiana for legal and legitimate reasons.”Louisiana already bans most abortions, except when women’s lives or health are in danger or fetuses have some fatal conditions. As a result, abortion rights advocates and legal scholars said that in practice, the measure might not prevent many abortions among Louisiana women. Since the state imposed its strict abortion ban after the Supreme Court overturned Roe v. Wade, many patients have traveled to states where abortion is legal or have obtained pills under shield laws from doctors or nurses in other states who prescribe and mail the medications to Louisiana. Such circumstances would not be affected by the new bill, experts say.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Use of Abortion Pills Has Risen Significantly Post Roe, Research Shows

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      The NewsOn the eve of oral arguments in a Supreme Court case that could affect future access to abortion pills, new research shows the fast-growing use of medication abortion nationally and the many ways women have obtained access to the method since Roe v. Wade was overturned in June 2022.The DetailsPackages of abortion pills being prepared to send to patients.Sophie Park for The New York TimesA study, published on Monday in the medical journal JAMA, found that the number of abortions using pills obtained outside the formal health system soared in the six months after the national right to abortion was overturned. Another report, published last week by the Guttmacher Institute, a research organization that supports abortion rights, found that medication abortions now account for nearly two-thirds of all abortions provided by the country’s formal health system, which includes clinics and telemedicine abortion services.The JAMA study evaluated data from overseas telemedicine organizations, online vendors and networks of community volunteers that generally obtain pills from outside the United States. Before Roe was overturned, these avenues provided abortion pills to about 1,400 women per month, but in the six months afterward, the average jumped to 5,900 per month, the study reported.Overall, the study found that while abortions in the formal health care system declined by about 32,000 from July through December 2022, much of that decline was offset by about 26,000 medication abortions from pills provided by sources outside the formal health system.“We see what we see elsewhere in the world in the U.S. — that when anti-abortion laws go into effect, oftentimes outside of the formal health care setting is where people look, and the locus of care gets shifted,” said Dr. Abigail Aiken, who is an associate professor at the University of Texas at Austin and the lead author of the JAMA study. The co-authors were a statistics professor at the university; the founder of Aid Access, a Europe-based organization that helped pioneer telemedicine abortion in the United States; and a leader of Plan C, an organization that provides consumers with information about medication abortion. Before publication, the study went through the rigorous peer review process required by a major medical journal.The telemedicine organizations in the study evaluated prospective patients using written medical questionnaires, issued prescriptions from doctors who were typically in Europe and had pills shipped from pharmacies in India, generally charging about $100. Community networks typically asked for some information about the pregnancy and either delivered or mailed pills with detailed instructions, often for free.Online vendors, which supplied a small percentage of the pills in the study and charged between $39 and $470, generally did not ask for women’s medical history and shipped the pills with the least detailed instructions. Vendors in the study were vetted by Plan C and found to be providing genuine abortion pills, Dr. Aiken said.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Biden Campaign Sharpens Its Post-Roe Message: Abortion Is About Freedom

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      In events next week, the president and vice president will argue that abortion access is crucial to personal freedoms, and warn of what is at stake if Donald J. Trump is re-elected.President Biden and Vice President Kamala Harris will headline events next week centered around protecting abortion rights, throwing more heft behind an issue that has galvanized voters in the 18 months since the Supreme Court struck down Roe v. Wade.On Monday, Ms. Harris will visit Wisconsin to begin a national tour focused on preserving access to reproductive health care as Republicans call for more restrictions. Then on Tuesday, she will join Mr. Biden at a rally for abortion rights in Virginia, where Democrats recently took control of the state legislature and have proposed to enshrine abortion protections in the state constitution.Ms. Harris offered a preview of the administration’s election-year messaging to Americans when she visited “The View,” the most popular daytime talk show in the country.“We are not asking anyone to abandon their personal beliefs,” she said during an appearance on Wednesday, adding that “the government should not be telling women what to do with their bodies.”The idea that preserving access to abortion is tantamount to preserving personal freedoms has been embraced by Biden administration officials, lawmakers and activists who hope it will energize a flagging base and draw independent voters into the fold. They also want to contrast the administration’s policies with the political peril that the Republican Party faces by embracing hard-line measures.“I start from the place that most Americans believe that women should have the freedom to make their own decisions about health care, including abortion, without government interference,” Senator Tina Smith, Democrat of Minnesota, who traveled to the Iowa caucuses as a surrogate for Mr. Biden, said in an interview. (About 69 percent of voters think abortion should be legal in the first three months of pregnancy, according to a Gallup poll last year.)We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber?  More

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      Biden Has Something He’d Like to Tell You

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      Gail Collins: Well, Bret it looks like Joe Biden will be announcing his re-election bid this week.Bret Stephens: Proving my prediction from last week dead wrong.Gail: I know you disagree with him on many issues, particularly relating to the economy.But given the likely Republican presidential candidates, any chance you’ll actually be able to avoid voting for him?Bret: Arghhhhhhhhhhhhhhhhhhhh. Probably not.It says something about the state of the Republican Party that the two current front-runners — let’s call them Don Caligula and Ron Torquemada — are nonstarters for a voter like me. And I’m a guy who believes in low taxes, a strong military, broken-windows policing, entitlement reform, a border wall and school choice. That’s the Nikki Haley side of the party — now reduced to single digits of the G.O.P. base.Gail: Sorry about Haley’s failure to take flight. I know you were rooting for her.Bret: Well, I’m still holding out hopes — increasingly faint though they are.On the other hand, I really, really wish Biden weren’t running, for all the reasons we’ve discussed. He’s just not a convincing candidate. And for all the talk of Donald Trump being unelectable in the general election, we’ve heard those predictions before. All it might take is a recession — which is probably coming — for swing voters to care a lot less about abortion rights in Florida or the Jan. 6 attempted coup than they will about jobs and the economy.Aren’t you a wee bit nervous?Gail: Nervous? Just because we’re talking about a presidential election in which one of the two major parties nominates either a loony ex-president drowning in legal problems or a deeply unappealing, extremely right-wing enemy of Disney World?Bret: It’s a game of Russian roulette, played with three bullets in the six-shooter.Gail: As for the Democrats, I’ve already told you I think 80 is too old to be planning another presidential campaign. And Biden has been around so long, it’s hard to make anything he talks about doing sound exciting.But what you’re worried about — a popular reaction against a bad economy — would be a problem for anybody in the party.Bret: True, but Amy Klobuchar or Gretchen Whitmer or some other plausible nominee can’t be accused of owning the economy the way Biden can.Gail: Biden certainly has negatives. But Trump has a lot more — all way more dire. And even if Ron DeSantis weren’t a terrible campaigner, I can’t see him winning over the electorate with his past plans to torpedo Medicare.Bret: You’re probably right about DeSantis, who seems too obsessed trying to slay Mickey and Minnie to appeal to regular voters outside Florida. As for Trump, this is a strange thing to say, but: The guy has demon energy. You know the movie “Cocaine Bear”? Trump is “Diet Coke Cujo,” if you get my Stephen King reference.Gail: Yeah, he’s never boring. Sigh. But we’ll see how energetic he looks when he’s defending himself for falsifying business records, and all the other investigations that await him.Alas, we’ll be conversing about this for a very long time, Bret. On the more immediate horizon, there’s the Fox-Dominion settlement. Tell me your thoughts.Bret: I am sorry we didn’t get to watch Tucker Carlson, Laura Ingraham and the rest of the gang of cynical, lying, repulsive and wretched propagandists squirm under oath in courtroom testimony. Would have paid money just to see that.But, realistically speaking, it’s probably the best possible result. $787.5 million is rich vindication for Dominion. It’s the closest Fox will ever come to admitting guilt. And it spares us the possibility of an appeals process that might have ended with the Supreme Court revisiting the strict libel standards of Times v. Sullivan and potentially limiting the freedom of the press.Gail: Yeah, for all my daydreams about Fox celebrities having to get up in court and apologize to the nation, in the real world this is probably the best you can get while protecting all the rights of a free press.Bret: The good news, Gail, is that Dominion still has suits pending against Rudy Giuliani, Sidney Powell, Newsmax and Mike Lindell, the MyPillow Guy, along with a few others. And there’s also the pending Smartmatic suit against Fox, too.Having fun, making bank and doing good at the expense of creeps has got to be the greatest joy adults can have in a boardroom.But we mentioned the Supreme Court. Any thoughts on the mifepristone ruling, staying the lower court’s ban on the abortion pill? I’m relieved, of course, that the court will allow the pill to remain on the market.Gail: Well, this is the nice thing about a democracy. You have the powers that be suddenly realizing the public is totally not on their side. So they fudge a little, dodge a little and quietly backtrack.Bret: It’ll be some irony if Republicans come to rue last year’s Dobbs decision for making them unelectable in all but the reddest parts of the country — and Democrats come to celebrate it for helping them cement a long-term majority that eventually changes the composition of the court so that abortion rights are restored.Gail: But we’re still a long way from living in a country where every woman has the right to control her own body when it comes to reproduction issues.Bret: As the dissents from Clarence Thomas and Samuel Alito in the mifepristone ruling make clear ….Gail: I’ve always wanted to see state lawmakers from both sides get together on a package of reforms that would couple abortion rights with easily available, easily affordable health and counseling services for poor pregnant women.Along, of course, with high quality child care for low-income working mothers. Ahem.Bret: Gail, would it shock you to know that I don’t disagree with anything you just said? Of course, child care won’t solve the root of so many of our problems, which is the near-destruction of stable two-parent families in too many poor households. But that’s a disaster whose cure lies beyond a government’s ability to solve.Gail: Wow — government support for high-quality early education? I think I’m hearing a major change of heart. If so, gonna buy a very nice bottle of wine for dinner tonight and drink a toast to you.Bret: I tend to soften in your presence.Gail: Awww. Well, go on — back to the issues of the day.Bret: Speaking of disasters, your thoughts on Biden’s E.P.A. rule controlling emissions from power plants?Gail: A worthy effort to protect future generations from environmental disaster, and of course the Republicans hate it.Bret: There should be a better way of saving the planet than by using administrative means to impose high costs on industry that will inevitably be passed along to consumers in the form of higher energy prices — which also hit poorer people harder — while setting wildly unrealistic target dates for an energy transition.Notice that I’m saying this and I still will probably have no choice but to vote for Biden. Unbelievable.Gail: Our colleague Jim Tankersley wrote a great analysis about the ongoing crisis over raising the debt limit, which has got to get done this spring. And how more than half of the Republicans’ 320-page version of a debt limit bill is actually about removing clean energy restrictions.Bret: I’d need to see the fine print before making a judgment, but a lot of what passes for “clean energy,” like biofuels, is really a dirty-energy, big government, big business boondoggle. As for the debt limit, it wouldn’t be a bad thing if Biden showed any willingness to meet Republicans halfway on spending cuts and work requirements for able-bodied adults taking federal subsidies.Gail: Bret, the debt limit is — something responsible people take care of without creating a political crisis with demands they’ll never achieve.But hey, that’s a mean way to end our talk. You’re always great about telling me about something new you’ve just read. Go ahead.Bret: Gail, I have to recommend Katie Hafner’s smart and humane obituary on Richard Riordan, the last Republican mayor of Los Angeles and a man who brought calm good sense to a city reeling from riots and racial strife. Riordan was a warts-and-all kind of guy, who cracked some dumb jokes that would have probably been politically fatal in our cancel-culture age. But he also brought common sense and a strong work ethic to his job and embodied a Republican pragmatism that we could sorely use today. He was the last of nine children born to an Irish Catholic family — California is better because his parents were persistent.The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram. More

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      Where the Likely 2024 Presidential Contenders Stand on Abortion

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      Not quite a year after the Supreme Court overturned Roe v. Wade, abortion continues to be one of the main issues shaping American politics.Abortion is not fading as a driving issue in America, coming up again and again everywhere policy is decided: in legislatures, courts, the Oval Office and voting booths.An 11-point liberal victory in a pivotal Wisconsin Supreme Court race last week was fueled by the issue. Days later, a Texas judge invalidated the Food and Drug Administration’s 23-year-old approval of the abortion drug mifepristone (late Wednesday, an appeals court partly stayed the ruling but imposed some restrictions). And Florida, under Gov. Ron DeSantis, a likely Republican presidential candidate, is poised to ban abortion after six weeks’ gestation.The fallout from the Supreme Court’s revocation of a constitutional right to abortion last year looks poised to be a major issue in the upcoming presidential race. So where do the likely candidates stand?Here is what some of the most prominent contenders, declared and likely, have said and done:Anti-abortion protesters rallying in Indiana last July while lawmakers there debated an abortion ban during a special session.Kaiti Sullivan for The New York TimesPresident BidenPresident Biden condemned the ruling invalidating the approval of mifepristone, which his administration is appealing, and called it “another unprecedented step in taking away basic freedoms from women and putting their health at risk.”Mr. Biden has a complicated history with abortion; before his 2020 presidential campaign, he supported restrictions, including the Hyde Amendment, which prohibits federal funding for most abortions. But he has since spoken more forcefully in defense of unfettered access, including endorsing congressional codification of the rights Roe v. Wade used to protect.White House officials have said he is not willing to disregard the mifepristone ruling, as some abortion-rights activists have urged.Mr. Biden has said he is planning to run in 2024, but has not formally declared his candidacy.Donald J. TrumpMore than perhaps any other Republican, former President Donald J. Trump is responsible for the current state of abortion access: He appointed three of the six Supreme Court justices who overturned Roe v. Wade and the district judge who invalidated the approval of mifepristone. But lately, he has been loath to talk about it.Last year, Mr. Trump privately expressed concern that the ruling overturning Roe would hurt Republicans — and it did, both in the midterms and in the Wisconsin Supreme Court election.If elected again, he would be under tremendous pressure from the social conservatives who have fueled the Republican Party for decades — and who helped elect him in 2016 — to support a national ban. He has not said whether he would do so.Ron DeSantisGov. Ron DeSantis of Florida, whom polls show as the top potential Republican competitor to Mr. Trump, is pushing forward with the Florida Legislature to ban most abortions after six weeks. The bill passed on Thursday and was sent to Mr. DeSantis’s desk. Polls show that most Americans, including Floridians, oppose six-week bans.It is a more aggressive posture than he took last year, when Florida enacted a ban after 15 weeks and Mr. DeSantis — facing re-election in November — did not commit to going further. He made his move after winning re-election by a sweeping margin.Nikki HaleyAt a campaign event in Iowa this week, Nikki Haley, a former governor of South Carolina and former United Nations ambassador, gestured away from anti-abortion absolutism — saying that she did not “want unelected judges deciding something this personal.”But her comments were muddled: She said she wanted to leave the issue to the states, but at the same time suggested that she would be open to a federal ban if she thought there was momentum for one.“This is about saving as many babies as we can,” she said, while adding that she did not want to play the “game” of specifying when in pregnancy she believed abortion should be allowed.Asa HutchinsonSince starting his presidential campaign this month, former Gov. Asa Hutchinson of Arkansas has said only that he is “proud to stand squarely on my pro-life position” when it comes to abortion.He has not detailed what, if any, federal legislation he would support.Last year, Mr. Hutchinson criticized the lack of an exception for rape and incest in an Arkansas abortion ban he had signed. When he signed it, he said that he wanted the exception but legislators didn’t, and that he accepted their judgment as the will of voters — though a poll last year found that more than 70 percent of Arkansans supported such an exception.Mike PenceA staunch social conservative, former Vice President Mike Pence has been more open than most Republicans about continuing to advertise his opposition to abortion.“Life won again today,” he said in a statement on the mifepristone ruling. “When it approved chemical abortions on demand, the F.D.A. acted carelessly and with blatant disregard for human life.” Last year, Mr. Pence said anti-abortion activists “must not rest” until abortion was outlawed nationwide. Mr. Pence is considering a 2024 run, but has not formally joined the race.Tim ScottSenator Tim Scott of South Carolina repeatedly dodged questions about whether he supported federal restrictions on abortion in the days after announcing a presidential exploratory committee this week.Asked in an interview with CBS News whether he supported a 15-week ban, he called himself “100 percent pro-life.” When the interviewer suggested that his stance indicated he would support a 15-week ban, he replied, “That’s not what I said.”On Thursday, he told WMUR, a New Hampshire news station, that he would support a 20-week ban, but still did not say whether he would back something stricter. More

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      In Iowa, Kamala Harris Says Republicans Won’t Stop at Abortion

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      “If politicians start using the court to undo doctors’ decisions, imagine where that can lead,” Ms. Harris said at a discussion on abortion with local lawmakers and medical officials.DES MOINES — Vice President Kamala Harris said on Thursday that a lawsuit seeking to overturn federal approval of a widely used abortion pill amounted to an attack on “our public health system as a whole.”During her first trip to Iowa as vice president, Ms. Harris portrayed Republican attempts to impose a nationwide ban on abortion as immoral and extreme.“If politicians start using the court to undo doctors’ decisions, imagine where that can lead,” Ms. Harris said as a judge in Texas considered whether he would issue a preliminary injunction that could take the pill, mifepristone, off the market.Ms. Harris has taken a lead role on abortion as President Biden prepares to announce an expected run for re-election. Without the votes in Congress to enshrine abortion protections into law, the White House hopes Ms. Harris can help sustain the sort of anger that motivated Democratic voters during the midterm elections.In her appearance Thursday at Grand View University, Ms. Harris framed the abortion issue as part of a broader struggle for health care and privacy, a strategy aimed at galvanizing the broadest coalition of voters.“This is not only about reproductive health,” Ms. Harris said, adding that overturning F.D.A. approval for abortion medication could set a dangerous precedent, potentially affecting the availability of other medications.The last-minute trip to Iowa, planned by the vice president’s team only in the past few days, is part of a push by Ms. Harris to get out into the country more to overcome an impression from allies and critics alike that she has not forged a definitive role in the administration.Top Republicans have flocked to Iowa in recent weeks in anticipation of the 2024 Iowa caucuses, including former President Donald J. Trump; former Vice President Mike Pence; Nikki Haley, the former United Nations ambassador; Gov. Ron DeSantis of Florida and Senator Tim Scott of South Carolina.Democrats have overhauled their primary calendar, replacing Iowa with South Carolina as the party’s first nominating contest. But the rush of Republicans to Iowa presented an opportunity for Ms. Harris to call attention to restrictions that could be imposed by Republican-led legislatures.“We need to show the difference that while Republicans are taking health care rights away from them, we in the Democratic Party are saying that is not acceptable,” said Elizabeth Naftali, a deputy finance chair of the Democratic National Committee.Ms. Naftali said that Democrats could not allow a “steamroll by Republicans” just because the primary calendar had changed.Most abortions are now banned in more than a dozen states following the Supreme Court’s decision to overturn Roe v. Wade last year. While Iowa has not banned abortion, it is one of many states the administration fears could soon enact more severe abortion restrictions.Last year, the Iowa Supreme Court found that there was no right to an abortion under the state’s constitution. A ban on the procedure after six weeks of pregnancy has been blocked by a state judge since 2019 but Gov. Kim Reynolds, a Republican, has appealed the decision to the higher court. The state currently bans abortion after 20 weeks.Most Iowans — 61 percent — believe abortion should be legal in all or most cases, according to a Des Moines Register/Mediacom poll last fall. Thirty-three percent say it should be illegal in most or all cases, and 6 percent are not sure.“We have just seen a lot of panic and fear among patients who are worried,” said Mazie Stilwell, the director of public affairs for Planned Parenthood Advocates of Iowa.White House officials acknowledged that there was only so much that they could do to protect abortion access without Congress, but many abortion advocates are calling for policies that would protect both medical officials providing abortions and those seeking them.“What I know feels frustrating for me and many organizers on the ground is we keep having meetings but there’s not any action,” said Renee Bracey Sherman, the founder and executive director of the reproductive rights advocacy group We Testify.No major policy announcements came on Thursday. But Ms. Harris described those pushing for abortion restrictions as “extremist so-called leaders who purport and profess to hail themselves as a beacon of freedom and opportunity.”Stefanie Brown James, a co-founder of the Collective PAC, an organization dedicated to electing African American officials, said such blunt messaging would be imperative for both Ms. Harris and Mr. Biden in the months ahead.“In the event Kamala Harris continues to be his second in command, it’s important for her now to be out having conversations as much as it is for him to be,” Ms. James said. “This issue is not going away anytime soon.” More