Abortion Pills Over the Counter?

If pro-lifers don't act, this may soon be a reality

According to one analysis, 20% of all legal abortions in the first quarter of 2024 were done by telehealth.

The Dangers of Telehealth Abortion

In the first three months of 2024, there were about 19,700 telehealth abortions a month. If this number held for the entire year, that would mean there were 236,400 telehealth abortions in 2024.

The number is probably higher. More and more telehealth providers are springing up throughout the country. And these telehealth providers, protected by shield laws, are even mailing abortion pills into states where abortion is illegal.

In a telehealth abortion, the pregnant person meets with the abortionist either over Zoom or a similar platform, or over the phone. The abortionist could be many miles away. After a brief conversation, the abortionist mails the abortion pill to the pregnant person.

The person who is pregnant takes it. She never sees a doctor, never gets an exam, and never has an ultrasound.

If the consultation is done over the phone, the abortionist does not know whether someone else, like the baby's father, is standing there coaching her on what to say. With a consultation using a WebCam, someone could stand just out of view, making sure the pregnant person says exactly what he wants her to.

It is difficult to screen for coercion in a ten to fifteen-minute consultation.

Even worse is the fact that the woman has no exam or ultrasound. She is just asked to remember the date of her last menstrual cycle. If she's wrong, she could end up taking the abortion pill further along in her pregnancy than is safe.

Even worse, she could be the victim of an ectopic pregnancy, where the child implants and develops in the Fallopian tube. If undetected, the tube will rupture, causing massive internal bleeding and killing her.

Ectopic pregnancies aren't rare. In one study in the prestigious New England Journal of Medicine of women seeking abortion pills, 1.2% had an ectopic pregnancy.

This would mean that 12,320 women seeking an abortion a year have ectopic pregnancies.

The symptoms of an ectopic pregnancy, bleeding and cramping, mimic those of the abortion pill. This could cause a pregnant person not to seek help until it's too late.

An ultrasound is the only reliable way to detect an ectopic pregnancy. Without an ultrasound, a pregnant person has no way of knowing if she's one of those 12,320 women.

Even the inventor of the abortion pill, French scientist Etienne-Emile Baulieu, opposed giving it without providing an ultrasound first. In the pro-abortion book The Abortion Dilemma: Personal Views on a Public Issue (page 117) he said:

If ectopic pregnancy is not detected, the woman goes through a disaster, regardless of whether or not she uses RU-486 [the abortion pill], because it will rupture with heavy internal hemorrhaging…

This is why I insist that a woman should be medically examined if she wants an abortion of any kind, surgical or medical. Ectopic pregnancy presents a great risk.¹

Right now, abortion is available through telehealth. But things could get much worse soon.

Abortion Pills Over the Counter

In November of this year, the Journal of the American Medical Association published an editorial by two doctors encouraging the FDA to allow abortion pills over-the-counter.

This follows another editorial in the British Journal of Obstetrics and Gynecology encouraging the same thing.

Daniel Grossman, who, along with five other doctors, wrote these editorials, explained his reasoning in The Guardian:

[D]o the drugs used in medication abortion meet the criteria of the US Food and Drug Administration (FDA) for over-the-counter sale? The answer is a qualified yes…

[I]n the same way that women around the globe are getting contraceptives on their own, many are obtaining medication abortion over the counter at pharmacies. The limited data so far suggests women are doing this safely…

Women Would Buy The Abortion Pill Over the Counter

If abortion pills become over-the-counter, the demand is there.

Researchers conducting a recent study in the Journal of the American Medical Association polled a large cross-section of women (those assigned female at birth) and asked them if they favored making abortion pills available over the counter with no prescription necessary.

Over half of respondents, 55.2%, said they favored it, with 36% saying they strongly favored it, and 19.2% saying they somewhat favored it.

In addition, 42.5% said they would purchase abortion pills over the counter and use them. 25.7% said they definitely would, and 16.8% said they probably would.

Note that this survey was of all women, including those who were pro-life. This seems to mean that the vast majority of pro-choice women will buy abortion pills from a pharmacy over the counter without ever seeking a doctor.

Public demand for over-the-counter abortion pills is already here. Doctors in the most prestigious medical journals in the world are discussing it. These deeply influential journals are giving these doctors a platform.

I believe it is likely that we will see a major push by the medical community to sell abortion pills over the counter. The only thing standing in the way is the Department of Health and Human Services.

The Danger of Our Current Nominee

And who has just been nominated to head the Department of Health and Human Services, including the FDA? A pro-abortion politician.

If Robert F. Kennedy Jr. is confirmed as Secretary of Health and Human Services, he will be able to greatly, greatly influence whether abortion pills become over-the-counter.

He will also have the power to limit (or eliminate) telehealth abortions.

So what will Kennedy do?

First of all, what are Kennedy's views on abortion?

He is strongly pro-abortion.

In a video, he described his pro-abortion convictions. He says:

…I fought as hard as anybody in our country for bodily autonomy. I trust a woman's maternal instincts.

He believes in reducing the number of abortions, but "by choice and not by force." That is, he rejects laws restricting abortion and wants to lower the abortion rate in other ways. He believes any law protecting the preborn constitutes "force."

He supports access to the abortion pill and supports unlimited abortion in the first two trimesters.

In the video, Kennedy says:

I support the emerging consensus in this country. It's that abortion should be legal up until a certain number of weeks and restricted thereafter…

[A]bortion should be unrestricted up until a certain point. I believe that point should be when the baby is viable outside the womb, therefore, I would allow appropriate restrictions on abortion in the final months of pregnancy.

Note Kennedy's language. He doesn't say he would make abortion illegal in the "final months of pregnancy", only that he would allow "appropriate restrictions." What are the restrictions he considers appropriate?

Would he allow third-trimester abortions of disabled babies? Would he allow them for threats to the woman's "mental health," which we all know is a loophole that would permit any abortion?

This is all speculation. But what is not speculation is that Kennedy supports the abortion pill and is all for abortion in the first two trimesters.

His whole political career, he has voted in favor of abortion.

Mike Pence's organization, Advancing American Freedom, has been trying to warn the pro-life movement about what it would mean if a pro-abortion person like Kennedy controls the HHS. They write:

While RFK Jr. has made certain overtures to pro-life leaders that he would be mindful of their concerns at HHS, there is little reason for confidence at this time…

There are hundreds of decisions made every day at HHS that either lead our nation toward a respect for life or away from it—decisions about federal funding for Planned Parenthood, regulations on the abortion pill (currently accounting for three out of every five abortions), insurance coverage of abortion, and more.

And yet, many pro-life senators (foolishly, in my opinion) are supporting RFK and claiming he will support the pro-life cause. Senator Josh Hawley of Missouri, who supports RFK, stated:

[Kennedy] committed to me to reinstate President Trump's prolife policies at HHS. That includes reinstating the Mexico City policy & ending taxpayer funding for abortions domestically…

He pledged to reverse the Biden Admin's Section 1557 rule and also said all of his deputies at HHS would be prolife. He told me he believes there are far too many abortions in the US and that we cannot be the moral leader of the free world with abortion rates so high.

RFK also pledged to reinstate conscience protections for healthcare providers.

Note that Kennedy never said a word about the abortion pill. Not only is he not committed to rolling back telehealth, but he's said nothing indicating he would oppose making abortion pills available over the counter.

He says he will allow some pro-life things, but any other nominee who actually is pro-life would also do those things and more—and would oppose the abortion pill.

Also, several of Kennedy's promises are outside the purview of the Department of Health and Human Services. The Mexico City policy is determined by executive order, as it has been for the past five presidencies. Congress controls the allocation of tax dollars.

I can say that I won't do anything to prevent Disney/Marvel from releasing another Spider-Man movie, and I'm telling the truth as far as it goes. But how significant is that?

If abortion pills become available over the counter, and all a woman has to do is drive to her local pharmacy to get them, the abortion rate will rise dramatically. Already, at least 236,400 abortions are done through telehealth every year.

Each one represents a baby killed and a pregnant person put at risk.

We need a head of HHS who will stop this—who will direct the FDA to restrict telehealth abortions—something the FDA would have the power to do, but cannot do, without the approval of the head of HHS.

We need someone who will fight against the push to make abortion pills available in every pharmacy with no prescription.

We can't trust a career politician, who has affirmed his pro-abortion beliefs time and time again and voted pro-abortion for decades, to protect the preborn.

Kennedy supports the abortion pill and wants it to be widely available. We can't trust him to protect preborn babies and their mothers.

Please Take Action

We need to defeat Kennedy's nomination. The lives of hundreds of thousands of preborn babies, and possibly those of thousands of women, are at stake. Whatever else you may think of Kennedy and his positions on other issues, protecting the preborn must be the number one priority.

Please write to your senators and your representatives with the following message:

"I oppose Robert F Kennedy Junior's nomination as the Secretary of Health and Human Services. Please vote no on his nomination."

If you want to, you can then explain why and express how important it is to protect both women and their preborn babies from the abortion pill.

Please join me in doing this today. The hearing is tomorrow. We have little time.

To prevent the deaths of hundreds of thousands of babies, both now and in the future, we must act before the abortion pill becomes even more widely available.

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Permission is given to pro-life organizations to repost or reprint this article, but please include the following:

This article originally appeared on Sarah Terzo’s Substack. You can read more of her articles here.

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1. Miriam Claire The Abortion Dilemma: Personal Views on a Public Issue (Xlibris Corporation, 2013) 117