Wyoming became the first state to ban the use of abortion pills, adding momentum Friday to a growing push by conservative states and anti-abortion groups to target medication abortion, the method now used in a majority of pregnancy terminations in the United States.
Wyoming's new law comes as a preliminary ruling is expected soon by a Texas judge that could order the U.S. Food and Drug Administration to withdraw its approval of mifepristone, the first pill in the two-drug medication abortion regimen. Such a ruling, if it stands, could upend how abortion is provided nationally, affecting states where abortion is legal as well as states with bans and restrictions.
Legislation to ban or add restrictions on medication abortion has been introduced in several states this year, including a bill in Texas that would not only ban abortion pills but also require internet service providers to take steps to block medication abortion websites so people in Texas could not view them.
In these states, proposals to block or restrict abortion pills have typically been introduced along with other anti-abortion measures, a reflection of the range of obstacles to abortion these states have tried to erect since the Supreme Court overturned the national right to abortion in June.
Medication abortion is already outlawed in states that have total bans, since those bans already prohibit all forms of abortion. But Wyoming became the first state to outlaw the use of pills for abortion separate from a total ban.
Wyoming Gov. Mark Gordon, a Republican, signed that state's abortion pill ban on the same day that he said he would allow another more sweeping measure banning abortion to become law without his signature. That law, which takes effect Sunday, would ban abortion under almost all circumstances, making it a felony to provide an abortion.
"I have acted without bias and after extensive prayer, to allow these bills to become law," Gordon wrote in a letter to Wyoming's secretary of state released Friday evening.
Gordon said in the letter he withheld his signature from the broader abortion ban because he feared it would complicate matters in an ongoing legal battle over an earlier abortion ban passed by Wyoming legislators.
The broader ban outlaws medication abortion as well, and the measure that bans abortion pills would mostly have the effect of creating additional penalties for medication abortion providers.
Both laws are likely to be challenged quickly in court by abortion providers, who will seek to prevent the bans from taking effect while the legal challenge proceeds.
A previously enacted abortion ban has so far been blocked by the courts after providers and others filed suit claiming that the law violated the Wyoming Constitution's guarantee of freedom in health care decisions. The newly enacted abortion ban is an attempt to circumvent that constitutional provision by declaring that abortion is not health care.
Wyoming's abortion pill law would take effect July 1 and would make it illegal to "prescribe, dispense, distribute, sell or use any drug for the purpose of procuring or performing an abortion."
Doctors or anyone else found guilty of violating this law would be charged with a misdemeanor, punishable by up to six months in prison and a $9,000 fine. The law explicitly says that pregnant patients will be exempt from charges and penalties.
RESTRAINING ORDER FILED
Wyoming has only one clinic that provides abortions, Women's Health & Family Care Clinic in Jackson. It provides only medication abortion, not the surgical procedure.
"The impact of that legislation not only infringes on our constitutional rights, it actually causes harm," said Dr. Giovannina Anthony, an OB-GYN at the clinic. "Criminalizing evidence-based medicine is really what this boils down to, and that, in the end, honestly, will lead to maternal deaths and horrible outcomes for both mothers and babies."
Anthony and other health providers are plaintiffs in a lawsuit against Wyoming's previously enacted abortion ban, which the courts have blocked pending review by the Wyoming Supreme Court.
On Friday, the same plaintiffs filed a request for a temporary restraining order to block the new broader abortion ban, since that ban would otherwise take effect right away. A hearing on that request is scheduled for Wednesday.
Anthony said she and the other plaintiffs will also be filing a court challenge to the medication abortion ban. In the meantime, Anthony said, she will be canceling abortion appointments scheduled for Monday and Tuesday.
"The number of women who pursue abortion in a rural state like this is relatively few compared to more highly populated states, but it still is a very chilling effect on our obstetric care," she said.
Earlier versions of the bill had named specific drugs: mifepristone and two brand-name versions of it, as well as misoprostol, the second drug used in the medication abortion regimen. But doctors testified in objection, pointing out that misoprostol, in particular, had many other medical uses, including helping pregnant patients successfully give birth.
The doctors raised concerns that pharmacists would be fearful of stocking any of the drugs, and some Republicans said names of abortion medications could simply be changed to get around the law. As a result, the final language was broadened to outlaw using any medication for abortion without mentioning specific drugs.
At least three other bills have been introduced this year that seek to ban medication abortion.
In Iowa, the bill did not make it to a vote before the legislative session ended, and in Hawaii, a Democratic state, the bill seems unlikely to succeed.
A bill introduced in Texas, a state that already bans abortion, includes many provisions that seek to close off any access to pills, including making it difficult for Texas patients to learn about or use abortion services outside of the state. The bill would make it illegal to manufacture, distribute or "provide an abortion-inducing drug in any manner to or from any person or location in this state."
Under the other new Wyoming law, the "Life Is a Human Right Act," performing an abortion or administering abortion medication would be considered a felony, punishable by up to five years in prison, and doctors would have their licenses revoked. The law bans abortion with narrow exceptions for rape, incest and dire risks to the pregnant patient's life or health.
"While other states are pushing an extreme abortion agenda, comparable to North Korea's and China's inhumane laws, Wyoming is a pro-life state, affirming that life is a human right and ensuring that women have real support," said state Rep. Rachel Rodriguez-Williams, sponsor of the bill.
The law is intended to replace an existing ban, which is now on hold because of a legal challenge over its constitutionality. How that affects the actions of the Wyoming Supreme Court, though, remains to be seen.
At issue is the definition of health care: Under the Wyoming Constitution, residents have the right to make their own health care decisions. So, the new law stipulates that abortion is not health care.
"Instead of being health care, abortion is the intentional termination of the life of an unborn baby," the new law states. "It is within the authority of the state of Wyoming to determine reasonable and necessary restrictions upon abortion, including its prohibition."
A group seeking to open an abortion and women's health clinic in Casper said it was evaluating legal options.
"We are dismayed and outraged that these laws would eradicate access to basic health care, including safe, effective medication abortion," Wellspring Health Access President Julie Burkhart said in a statement Saturday.
The clinic, which a firebombing prevented from opening last year, is one of two nonprofits suing to block an earlier Wyoming abortion ban. No arrests have been made, and organizers say the clinic is tentatively scheduled to open in April, depending on abortion's legal status in Wyoming then.
In a statement, Wyoming ACLU advocacy director Antonio Serrano criticized Gordon's decision to sign the ban on abortion pills.
"A person's health, not politics, should guide important medical decisions -- including the decision to have an abortion," Serrano said.
Information for this article was contributed by David W. Chen and Pam Belluck of The New York Times and by Mead Gruver of The Associated Press.