The fight over abortion pills in a post-Roe America

Transcript

ERICA PANDEY: Good morning! Welcome to Axios Today!

It’s Monday June 27th. I’m Erica Pandey in for Niala Boodhoo.

Here’s what we’re covering today: lessons from a historic heat wave…as the U.S. faces more extreme heat.

But first, today’s One Big Thing: the fight over abortion pills in a post Roe America.

Americans this weekend reacted to the repeal of Roe v. Wade with massive protests…

[Crowd chants "My body, my choice!]

and some celebrations…

[Crowd chants "Pro-life is pro-women!"]

…outside the Supreme Court, and around the country. A few hours after the court issued its decision, trigger laws banning abortions went into effect in seven states. Most abortions are now illegal in Arkansas, Kentucky, Louisiana, Missouri, Oklahoma, South Dakota and Utah. At least six other states are expected to officially ban or heavily restrict access in the coming weeks. Abortion rights remain protected in 16 states.

Now searches for quote “abortion pill” — which is abortion by medication — have surged, according to Google trends data from Friday and Saturday. Medication abortion bans are harder to enforce than for surgical abortions, and they’re set to be at heart of legal battles in states across the U.S.

For more on that Axios health care editor Tina Reed is with us. Hey, Tina.

TINA REED: Hi Erica.

ERICA: Tina, what exactly are abortion pills? And how much are they used for abortions in the U.S.?

TINA: Abortion pills are a method of abortion, referred to as medication abortion, and they're used in actually a majority of abortions in the United States. As of 2020, they were used in 54% of abortions, according to the Guttmacher Institute and these medications are authorized by the FDA for use in the first 10 weeks of pregnancy and involves taking the drugs 24 to 48 hours apart to first stop the development of pregnancy and then cause contractions to expel the fetus.

ERICA: How do women access these pills?

TINA: So it does require a consultation with a doctor and it requires the patient is located physically in a state where abortion is legal. It can be accessed or ordered online, sent via the mail and taken by the patient at home.

ERICA: So explain to me, why is the legality of these abortion pills more complicated than with surgical abortion?

TINA: So when we talk about these medications, they have been deemed safe and effective by the FDA. And so that makes it tricky for a state to say they're going to ban the use of that pill. And Attorney General Merrick Garland even came out and already has said that states cannot ban drugs that are FDA approved. There's actually some case law out there on this. Back in 2014, Massachusetts tried to ban a particular opioid and lost in a court that said you couldn't ban an FDA-approved drug. However, a lot of folks in the legal sector are saying that this is definitely going to be fought out in the courts and it's not necessarily clear how it would land.

ERICA: Right, so I was gonna ask you, are we seeing this start to play out already in some states, some of these questions start to get dug into? What's happening so far?

TINA: So it's too soon, I think to say exactly where and how this is going to be challenged. But a lot of folks are saying that because of the conservative makeup of many different courts throughout the United States, it is entirely possible that the courts could potentially allow states in the future to ban a particular drug. It's just not clear how and when that's going to happen, but they say it's almost certain that this will be challenged in a court of law.

ERICA: And, and what are you watching in this fight? What should we be paying attention to as this unfolds?

TINA: I think what I would be paying attention to right now is what the health ramifications are of some of these trigger bans, whether or not they might ban other devices or procedures such as IUDs or IVF and, potentially emergency contraception, like Plan B. And I think it's going to be interesting to see as some of these different health implications come out, how the states actually ultimately respond to that.

ERICA: Axios health care editor Tina Reed. Thanks Tina.

TINA: Thanks, Erica.

ERICA: In a moment, how better social infrastructure can save us from extreme heat.

[ad break]

ERICA: Welcome back to Axios Today. I’m Erica Pandey in for Niala Boodhoo.

Heat waves have been striking around the world – including here in the U.S. Late last week at least 15 states hit 100 degrees, according to the National Weather Service. More people die each year because of heat in the U.S. than any other type of extreme weather… and NYU Sociologist Eric Kleinenberg says one reason… is social infrastructure.

To understand that, we can look back to a week-long heat wave in Chicago, 27 years ago, when more than 700 people died. It was one of the deadliest heat waves in US history.

Eric Kleinenberg is the author of Heat Wave: A Social Autopsy of Disaster in Chicago, and he sat down with Niala last week to talk about what we can learn from Chicago…as we look ahead.

NIALA BOODHOO: Eric, let's start with what happened in Chicago almost 30 years ago. Your research showed that fewer Latino people died in part because of the neighborhoods that they lived in, whereas more Black people died because of isolation. Men were twice as likely to die as women. So can you explain what role social connection plays in these types of disasters?

ERIC KLEINENBERG: You know, what I learned when I looked closely at the map of who died in Chicago is that the neighborhoods that were hit really hard were places that weren't just poor and segregated, but also really abandoned and depleted. They didn't have what, what I've come to call, a robust social infrastructure, not a lot of great parks or gathering places, a lot of empty lots and abandoned buildings, this kind of depletion that makes daily life more isolating and makes it more difficult for people to support their neighbors.

And, you know, as it happens in Chicago, the neighborhoods that look like that are primarily Black neighborhoods. Latino neighborhoods are really different because although they're also very poor and increasingly segregated in Chicago, they're crowded. In a heat wave, the crowding is protective. The thing that makes a place like Chicago so dangerous is cities are heat islands because they have a lot of concrete and steel that attracts the heat. And then, this is crucial - they stay hot at night because the pollution traps heat in cities. And it's that combination of the ecological threat and the social reality that creates fault lines.

NIALA: What happens to our bodies in a heat wave?

ERIC: Your body starts to break down if it's overheated. A lot of people experience kidney failure, essentially when your internal organs start to overheat, you lose your body's capacity to even sense its own temperature. Actually a heat illness or heat death is relatively easy to prevent. You just need someone there with you who can recognize that, you look sick, that you are overheated, that the place where you are is dangerously hot. And, and if you can get that person into cool water or into an air conditioned environment, you can really prevent the death. What, what we saw in Chicago and what we see in heat waves around the world is people who are vulnerable are people who are isolated.

NIALA: As we think about how our society adapts to the increasing frequency of these events, what kind of social infrastructure do we need to really prevent more death and suffering?

ERIC: The first thing we need to do to prevent more death and suffering is start to decarbonize. We've gotta shift to renewable energy because if we, if we don't change that it's going to get so hot so often that we won't be able to adapt. Then, I think we need to pay a lot more attention to the social infrastructure. What kinds of places do neighborhoods have that give people who live there capacity to help each other out? You know, it's about the playground. It's about the park. It's about the commercial strip. You know, when you're in a neighborhood that's got a rich social infrastructure where the daily routine involves, you know, sitting on a stoop or hanging out in a park bench or going to the local library or shopping in a shared marketplace. You notice when your neighbor. who's always there isn't there that day. And if it's 104 degrees outside, you knock on their door. And what we need to do right now is build neighborhoods that encourage knocking on the door.

NIALA: Eric Kleinenberg is the director of the Institute for Public Knowledge at New York University. Thanks, Eric.

ERIC: Thank you.

ERICA: That’s all we’ve got for you today! I’m Erica Pandey in for Niala Boodhoo - thanks for listening - stay safe and we’ll see you back here tomorrow morning.