Texas Restrictions and the Evolving Landscape of Medication Abortion Access
As the state of Texas reeled from a new law banning nearly all abortion, a separate bill that would restrict the use of medication abortion in the state is poised to become law. The bill was finalized hours before a law banning nearly all abortions in the state went into effect. On September 17, Texas Gov. Greg Abbott signed this bill into law.
New Restrictions Under Texas SB 4
The legislation, known as SB 4, would shorten the window for a pregnant person to have a medication abortion. Currently, a person who is up to 10 weeks pregnant can have a medication abortion in Texas; the bill would ban the use of abortion-inducing medication for anyone who is more than seven weeks pregnant. Most people do not know they are pregnant at seven weeks of pregnancy, a similar point highlighted by medical providers who opposed the six-week abortion ban that went into effect in Texas.
Kristen Gonzales, executive director of the Democratic-led Texas Women’s Health Caucus, noted the timing of the bill and the Texas law. “It’s two templates. It’s two separate avenues and vehicles to get to the Supreme Court and overturn Roe,” she told The 19th, referencing the 1973 Supreme Court decision that guarantees the right to an abortion.
Legal Penalties and Enforcement
The medication abortion bill out of Texas also states that someone who “intentionally, knowingly, or recklessly” violates the law commits a “state jail felony” offense. This legal framework includes the following consequences:
- The charge carries a potential jail sentence of between 180 days and up to two years.
- A person could be subject to fines of up to $10,000.
- It could also lead to disciplinary action for medical providers.
Rep. Ann Johnson, a Democrat, called the bill “devastating” for reproductive rights in the state. “The legislature, the body, has inserted themselves into every OB-GYN’s practice,” Johnson told The 19th.
The Role of Medication Abortion
Medication abortion — which typically involves taking two pills, mifepristone and misoprostol — is widely used. About 60 percent of people who get abortions by 10 weeks choose medication abortions, according to the Guttmacher Institute. The U.S. Food and Drug Administration first approved medication abortion in 2000. In 2016, the agency released additional guidelines that medication abortions are safe for use up to the first 70 days of pregnancy.
Comparison of Medication Abortion Access and Regulations
| Entity / Jurisdiction | Gestation Limit | Access Framework |
|---|---|---|
| FDA Guidelines | Up to 10 weeks (70 days) | Allows pharmacy pickup with prescription |
| Texas (SB 4) | Up to 7 weeks | State jail felony for violations; no mailing |
| Colorado | Up to 10 weeks | Telehealth appointments and mailing allowed |
Federal FDA Decisions and State-Level Expansion
The FDA on Jan. 3 issued a decision that allows the abortion drug mifepristone to be picked up at a pharmacy if the patient has a prescription, eliminating a previous requirement that the drug be given directly from a health care provider. Mifepristone is approved for a medication abortion up to 10 weeks gestation when taken with a second drug, misoprostol. Dr. Kristina Tocce, medical director at Planned Parenthood of the Rocky Mountains, said the FDA’s decision is a “really big breakthrough” to increase access and normalize medication abortions across the country.
Colorado has already allowed medication abortions through telehealth appointments and mailing abortion medication to patients, which Tocce said was particularly helpful during the peak of the COVID-19 pandemic. She said providing medication abortions through telemedicine has been thoroughly studied and published, showing it is a safe and effective means of abortion care. However, the fact that pharmacies need to opt in and go through certification processes to have the drug on hand could make it more challenging, since not all local pharmacies will do this.