What A Day - The Pill That May Save Abortion Rights

Episode Date: March 30, 2024

Mifepristone revolutionized abortion access in America, so much that, two years after the fall of Roe v. Wade, abortions in the United States are up.But now “Mife” is taking its turn in the crossh...airs of the anti-abortion movement, facing a challenge before the Supreme Court that could cut off access to the drug. Can it survive this challenge? And, if so, would that mean the pro-choice movement is quietly winning the fight for abortion access in America?This week on “How We Got Here,” Hysteria’s Erin Ryan and Offline’s Max Fisher tell the story of how Mifepristone became the anti-abortion movement’s #1 enemy and the new lows that movement has had to go to get this challenge before the court. SOURCES: Cover Up: The Pill PlotTimeline of the Supreme Court’s mifepristone abortion pill ruling | CNN PoliticsOne in Six Abortions Is Done With Pills Prescribed Online, Data Shows - The New York TimesAbortion Shield Laws: A New War Between the States - The New York TimesChallenging Abortion, Again - The New York TimesDespite State Bans, Legal Abortions Didn’t Fall Nationwide in Year After DobbsAbortion Bans Across the Country: Tracking Restrictions by State - The New York TimesAbortion Ruling Could Undermine the F.D.A.’s Drug-Approval Authority - The New York TimesThe many lives of mifepristone: Multi-glandular exaptation of an endocrine molecule - PMC.A Political History of RU-486NYT Archive: DRUG MAKER STOPS ALL DISTRIBUTION OF ABORTION PILLThe long and winding history of the war on abortion drugsThe Complicated Life of the Abortion Pill | The New Yorker

Transcript
Discussion (0)
Starting point is 00:00:00 Erin, I saw something weird on the internet the other day. Max, I thought I told you that despite the cute name, that subreddit is a bad place. No, no, I'm staying away. The weird thing I saw was a headline that said that in the two years since Roe v. Wade was overturned, which was supposed to be, like, the big victory for the anti-abortion movement and did lead to all these red state abortion bans, that despite all that, the number of abortions in the U.S. has actually gone up? Ah, yeah, you're operating under the assumption that banning something makes people do it less.
Starting point is 00:00:33 Okay, well, usually that's how it works. Yeah, well, you're not wrong to be surprised. When the Supreme Court handed down their Dobbs decision in 2022, anti-abortion advocates celebrated what they hoped was the beginning of the end of abortion in America, a victory nearly 50 years in the making. But what happened was not total anti-abortion victory, not at all, because now the anti-choice side got another war to fight, one that they did not see coming, but might be even tougher for them than Roe, thanks to a drug called mifepristone.
Starting point is 00:01:07 And we saw the first battle in that war at the Supreme Court just this week. I'm Erin Ryan. I'm Max Fisher. And this is How We Got Here, a series where Erin and I explore a big question behind the week's headlines and tell a story that answers that question. This week, how did mifepristone, a.k.a. RU486, become public enemy number one of the anti-abortion movement? And does its popularity mean that the pro-choice side is quietly winning?
Starting point is 00:01:34 That's kind of what it sounds like. So I was surprised to learn that, according to the Guttmacher Institute, which is a reproductive rights policy and research organization, nearly two-thirds of abortions in the U.S. last year were medication abortions, i.e. popping some pills. Like, I had always pictured somebody needing to, you know, drive up to an abortion clinic, get escorted through protesters holding signs and shouting, go through a metal detector, sit in a waiting room surrounded by shatterproof glass. And that still happens. Surgical abortions are still a vital part of abortion care. That's because medication abortion isn't appropriate for all pregnancy terminations,
Starting point is 00:02:09 like if you need an abortion in the second trimester or later, for example, or in some cases when patients would just prefer the surgical procedure to pills. But for millions of people, the option to have a self-managed abortion at home is huge. Yeah, if given the choice between a minor surgical procedure and taking a few pills and binging Shogun on my couch, I'm going to choose the couch. Like, imagine if you could have wisdom teeth removed that way. Honestly, it would have saved me a very weird Uber ride in Brooklyn in 2013. Medication abortions also provide access for people who would find it difficult to get to a clinic, like if you live in a rural area or a state with an abortion ban, or maybe you face social or religious pressure against ending a pregnancy. Regardless, the availability of mifepristone has completely revolutionized abortion in America. Okay, I see where this is going. So the reason that so many people are still able to
Starting point is 00:03:05 have abortions in a country that is otherwise covered by a patchwork of abortion bans is they can just do it safely at home. Yeah, but it's not just the U.S. And I'm not being hyperbolic when I say that medication abortion, and specifically Mifepristone, has changed the course of world history. Wow. And because of that, there's more drama in the history of Mifepristone than on the second to last season of Vanderpump Rules. I will be, as a huge Vanderpump stan, the judge of that. Okay, buckle in. So if this is a prestige TV limited series, the pilot is in Brazil. And I mean that in more ways than one. Here's Kelly Baden, the VP for public policy at the Guttmacher Institute on the very first abortion pill.
Starting point is 00:03:46 It is activists in Brazil in the 80s who saw that the drug Cytotec, which was the brand name of misoprostol, came onto the market there over the counter to handle GI issues, ulcers, and had very clear labeling that you should not take it if you were pregnant. And the brilliant activists decided that that was something that they could test out and see if it actually worked to safely end an abortion. And that is where the understanding of misoprostol as a way to safely end a pregnancy came from. Wait, so this is how people discovered that misoprostol was a way to safely end a pregnancy? These were some hardcore citizen scientists. I mean, look at the advances Brazil has brought to waxing and soccer. But yes, they figure out it's safe. And it's around this time that a French endocrinologist, Etienne-Emile Bellieu, develops a new drug. Today's it girl, mifepristone. Right, that's the one in the news this week.
Starting point is 00:04:45 Yeah, he and a bunch of other doctors combine it with misoprostol, and this two-drug course becomes the gold standard of medication abortion. RU486 was also found to be safer, less invasive, and less expensive than surgical abortion for early pregnancy. Wow, the 1980s were a huge decade for breakthroughs in new wave music and abortion. Sure were. Bailu's new drug goes to market in France and China in September of 1988. And by late October of that year, more than 10,000 women had taken the drug, and it was on its way to being approved for use in the Netherlands.
Starting point is 00:05:18 But then... Everyone was really chill about it, and women were able to get the health care they needed for the rest of time. The least chill people of all time enter the picture, the American Right to Life movement. Yes, the American Right to Life movement, which had been growing more and more powerful during the Reagan years, started protesting RU486's manufacture in France, despite the fact that the company made it clear they had no plans to even try to enter the American market. Scary protests, too. They accosted employees in parking garages. They threatened global boycotts of the company's other drugs, which I think to executives is scarier than actually getting accosted. They were generally their intimidating and annoying selves. And to make matters worse, there was the Holocaust connection.
Starting point is 00:06:04 Sorry, did you say the Holocaust connection? Yeah. Dr. Beaulieu developed Mifepristone for a French pharmaceutical company, Rosselle-Hucloff. But Rosselle-Hucloff's main stakeholder was a German company that had, just a few decades before, helped manufacture the cyanide gas used in Nazi concentration camps. Okay, in fairness, that is a little bit uncomfortable.
Starting point is 00:06:26 Yeah, so naturally the anti-choice activists began comparing medical abortion to the Holocaust. Roussel Ouklaaf, executives did what executives do and chickened out. Like, nope, we're not dealing with this. And they pulled Mifepristone off the market. But then, after a global outcry, the French government mounted a pressure campaign with a health minister announcing, it is saying in this script that I should do this in a French accent. I think you should have to do it in a French accent.
Starting point is 00:06:52 From the moment government... I'm not doing this. From the moment government approval for the drug was granted, RU486 became the moral property of women, not just the property of the drug company. Finally, a government agency that puts women first. Yeah, well, they also held a stake in the company. Wow, it was a government agency?
Starting point is 00:07:13 The government of France held a stake in this pharmaceutical company, which is wild, but they could throw their weight around. And executives at Roussel-Lucloff actually seemed relieved that the decision to make and distribute Mifepristone was now technically out of their hands. They were being forced to do it by the French government. Okay. So that is what is happening with the first arrival of these pills in Europe back in the 80s. But presumably, it's showing up in other places too, right? Right. Well, China pirates a version of Mifepristone, which it uses to enforce its one-child policy.
Starting point is 00:07:45 Yikes. Meanwhile, Latin America begins cracking down on abortion pills, making even misoprostol hard to get. And Mifepristone is banned here in the U.S. One of the first big public challenges of that ban comes in 1992, when a punk anarchist, Leona Benton, and abortion activist, Larry Lader, punk the U.S. government. How punk are we talking? Like, international drug-smugglingS. government. How punk are we talking? Like international drug smuggling punk. That's pretty punk. I talked to TJ Raphael, the host of the podcast Cover Up the Pill Plot,
Starting point is 00:08:12 to get a handle on this story of Larry and Leona's scheme. They had flown to London where the pill was legal, secretly got some doses, and within 24 hours flew back to the States and, yeah, sent a message, sent a fax to the U.S. customs head telling her that, hey, we're coming into the country with this banned substance. And yeah, they got stopped and they brought it to the Supreme Court. Damn, this is like an anarcho-feminist Ocean's Eleven here. Yeah, this is the Ocean's Eight I would have preferred.
Starting point is 00:08:43 So those activists get back to the U.S., their pills get confiscated, there's a lot of press attention, it makes it to the Supreme Court, which in 1992 roundly rejects legalizing Mifepristone. So where does that leave things? Well, Larry is a clever guy. Here's TJ again. When he and Leona Benton had returned from London with the pills and they had been confiscated, unbeknownst to literally everyone, I actually asked Larry's attorneys about this, he had secretly stashed away an extra dose of mifepristone. Nobody knew that he had it. And he decides that, you know, if the government won't overturn the ban, maybe we can challenge the patent. There was this obscure New York state law that said if a company,
Starting point is 00:09:25 a drug maker won't bring in a drug to the United States, but it can be produced in state in New York, then you can use it here. So Larry later goes full Breaking Bad. He decides to build a secret lab in a warehouse, and he hires some scientists. He's able to confirm the exact chemical composition of mifepristone. So then Larry starts manufacturing the first ever made in America abortion pill. And he actually goes to the FDA and gets permission to start clinical trials, some of the earliest clinical trials in the United States with this medication. Okay, change of plans. If I could take a pill to dissolve my wisdom teeth, I'm staying home and binging this show. Like, sorry, Shogun. If you want to know
Starting point is 00:10:09 more about the absolutely wild history of the abortion pill in the U.S., listen to TJ's podcast Cover Up the Pill Plot. We'll link in our show notes because truly what she shared is not half of it. Okay, so that brings us up to the Clinton years. Yeah, shortly after Bill Clinton took office in 1993, he directed the FDA to take steps to investigate unbanning mifepristone. The first U.S. trial begins in 1994, and by 1996, an, just a couple of months before Bush v. Gore. Mifepristone slides into legality like Chris Pratt escaping the raptor pen in a bad Jurassic Park movie. Stand down. Hey, hey, what did I just say? Hey, Jurassic World was an enjoyable theatrical experience.
Starting point is 00:11:04 If you say so. One thing that we hear parroted by people who want mifepristone taken off the market now is that the drug isn't safe or it was somehow rushed through the approval process, which just isn't true. There were mountains of evidence showing that it was safe and effective across Europe, China, Israel, and in U.S. trials. Starting in September 2000, Americans began using it largely without complications. But then, 11 years later, the FDA added it to a list of risky drugs that require patients to jump through several hoops to get it. Oh, so like did patients have to solve a series of riddles? That would have been kind of fun. No, it wasn't fun. FDA rules required that
Starting point is 00:11:42 RU486 be prescribed only by a doctor qualified to perform follow-up care in the event that the drugs didn't work. But the likelihood that they would actually need to do a surgery after taking mifepristone was low, right? Yeah, the two-drug combination taken early enough in pregnancy was shown to be upwards of 95% effective. Wow. 95% effective. But just to make triple extra sure, the FDA also required the pill to be dispensed in person and for the patient to take the drug in front of the provider. That kind of sounds like being in a psych ward or jail. Yeah, exactly. Well, and then 2016 happened. Sorry, what happened in 2016? I went to the Eternal Sunshine of the Spotless Mind Clinic
Starting point is 00:12:23 and had my memory of that year completely wiped. I'm going to need you to tell me how to get to that clinic after we're done recording. I am jealous. So in 2016, the FDA removed mifepristone from the list of drugs requiring extra safety precautions, as all that red tape wasn't making patients any safer. So now abortion drugs could be prescribed by other healthcare providers and without ultrasounds. Then in 2021, the Biden administration announced that it would no longer be requiring providers to dispense RU-486 in person, which opened it up to telemedicine. And also that pharmacies could fill prescriptions for it as well. And then in June 2022, the Supreme Court overturned Roe v. Wade. And shortly thereafter, a strange lawsuit cropped up in the Texas panhandle.
Starting point is 00:13:09 So this is the case that we saw argued now before the Supreme Court just earlier this week. And I keep hearing court watchers talking about, like, how weird this whole thing is. Yeah, we've finally arrived at the alliance for Hippocratic Medicine versus the FDA, a cynical attempted legal rigging that is, yes, also deeply weird. The lawsuit was filed by a group of anti-abortion doctors that banded together to sue the FDA over the way that mifepristone is prescribed. The doctor's group argued that the drug was dangerous and that they were being forced against their conscience to treat patients suffering side effects of the medication.
Starting point is 00:13:46 Here's ACLU attorney Julia Kay, who gave us some background on the plaintiffs. Many of the members of these groups are not practicing at all. They are retired, or they are dentists, or they practice in an area of medicine where there is absolutely zero chance that they would ever encounter one of the exceedingly, exceedingly rare circumstances of a complication from medication abortion. I hate it when my dentist refuses to help me with my abortion. Dentists? So it's just completely like a manufactured case because dentists don't have anything to do with this. No, they don't. They're tooth doctors.
Starting point is 00:14:27 So they argued that the FDA had not done its due diligence, they claimed, in approving the drug and were asking the court to mandate that the agency pull the drug from the market entirely or at least reinstate those onerous pre-2016 prescription standards like you had to take it in front of a doctor. And the justices seem skeptical that the alliance of offended doctors and dentists, some of whom, again, were retired, had been harmed by Mifepristone considering they're already granted exemptions from having to perform procedures that they object to. Here's Justice Katonji Brown-Jackson. So the obvious common sense remedy would be to provide them with an exemption, that they don't have to participate in this procedure.
Starting point is 00:15:14 And you say, and you've said here several times, that federal law already gives them that. So this wild moment in the arguments where Erin Hawley, who is the lead attorney for the plaintiffs who are bringing this suit, was not able to present a single concrete example of her client's conscience rights being infringed upon by the existence of this drug. Oh, yes. But they were very much victimized in their imaginations. But even conservative justices like Neil Gorsuch and Amy Coney Barrett seem skeptical of the plaintiff's standing in the case.
Starting point is 00:15:47 So we won't know until June how this will all shake out, although most court watchers predict a loss for the anti-Mifepristone crowd. But if we know anything about the anti-abortion movement, it's that they play the long game. And we can be pretty sure that this isn't going to be the last swing for the fences they make for mifepristone. Well, let's back up a bit. So this medication has been around for years. More and more people have been using it ever since the FDA relaxed those regulations back in 2016. So why are abortion opponents only going after it like this now? Well, for one, in 2016, when your memory was erased and those mifepristone restrictions were relaxed,
Starting point is 00:16:44 overturning Roe seemed like a faraway dream for the antis. So they were still focused on overturning Roe back then for all those years, even as Mifepristone was growing in popularity. Yes, they were obsessed with overturning Roe. But then Roe fell in 2022 and the anti-abortion movement, once they got over their champagne hangover, looked around and realized the landscape had totally changed. So, okay, for decades they had focused everyone in the movement on this strategy, overturning Roe, their white whale, that made sense in the context of, like, the 80s or 90s,
Starting point is 00:17:16 but not really in the era of Mifepristone and telemedicine. But they figured it out pretty quickly. That Texas lawsuit challenging the FDA's approval of Mifepristone, the one at the center of this week's SCOTUS arguments, got filed just five months after the Dobbs decision. Oh, okay. So because Roe fell in the Dobbs decision, 14 states banned abortion, a bunch more passed all these new restrictions, and yet nationwide abortions went up. Part of that was backlash to Dobbs. Some blue states expanded access to abortion or started offering assistance to people traveling from nearby red states or shielding people within
Starting point is 00:17:52 their borders from being prosecuted for helping red state women get abortion care. Public awareness of abortion rights seems to have improved in response too. Sure, but I'm still confused because all of this made it harder for many millions of people to access abortions, right? It made it harder for millions of people to access abortion clinics. What the anti has failed to anticipate, I think, is that women will continue to seek abortion care until the cost of having an abortion is greater to them than the cost of having a baby they don't want. But regardless, in a lot of circumstances, even in red states, as long as you don't medically require a clinic visit, it's actually easier to access an abortion in the Mifepristone
Starting point is 00:18:33 era than it was under Roe. Oh. And that's what mostly drove the rise in abortions. It's also important to note that the increase in abortions recorded by Guttmacher only tracks abortions that take place within the medical system. So we don't know how many women use pills by mail requested and sent through channels outside of medical establishment to terminate their pregnancies. That is a fairly common practice, especially in places like Texas. So the number of abortions that actually occurred in the U.S. since Dobbs is probably a lot higher than what's been reported.
Starting point is 00:19:11 Wow. Okay. So it's like if Roe v. Wade was the castle wall protecting abortion rights in America, then the anti-abortion movement knocked it down only to discover that immediately behind that wall was another equally sized wall called Mifepristone. That sounds frustrating. Well, even if they did win this case, they would discover that there's a third wall, misoprostol. Okay, so that is the drug that is used in concert with mifepristone, right? Yeah, it's also quite safe and effective when used on its own, which in a lot of the world it is. So does that mean that they're going to go after misoprostol now too? That would be pretty hard because misoprostol has a lot of other uses like treating ulcers and treating rheumatoid arthritis. So we're not worried that Justice Alito is about to discover that
Starting point is 00:19:50 misoprostol violates the religious freedom of ulcers? Our lady of the bleeding stomach. For now, the anti-abortion movement is focused on mifepristone. That's the focus of this suit, maybe just because they think it's a better place to start. Well, but why are reproductive rights groups sounding the alarm over protecting mifepristone if we have this other drug too, misoprostol? They're a bit more effective together. Misoprostol alone is 88% effective, but when you add mifepristone, it becomes 95% plus effective. Misoprostol on its own is also more painful. It can involve long hours of pain and bleeding and more side effects like nausea. Combining it with mifeprostone counteracts that.
Starting point is 00:20:31 And mifeprostone is important for treating miscarriages, which is another big reason that reproductive rights activists want to protect it. Here's Dr. Jennifer Conte, an OBGYN and medical journalist. A lot of times we use this medicine for managing miscarriages that haven't been completed. It's really common. It's a lot less uncommon than you would think to have a miscarriage in this way that just doesn't completely get recognized by your body and then get expelled. Miscarriage in general, we think happens to like one in five pregnancies. And so a large chunk of those pregnancies are going to,
Starting point is 00:21:06 you know, at some point in the process, maybe need help getting expelled. And that's a huge use of mifepristone. So when we talk about taking it away, we're not just talking about taking it away for the purpose that these asshats think that we're taking it away for. It has other uses. Boy, I can't say I'm surprised to learn that the anti-abortion groups are really unbothered by the idea that banning mifepristone will mean women having to face more dangerous and painful miscarriages. Health of the mother, not exactly a top priority. But still, I'm surprised they're going this hard for mifepristone if banning it wouldn't even end medication abortion.
Starting point is 00:21:45 Like, I take your point that maybe this is just step one and there's a file somewhere in a basement laying out a plan to target misoprostol 2, but it still seems really odd to me. Yeah, there's a real throwing spaghetti at the wall quality to this entire legal strategy. Well, if the spaghetti is weird right-wing lawsuits and the wall is the Supreme Court, then in fairness, this wall has proven pretty sticky. That metaphor got a little away from you. Okay, guys, I guess what I mean is that this court's conservative majority has used a lot of very flimsy legal cases to justify imposing conservative values like, say, overturning Roe. And this lawsuit also seems designed to appeal to this court's love of gutting federal regulatory agencies like the FDA.
Starting point is 00:22:29 That's exactly why the slapdown in oral arguments this week was so striking. It really revealed how weak the legal case is for banning Mifepristone. And I'm not just saying that to dunk on the antis here. Come on, a little bit you are. I mean, Aaron Hawley really deserves it. Sure, it's fun to revel in the humiliation of terrible, cruel people. I won't deny it. But I do have a bigger point here, which is that the galling weakness of this case shows how hard this next stage of the abortion fight is going to be for the anti-movement. Yeah, we talked earlier about one prong of their case, that administering mifepristone caused injury to a handful of
Starting point is 00:23:05 doctors and, I guess, retired dentists. But there's some other prongs to this too, right? So the doctor thinks about proving legal standing that they have the right to bring this suit by showing someone was injured by the FDA approving mifepristone. But their actual legal challenge is different. They say the FDA should never have approved mifepristone at all. Yeah, this is where it gets weird. The lawsuit argues in part that the FDA used basically the wrong regulation to approve mifepristone back in 2000. Telling the government it filled out the wrong government form
Starting point is 00:23:34 does have a certain appeal as someone who has been to the DMV, but that seems like a really weak case for banning an entire medication. Yeah, why are you hitting yourself? Why are you hitting yourself? They're also arguing more dramatically that the FDA ruled incorrectly on the science when it approved mifepristone. Put aside whether or not they're right.
Starting point is 00:23:51 Which they're not, I take it. No, no. But the point is that they're asking the courts to overrule the FDA on the science. That would be a really radical change in how drug regulation works in this country.
Starting point is 00:24:02 The way it's always worked is that agencies like the FDA are the final authorities on scientific questions. Well, they have the lab coats and the microscopes and the fancy degrees after all. Yeah, so the courts might get involved if they think an agency like the FDA has exceeded its legal authority, but they're not going to start second guessing whether government scientists got their calculations right. Well, except this case is asking them to do exactly that. Which is why they probably won't. But if the Supreme Court were to comply, it would open the door to all sorts of politically motivated lawsuits aimed at getting judges to ban drugs
Starting point is 00:24:33 or medical procedures for ideological reasons. So if the Supreme Court broke down this firewall and how regulation is usually worked, you could have like whack job activists soliciting red state judges to ban, you know, Plan B or, I don't know, birth control. Now you're cooking with gas. I mean, it was barely a month ago that the Alabama State Supreme Court effectively banned IVF in the state. So these are not fringe scenarios. And there's another even weirder and scarier argument in this lawsuit too, right? Would you believe that they want the
Starting point is 00:25:06 Supreme Court to consider abortion medication as equivalent to pornography? I would believe that actually, yes, but please explain. The lawsuit argues the FDA, by permitting Mifepristone to be sent in the mail, violated something called the Comstock Act. I have never heard of this before. You are so lucky. It is a law from 1873, and it was bizarre and puritanical, even for its time. It banned using the mail to deliver indecent or pornographic materials, which lawmakers at the time defined as including any material promoting abortion and even contraception. Okay, the existence of Planned Parenthood mailers and, you know, Playboy feels like evidence that this law is not really enforced. The lawsuit asks the Supreme Court to use the Comstock Act anyway
Starting point is 00:25:54 to basically create a federal ban on telemedicine abortion pills. Whoa. Yeah, again, doesn't appear that the court was receptive because that means an end to Viagra. Anything that your pharmacy would get in the mail that somehow deals with sexual health and wellness. No more toys in Babeland boxes tastefully disguised. Well, this is part of what's important about this, right? Because it feels scary that these are now the sorts of demands that the anti-abortion movement is advancing, like 19th century anti-porn laws or gutting the FDA or no more Playboy.
Starting point is 00:26:32 I don't know what they're doing print anymore, actually. That's fair. The good news is that they're going to these extremes because they have to, because they're realizing that for the large share of potential abortion seekers for whom pills like Mifepristone are sufficient, the abortion rights movement is kind of one. So yes, they kind of have. But of course, we shouldn't gloat because lots and lots of women do still need to visit a clinic for an abortion, especially for people suffering from medical emergencies, pregnancy complications. And if you are one of those people and you live in a red state, the post-Roe landscape is really bad. And the same goes for abortion providers in those
Starting point is 00:27:11 states too. So we've ended up at this like post-Roe, post-Mephepristone landscape that is both a huge step backwards for some women who can't rely on medication for abortions, and a big step forward for the larger number of women who can, at least for now. Yeah, it's very much hanging in the balance, because if the FDA can change the way that abortion is accessed just by changing a rule about how something is prescribed, then a change in president who decides they want to throw their weight around could possibly bully the FDA into making changes again. You know, it's easy to imagine all the ways that this can go sideways. But for now, as long as the FDA is not a political arm of the White House, the only way abortion foes are going to be able to stop abortion in the U.S. is either ban the abortion pill or convince the government to start messing around with
Starting point is 00:28:06 interstate commerce and the mail. So both of these are kind of steep hills to climb as we saw this week. But that's my optimistic take. My chicken little take here is that the Mifepristone case is only the beginning. Anti-choicers have made it clear they're coming for things like IUDs in the morning after pill. There's a couple states where they've already tried to make it not possible for people to use government insurance to get an IUD, which is pretty crazy. If they need to neuter the FDA and thereby endanger the safety of all other drugs
Starting point is 00:28:36 in order to eliminate abortion, that's a price they're willing to pay. Well, I'm crossing my fingers that the optimistic Aaron is right, but chicken little Aaron is probably a little right too. I don't know which one's going to be right. And I want to find the eternal sunshine of the spotless mind clinic and erase my memory of the Trump years. And hopefully on the other side of that, we're in a better future. I'm going to ask the FDA to approve telemedicine eternal sunshine.
Starting point is 00:29:19 How We Got Here is written and hosted by me, Max Fisher, and Erin Ryan. Our producer is Austin Fisher. Emma Illick-Frank is our associate producer. Evan Sutton mixes and masters the show. Jordan Cantor sound engineers the show. Audio support from Kyle Seglin, Charlotte Landis, and Vassilis Fotopoulos. Production support from Leo Duran, Raven Yamamoto, Natalie Bettendorf, and Adrienne Hill. And a special thanks to What A Day's wonderful hosts, Travelle Anderson, Priyanka Arabindi, Josie Duffy Rice, and Juanita Tolliver for welcoming us to the family.
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