After training as a family medicine physician across the country, I returned to my home state of Texas in 2015 because I believed that Texans need and deserve access to abortion care amid what were, at the time, some of the most extreme attacks on reproductive rights in the United States. More than six years later, the situation is much worse. A Supreme Court with three Trump appointees has empowered Texas politicians to ban abortion before many people even know they're pregnant. Under the new law known as S.B. 8 — which went into effect statewide on September 1 — private citizens are encouraged to sue doctors like me to collect cash bounties.
Still, I am fighting for my patients — my fellow Texans and neighbors — to ensure that neither the State of Texas nor the Supreme Court has the power to force people to stay pregnant against their will. As we fight this latest battle, I believe we must go beyond playing defense, and work to advance and expand access to abortion, especially medication abortion care.
Of course, abortion providers are used to playing defense. Despite our expertise, compassion, and commitment to the people we serve, we are constantly under attack. Our expertise is questioned by politicians with no medical training who continue to push forward legislation that is not rooted in science or medical evidence. We are forced to give our patients medically inaccurate information intended to dissuade them from continuing care. And some of these attacks are literal — shootings, clinic bombings, and other violence against providers has been on the rise for years.
Despite all this, providers maintain a deep dedication to our work, which includes keeping up with the latest medical advancements and best practices — such as expanding and improving access to medication abortion care. Medication abortion care is an FDA-approved, safe option for ending an early pregnancy, with a 20-plus year track record of being used safely and effectively in the United States. Today, medication abortion care accounts for about 40 percent of all abortions; my patients have told me that they appreciate the privacy and sense of control that comes with being able to decide more flexibly when, with whom, and under what circumstances to end their pregnancies.
Unfortunately, providers' ability to prescribe medication abortion care has not kept up with what we know about the safety and efficacy of the medication. Because of the pandemic, the FDA temporarily lifted some medically unnecessary restrictions on medication abortion care, such as requirements that force people to pick up the medication in person from a clinician, rather than by mail to their home — with remote support from providers. This way, patients can obtain their medication in a manner that meets their needs, and health care providers like me can support our patients throughout the process, be available to answer questions, and on call to offer advice. The FDA is considering making these changes permanent, and they absolutely should.
But there are still other barriers. In 19 states, including Texas, using telehealth for any part of the process of providing medication abortion care is prohibited. In addition to SB 8, the Texas Legislature also recently passed a bill that limits when medication abortion care can be used and bans the medication from being mailed to patients. If this wasn't the case, we would still need to solve for the reality that many communities do not have access to broadband or language support that makes telehealth possible. As a provider, I care deeply about my patients having a safe and dignified health care experience, however they choose to get care.
In short, barriers to abortion prevent me from providing the best care possible to my patients and prevent people from having equal access to safe abortion.
With Texas essentially banning abortion and other states — such as Florida — rushing to do the same, we must expand options for abortion access in this country. Because of its two-decade track record of safety and effectiveness, medication abortion care is a commonsense place to start.
More and more, people are meeting with their providers by video or phone, and feel good about getting remote support from health center staff. Accessing abortion care should be no different — for my patients in Texas, who deserve better than to have their bodies turned into political battlefields, and for everyone across the country.
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