There Are No Girls on the Internet - Self managed abortion is a tech issue - Stuff Mom Never Told You

Episode Date: May 3, 2022

Late last night, Politico published a leaked draft opinion of a Supreme Court opinion overturning Roe v Wade, the ruling legalizing abortion in the United States.Things are bleak, but it's not all bad news! In December, the FDA permanently eased rules around accessing abortion pills via telemedicine. Shortly after that change Bridget joined her friends Sam and Anney at the podcast Stuff Mom Never Told You to discuss the tech implications of self managed abortion through abortion pills.    DONATE TO ABORTION FUNDS: tangoti.com/donate FIND AN IRL MOBILIZATION NEAR YOU TO SUPPORT ABORTION ACCESS: https://front.moveon.org/bans-off-our-bodies-resources/   Want to support the show? (thank you!) Subscribe, tell a friend, leave a review, or buy some merch at There Are No Girls on the Internet’s store: TANGOTI.COM/STORE Join our newsletter: Tangoti.com/newsletter Say hello at [e-mail] omnystudio.com/listener for privacy information.

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the landmark Supreme Court decision that legalized abortion in the United States. And what's really gross and fucked. up to me is that Elito based it on a thoroughly debunked anti-choice extremist talking point about abortions being a tool to control black populations. And he also went out of his way to set the stage for this opinion to service the basis for undermining other rights in the future, like marriage equality and interracial marriages. At a time when the rights of people of color, queer folks and trans folks are already very much under attack. Now, this opinion is completely outrageous. But it is still just a draft.

until the final Supreme Court decisions come out in June. So that means for now, abortion is still legal. And I know things are awful. I'm angry, I'm scared, I'm exhausted, and I am willing to bet that you are too. But it is not all bad. The good news is that this leaked opinion gives us time to mobilize. Donate money to abortion networks by going to abortion funds.org or tangoody.com slash donate.

People all over the country depend on abortion funds. And their difficult work is about to get even harder. So you can really make a difference by supporting their critical, life-saving work. And the second piece of good news is that in December of 2021, the FDA permanently eased rules on abortion pills, making it easier to access pills online through telemedicine, which will become even more important if and when Roe is overturned. Abortion pills are safe and effective. That's why, though tempting, using scary images of coat hangers to talk about Roe being. overturned isn't really accurate or all that helpful. You can visit plan cpills.org for help finding abortion pills in all 50 states. Access to abortion pills is an issue that has huge

tech implications because even though abortion pills are safe, the real fight in states that criminalize self-managed abortion is now about online surveillance, both surveillance of people who need abortions and people who help others get abortions. Things like online search histories and chats have been used to create digital paper trails to criminalize accessing abortion pills online. I joined my friend Sam and Annie at the podcast Stuff Mom Never Told You to discuss the tech implications

of accessing abortion pills via telemedicine and why it's a win for abortion rights at a time when, frankly, I think we could all really use one. Everybody deserves to have autonomy over their own body, access to health care, access to abortion care if they need it. Even the conversation, I feel, is we shouldn't even have to be fighting for stuff like this. But, you know, in the fight for abortion rights,

it can be very negative, very taking many, many, many steps back. And so I do think it's important to, you know, highlight when we have something that is not awful happening. And this is actually something, I think I'd seen it in the headlines. And I know you and I talked about it, Bridget, a while back several years ago. And I didn't really know much about the abortion pill.

So can you tell you? what it is and how it works? Absolutely. So according to Planned Parenthood, the so-called abortion pill is a popular name for two different medicines used to end a pregnancy. Mifropytazone and another one,

misoprosatol. So pregnancy needs the hormone called pro-estrogen to grow normally. And Mifurpritazone blocks your body's own pro-estrogen. And so basically it's just a combination of pills that you take to induce an abortion. Yes. And

I know, like, you know, this conversation isn't only limited to the U.S. Was it Ireland had somewhere had a similar kind of conversation? It was Scotland. And Annie, you and I, we did that whole episode about the changing rules in the UK versus the United States. And so this is definitely a global issue, an issue where, like, other countries and other regions have different standards of the legality of how pregnant people can access this

kind of medication to get the abortion care they need. Yeah. And one of the things that we talked about in that, episode was also telemedicine and being able to get it and like from the comfort of your own home and how important that was for a lot of people for this. So can you share the history of this kind of abortion care via telemedicine in the U.S.? Totally. So telemedicine, if you don't know what that is, is basically when you access your doctor through the internet, through your phone, through video conferencing. That's kind of like the thing for me that makes this kind of a tech story is that

people have been relying on that kind of technology-enabled healthcare for a really long time. So abortion via telemedicine has been available in the U.S. since around 2008. When the first formal program began in Iowa, a patient in one clinic can confer via video conference with a doctor in another clinic and then they would get their pills to induce an abortion. And that video conferencing element, that satisfied a federal requirement that a doctor had to dispense the medication to induce an abortion in a clinic, office, hospital. And so that was a real instance where technology bridged that gap that satisfied this federal requirement that a doctor dispense. I'm using quotes around that, this medication. And so

there are so many reasons why that would be a huge deal for people who are pregnant or really anybody looking for any kind of health care. Because if you're someone who lives in a rural community or a remote community, you can't always get to a clinic. Maybe there's not one close. Let's say you don't of a car. Let's say you're just a busy person with a lot on your plate and you can't physically go see a doctor. Telemedicine really is this thing that can really bridge that gap and bring the health care that folks need right into their homes. And so huge, huge deal. Unfortunately, opponents responded pretty quickly prohibiting abortion via telemedicine in 20 states since 2011. In the U.S., the FDA regulates medication abortion under a set of rules called the Risk Evaluation and Mitigation

strategy, or REMS, which determines how and which doctors can provide abortion pills to patients. There was this really interesting paper called 16 years of overregulation, time to unburden Mifraprex, published in 2017 in the New England Journal of Medicine, were leading clinicians and public health experts argued that the FDA restrictions were medically unnecessary, and ACLU attorneys noted that the leading medical groups, including the American Congress of obstetricians and gynecologists, support making abortion pills available. by prescription at pharmacies. And here's a really good quote from one of the doctors.

He says, overwhelming medical evidence and decades of clinical experience show medication and abortion to be a safe and effective method to end pregnancy. There is simply no medical justification for these restrictions, and they create a needless and harmful burden for women seeking this care. And I think that really sums up, I feel, what this conversation is about. It's about what happens when there are needless and undue burdens that separate people from the medical care, including abortion, care that they need. Right. This also reminds me of because a lot of what you talk about,

Bridget has to do with, yes, the internet and misinformation and disinformation. And I know we've had conversations around CPCs or crisis pregnancy centers and how when you'll type, you know, where do I get an abortion? A lot of times the results will be, like the first results will be these CPCs. And I can just imagine for people trying to get access to this medication, the same kind of issue there. And then on top of that, people have, have been arrested, correct? Oh, absolutely. So the SIA legal team, a group of lawyers who specialize in people who have induced their own

abortions, knows of 21 people who have been arrested or prosecuted for ending their pregnancies outside of this medical setting that was required, you know, in terms of medication abortion, or helping someone else do it. This actually might even be undercounted since they rely on news reports to track these cases. The charges brought against people who self-abort can range from child abuse, the abuse of a corpse, or failure to report death. Now, to be clear, none of the women were prosecuted for buying abortion pills specifically,

but they note that buying pills online or even Googling phrases like buy abortion pills online can leave a paper trail that can be used as evidence against them in a trial. And so this is not something that is abstract. Like, we in this country, people have been prosecuted for trying to induce abortions on their own via pills they get online. A famous case in 2015,

an Indiana woman named Purvy Patel was sentenced to 20 years in prison for fetuside after she allegedly used abortion pills that she ordered online. Prosecutors claimed that her fetus had been, quote, born alive and that she allowed it to die, but later her conviction was overturned on appeal. So again, we are talking about very real circumstances where this right to access abortion care via pills, via telemedicine online, has been really, a fraught thing that people have been prosecuted for trying to do. And, you know, we have all of these instances where people have subjected themselves to unsafe, sketchy abortion pills because of the undue burdens that have been put in place to prevent them from getting access to the care they need. The case for the woman in Indiana, even though it's not related, kind of brings back the memories of what just happened in Alabama recently with a woman who lost the fetus.

to have this baby, not trying to have an abortion, but got prosecuted with those same types of charges for neglect of a fetus. And I'm like, we all were horrified and had it not been publicized, she probably would still have remained in jail or prison. And it also takes me to what's happening in Texas as the Supreme Court is now allowing the bounty law. That's what I'm calling it. I know that's not what it's actually called for it to go. And I'm wondering how this is going to affect if people are trying to access abortion pills. And then we are, you already said, I believe that 20 states are not allowing for this type of access in anyway.

So I'm guessing Texas is one of those. I'm honestly guessing Georgia is too, that how this is going to affect even more so in trying to prosecute those with uterus or those who are helping trying to get access at all. Yeah, it's a great question. And I think it really underscores just what scary, dire times we are in. And I remember talking to my mom about, you know, when she was coming of age,

protesting for, you know, abortion on her campus, trying to get access to birth control pills. And she once told me, she was like, oh, when I was doing all of that back then, I knew at least when I had a daughter, she wouldn't have to sort of fight these same fights. That these fights would be over and done with at the time my daughter was here. Well, talk about, you know, predictions that didn't come true. she was wrong. Here I am, her adult daughter still having to deal with this kind of stuff. And so we are in a really scary time for abortion access, for anybody who cares about abortion access. And that should really be everybody, everybody, regardless of gender, should care about this.

And so I agree with you. I think that sometimes I'll see, like, I think it was Chris Hayes who tweeted something. And I like Chris Hayes. I'm not trying to like get down on him. But he tweeted about, I think, the Texas abortion bill, like, I think that we're going to see miscarriages being criminalized next. And it's like, I hate to break it to you, Chris Hayes, but we're there. That's happening. You know, this is exactly that same level of like, oh, my God, we're still fighting for access. We're still trying to have this conversation about bodily autonomy for those with uterus, those who are non-binary, like trying to figure out how to even have rights at all.

Like, honestly, seeing the news, as I talked about earlier, I was like, but, but waiting for, you know, the hat to drop, waiting for, oh, no, it's going to go fall apart. I'm trying to figure out how even, how the FDA even came to this point? How did we get here, which is amazing, but how? Well, I actually have an answer for you, which is like, as much as I hated COVID, we kind of have COVID to thank for this important change. And so this new change, to be clear, it's not going to impact everyone on every state, like you said. But the reason why we have it is because of COVID.

And so in 2020, during the pandemic, medical groups filed a lawsuit asking that the in-person dispensing requirement be lifted because the pandemic meant that patients were faced with a greater risk of being infected with coronavirus if they were visiting clinics in person to get pills. And so a judge granted that request this that summer. But after a challenge by the Trump administration, of course, the Supreme Court reinstated the restriction. In March, medical organizations tried again right into President Biden and Vice President Harris. in April, the FDA decided not to enforce the in-person requirement for the duration of the pandemic and allowed these pills to be mailed to folks. And again, yesterday, the big decision is that that change, which at that point was temporary, is going to be made permanent.

And so, you know, fuck the pandemic. I hate it. I hate it, obviously. But this is one of those things where I think that the people who were fighting for this regulation change really saw a way to be like, you know, it doesn't make sense to ask people to go in person. to get the abortion care they need, particularly during a pandemic, and then being like, and also shouldn't we just end it altogether? You know, I really appreciate them kind of, like the strategy of this. Yeah, yeah.

You know, you've got to find your, like you said, your wins and your chances where you can. And if it's a pandemic, well. So could you go into just a bit more, like what exactly this ruling is means in terms of like, yeah, the states and how it's like specifically impacting different states and just what does it all mean, Bridget? Totally.

So I want to make clear that like it is important to know that this will not impact everyone in every state. As you said, in 19 states, mostly in the South and the Midwest, telemedicine visits for abortion are banned. And so that really, you know, there's really no change in those states. And then, you know, because everything is awful. And that because, you know, the powers that be are constantly chipping away at our rights and our access to abortion care, we do believe that conservative states are expected to pass other laws to further curtail the access to abortion pills. And so even though, again, I feel like this is a win, I want to be clear that it is not a

win that impacts everybody. And so this means that people who live in states that do not allow telemedicine for abortion must travel to a state that does. although, and this is kind of a weird point, they do not have to visit a clinic. They may be in any location within that state for their telehealth visit, even inside of a car. They may receive pills at any address in that state. So, again, it just seems like such a weird, obviously bullshit burden to be like, well, if you're in this state that does not allow for telemedicine appointments for abortion pills, you can't get them. But if you drive to a state that does allow them, you can sit in the Wendy's parking lot and have a telemedicine and visit over your phone and your car, and then that's all good.

That, again, it just seems like it really reveals that this is about putting ridiculous burdens and barriers to prevent people from getting the abortion care they need. Like, what if you don't have a car? What if you don't have the financial means to drive to another state? what if you have to work or already have kids and don't really have the ability to just like take a trip like this? It seems like such an obvious way to just prevent people from getting the care they need. And like to me it just like my bullshit alarm goes off.

Like this is clearly just like let's just make it hard for people to get the care they need. Yeah. I mean this is such a like a much more superficial problem. But it reminds me when I was a kid, we would drive to the border of Alabama. and where I'm located in Georgia and we'd right at the border there'd be all these fireworks.

I knew you were going to say that. We would get all these fireworks and I'd be like, but if they're illegal in Georgia, my parents would be like, you can't sell them, but we could shoot them off. I'm like,

that makes no sense to me. That's absolutely right. I was thinking the same thing with like alcohol cells, you know, within the southern states. Like they were very restrictive up into a certain point.

So people would cross borders to go get alcohol. So for the long, Georgia couldn't sell it on Sundays. So people would go to Alabama. Like that would have access to it. Again, this is very like less harmful than any other stuff. But it is also very reminiscent of the fact that they are shutting down clinics in certain states.

And so therefore we have to access clinics maybe two or three states away in general. And honestly, we've been watching what's happening with Poland as well as they have had one of the harshest restrictions and bans in the world as well. it is fairly new. And them talking about the fact that they're having to do essentially underground networks to get access to pills and to any type of reproductive health access by traveling across country border lines in order to get access. Another podcast from some SNL late night comedy guy, not quite. Unhumor me with Robert Smygel and friends.

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with Debbie Brown from the Black Effect Podcast Network on the Iheart radio app, Apple Podcasts, or wherever you get your podcast. And yeah, that's exactly what's happening in that level statewide for us that, yes, for some of these, they're going to make it so difficult that you will have to plan as if like you have to be away for a week to get a pill in order to get any kind of access. And if you can't afford it, sorry, then you're not allowed it. And so just like what's happening in Poland, we're seeing a bit of that here in the United States. So states like California and New York, states where you can access abortion pills via telemedicine, they've taken steps in recent years to further solidify access to abortion.

And they're expected to increase the availability of telemedicine for abortion pills, specifically to provide opportunities for folks in other states with these kinds of restrictions to obtain abortion pills by traveling to their state to get them. And so we are seeing this thing where other states that allow this are probably going to, going to be stepping up so that people, specifically so that people who live in states that, you know, they can't access this can get them. And so it is, it is a little bit like that. And, you know, even though this is a win, we shouldn't have to be doing any of this just to get abortion care. Like nobody should have to jump through ridiculous hoops to get medical care that they need. And so this is no different. And so I think of this as a win, but I just,

I have to keep like harping on that, that we shouldn't have to be fighting this way and like celebrating these sort of like incremental tooth and nail wins for something that like should just be a right that everybody should have. Yeah. And these pill-based abortions are actually pretty common, right? That's right. And so especially in the pandemic, the teleabortion project, which is a research program authorized by the FDA to conduct telemedicine appointments and male pills, has heard from many people. And they're saying that they have really seen from folks using their services that people are really stepping up the amount that they are seeking these kinds of services since the pandemic. Elizabeth Raymond, she said that of the 2083 abortions provided under the program

between July 2016 and October 2021, more than a third, 715 occurred during the pandemic. And that really mirrors what the CDC has found. The CDC found in 2020 in some states, including Indiana, Kansas and Minnesota, the method pill-based abortions accounted for the majority of abortions, according to state health department records. And the CDC also found that 79% of abortions occurred before the 10 weeks gestation period, suggesting that there are many, many, many more people who would probably choose abortion pills

over an in-clinic procedure if they could. Another great resource abortion on demand, which is an online platform that provides physician-supported medication abortion care online, said that they have seen a lot of growing interests in pill-based abortion since the pandemic as well. And so it makes complete sense that at a time when it's not safe to leave your house,

that people would be turning to the internet to get the kind of care that they need. And even beyond abortion, you know, I, when the pandemic started actually very early into the pandemic, this is like a little bit embarrassing, I had a cyst on my butt cheek, and my doctor had switched to telemedicine only. And I remember thinking like, well, certainly she's not going to want

to like have me take down my pants and show her my butt cheek over, you know, FaceTime, and that's exactly what I did. And I'm able to get the care that I needed. And so obviously, we should not be putting

unfair barriers in place when I think that the pandemic really showed how important it is to use the technology that we have to access healthcare. Right. And I know there are stories. You can find out there.

People who said, like, why it was so important to them and why they wanted to be in like their kind of, you know, home or where they felt comfortable when they did this. But also, unfortunately, a lot of times going to an abortion clinic can also not feel safe because there can be people protesting outside and that makes it a much more stressful experience. And speaking of,

I'm sure not everyone was happy about this news. Oh, of course not. So anti-choice groups were not happy about this announcement. The Susan B. Anthony Foundation said the Biden administration today move to weaken the long-standing federal safety regulations against male order abortion drugs designed to protect women from serious health risks and potential abuse. So here's my question about this. First of all, how and why would someone be abusing these abortion pills? It's not like they like, take it from me. They do not get you high. The side effects that you might have are like mild nausea. I don't really think that people are like, ooh, I can't wait to get these drugs to induce mild nausea. It's going to be a wild time. Can't wait to abuse them. So,

already have some questions there. And then doctors make it clear that pill-based abortions are safe. A research program by the FDA found that 95% of the 1,157 abortions that occurred through the program between May 2016 and September 2020 were completed without requiring any follow-up procedure. Patients made 70 visits to emergency rooms or urgent care centers with 10 instances of serious complications to study reported. And so that's really like pretty good in terms of, you know, know, the safety of this. Like, doctors have made it very clear that pill-based abortions are not

unsafe and telemedicine abortions are safe. For all the reasons that you've just said, Annie, they can be more convenient. Maybe you don't want to go to an abortion clinic where there's going to be people shouting at you when you're already stressed. Maybe you have to work or maybe you can't afford to get to a clinic. There are so many reasons why someone would choose to, you know, access the care they need through telemedicine. And it's, there's not really a lot of reasons why we are are regulating it in this way. And one thing I also want to point out is that this change is obviously like very long overdue, especially when you consider that out of the 20,000 different prescription medications currently regulated by the FDA, these abortion bills are the only one, the only one

the FDA previously required to be dispensed in person, but permitted patients to self-administer. And so that really, I mean, like, of all of these medications, like, why is this the only one? that had this unfair burden to access. This is one of the only medications that are given to people with uteruses and those who need reproductive health. Like essentially, this is why. We know these answers.

And I find that fascinating because as we're looking for the future and, of course, I think part of the reason and Annie and I are both hesitant in celebrating is because we are in Georgia, run by current governor Brian Kemp, who has absolutely put into place every restriction that you can think of

when it comes to accessing any kind of health care in general. And I say that very loudly as he is threatening to shut down any connections with federal assistance when it comes to coverage in the state at this point in time. And I think one of the things that we are talking about and trying to be very loud about is that these groups are not focusing on the women, obviously. It is a literal fight about what is moral in their eyes. And for a Bible Belt area of such as Georgia, it is a constant battle trying to to see how to combat these really generalized slash false narratives of the harming women,

as if they're truly trying to save women, what is actually they're trying to prevent women to get good access and good health care at all. So it's kind of one of those moments of like how, and I guess honestly the pandemic has shown a lot of light about the fact that when it comes to morality and because, because conspiracies, they don't care if it's from science. They don't care about the truth as we have learned. And I find it interesting that as we are trying to focus on this, what are some ways that we can maybe advocate for ourselves for people like Annie and I who are stuck in Georgia right now for more access to these things? Oh, what a good question. I mean, first of all, I just have to

honor what you just said because we are at a time where it is scary and the threat is real. Anybody who told you like, oh, they're not going to overturn Roe, like, you'll be fine. Like, we're not going to go backward. They were incorrect. They were telling you something that wasn't true. And I am sorry to have to say that, but here's the reality of where we are. And it's very real and it's very scary. And I completely understand the urge to be like, well, this.

This is happening. It's inevitable. Our rights are going to be rolled back. Women are going to die. People are going to die. This is going to be bad. Anybody who's feeling that that exhaustion and malaise, I'm with you. I get it. All I can say is that now is not the time to retreat. Now is the time to dig in. And so I have to really lift up and amplify all the amazing people who are doing the work on the ground of protecting abortion access. I want to shout out a few people right now. My colleague at Ultraviolet, Sonia Spoo, who is incredible. My friend Renee, who is doing a lot of work around abortion storytelling and just, like, helping people understand how many different people are impacted by abortion care and need abortions and, like, someone that you love has had an abortion. And then if you're looking like, what can I do? Absolutely. Now is the time to be supporting abortion funds around the country.

If you've got a local abortion fund in your community, throw them some money. If you've got some extra money, you can go to abortion funds.org and find out, you know, people are doing a lot of organizing of making sure that people can still get the access to care that they need. So definitely support those folks. Also, urge your lawmaker to support the Women's Health Protection Act. You can go to we are ultraviolet.org and find our petition demanding the Women's Health Protection Act be passed because we need, now is the time that we need to be fighting with all that we've got. I know it is scary. I know it is hard. I know we've all been through a lot. But now is the time to really dig in. And I think like one of the things that really gives me hope in this fight are things like abortion care networks, are things like just individuals doing what they can. And so I know that we got us. The government might not always have our back.

Our elected officials might not always have our back, but we have our own backs. And so this fight is hard and long, but I know, I know that we got each other. And so that's the one thing that really gives me hope. Oh, so well said. I know. I think I needed it because yes, I've been very stressed. I know we all are. Very concerned and worried.

But that was a nice bow on this. Our last recording with you, Bridget, in 2021. And some excellent advice as always. Hang in there. Yes. Hang in there. We can do this. We can do this.

Stay safe. That was supposed to be low key there. that's that's what i call you samantha loki mickmane so loki very loki yes yes well thank you as always bridget for joining us um and bringing this topic it is always such a delight to have you have fun you're about to leave for your your weirdo

christmas correct that's right in a matter of hours i will be wearing a fur hat like probably pretty drunk in the wood self-care is important in this whole conversation. Yes, yes. Have a lovely time. Where can the listeners find you? Well, you can find me all over the web. I'm at Bridget Marie on Twitter and at Bridgett Marie in DC on Instagram. Please follow me. I'm trying to get my followers up. Please follow. And you can follow me on my IHeart Radio podcast. There are no girls on the internet where we have all kinds of interesting conversations about culture and technology.

and gender and race and the internet. So please, please check it out. Yes, go check it out. It is fantastic. And as always, if you want to contact us, you can. Our email is Stephanie and Mom Stuff at iHeartMedia.com. You can find us on Twitter at Mom Stuff Podcast or on Instagram at Stuff Whenever Told You.

Thanks, as always to our super producer, Christina. Thank you. And thanks to you for listening. Stuff One Never Told News production of IHeart Radio. For more podcasts from IHeart Radio, visit the IHard Radio app, Apple Podcast, or wherever you listen to your favorite shows. Another podcast from some SNL, late-night comedy guy, not quirk. White, Unhumor Me with Robert Smygel and Friends, me and hilarious guests from Bob Odenkirk to David Letterman help make you funnier.

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