From Community Voices: Today we breathe easy on the Supreme Court’s mifepristone ruling – but the fight for reproductive rights continues

BY ANITA AGUIRRE

On June 13, the U.S. Supreme Court affirmed a woman’s right to access a medication abortion through a telehealth visit and by receiving mifepristone through the mail or certified pharmacy.

I’m the CEO of Santa Cruz Community Health and I’ve been celebrating this good news. Let me explain why this is a monumentally important decision from our highest court.

In 2004, during a crucial educational trip to Argentina focused on reproductive health, I witnessed a groundbreaking legislative milestone: the establishment of the National Program for Sexual Health and Responsible Procreation. This legislation not only legalized contraception, but also ensured its widespread availability at no cost in public health care facilities. And although the implementation of this program has been challenging and not without its problems, the concept of codified protections for women’s reproductive rights is a model for other nations.

That is a critical distinction between the spirit of the Argentinian law and what exists in the U.S. Although the U.S. had legal provisions for both contraception and abortion, our access to these fundamental rights in the U.S. is based on judicial rulings (Griswold v. Connecticut, 1965, and Roe v. Wade, 1973), not fortified by concrete statutory guarantees provided through legislation. 

Women’s reproductive rights in the U.S. are and always have been precarious. Since the beginning of time, one way or another, women have managed their own abortions.

The approval of mifepristone by the U.S. Food and Drug Administration (FDA) in 2000 for termination of early pregnancy changed significantly how, when and — most importantly — where a woman could have an abortion. Mifepristone gives women the option to end a pregnancy in the privacy of their own home.

The decision to have an abortion is very personal and not an easy one to make. In Santa Cruz County, between 750 and 1,000 women of reproductive age (15 to 44 years old) might seek an abortion in a given year.

Mifepristone was approved in the U.S. more than two decades ago based on a solid foundation of clinical research trials. The availability of medication abortion as a non-surgical option improved the accessibility for women to safely manage their reproductive health. In 2021, during COVID-19, the FDA updated the 2016 requirements allowing the medicine to be provided via telehealth. Since it was approved in 2000, more than 5 million women have safely used mifepristone to end their pregnancies. 

In 2023, 63% of all abortions in the U.S. were medication abortions. 

The Supreme Court decision on FDA v. Alliance for Hippocratic Medicine, ruling in favor of the FDA, means women will continue to have the option of accessing medication abortion through a telehealth visit and receiving mifepristone through the mail or certified pharmacy. It means women with no access to transportation or child care, or who are unable to take time off from work to travel to their health care provider, can have equitable access to medication abortion and make their own decisions about their medical care, reproductive lives, and futures.

When I think of the impact a different outcome to this ruling could have had on the 4,000-plus women of reproductive age whom we serve at SCCH, it makes me concerned for a future when even access to contraception is being questioned. 

The FDA is the expert federal agency on reviewing and approving drugs. This should never be determined by a judicial system with no medical or scientific research expertise or training.

But for now, we breathe a sigh of relief that the court sided with the FDA. 

SCCH, founded on the feminist goals of social, political and economic equality for the past 50 years, will continue to advocate for health care as a human right for our patients and the community.

Anita Aguirre is the CEO of Santa Cruz Community Health.