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How the Supreme Court abortion pill case could affect access in NH

The exterior of Planned Parenthood's clinic in Keene
Casey McDermott
Kayla Montgomery, with Planned Parenthood of Northern New England, said about 72% of patients opt for medication abortion across the three states they serve: New Hampshire, Vermont and Maine.

New Hampshire abortion providers say the medication at the center of a major legal fight before the U.S. Supreme Court has been key to expanding abortion access locally.

Abortions done via medication, rather than an in-clinic procedure, have become increasingly common in recent years, as the Food and Drug Administration has made it easier to access mifepristone – one of two drugs used in medication abortions.

The lawsuit before the Supreme Court is seeking to reinstate a series of restrictions that the FDA relaxed starting in 2016. Depending on the court’s decision, it could limit FDA approval for medication abortions to the first seven weeks of pregnancy – rather than the current 10 weeks – and bar providers from prescribing abortion pills via telehealth.

Medication abortions made up 63% of all abortions nationwide in 2023, according to the Guttmacher Institute, a research organization that supports abortion rights. That’s up from 53% three years earlier.

The share is even higher across Planned Parenthood of Northern New England, according to Kayla Montgomery, the organization’s vice president of public affairs. She said about 72% of patients are opting for medication abortion across the three states they serve: New Hampshire, Vermont and Maine.

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Montgomery said being able to see a provider virtually and receive pills by mail has made abortion more accessible for many Granite Staters. Since the FDA removed an in-person prescribing requirement in 2021, Planned Parenthood and other organizations have started offering medication abortions by telehealth.

“That is a great way to expand access for people, especially people who are living in rural parts of the state, in the North Country, or maybe aren't able to come to a health center due to other barriers like transportation or child care issues,” Montgomery said.

Montgomery said rolling back the timeframe when medication abortions can take place could also limit patients’ options.

“People learn that they're pregnant at different times,” she said. “There's no sort of start date to this, of when you find out.”

Telehealth abortions also offer patients more privacy, said Sandra Denoncour, the executive director at Lovering Health Center in Greenland. That can be especially important for people who fear an abusive partner.

“Whether people feel safe in relationships or in their community or in their home varies,” she said. “And so when I think about folks’ safety and privacy, most often what we hear from people is concerns about interpersonal safety.”

Potential impacts in New Hampshire

The FDA approved mifepristone in 2000 for use in terminating a pregnancy during the first seven weeks. It revised that to 10 weeks in 2016. During the pandemic, the agency removed a requirement that patients see a provider in person to receive the drug, allowing for widespread adoption of telehealth.

The lawsuit now before the Supreme Court was brought by a group of doctors who oppose abortion. Last year, a federal judge in Texas ruled the FDA’s original approval of mifepristone was invalid, creating widespread uncertainty about whether the drug would remain available.

An appeals court reversed that ruling, but said the FDA should reinstate certain limits on the drug’s use. That order is on hold while the Supreme Court considers the case.

The issue has drawn the attention of New Hampshire lawmakers. Last month, citing those lower-court orders, the New Hampshire House passed a resolution condemning “medically unnecessary restrictions” on medication abortion.

Meanwhile, the state Senate passed a bill directing New Hampshire health officials to study the availability of abortion medications and identify ways the state could improve access.

At Equality Health Center in Concord, which requires patients seeking medication abortions to have an in-person appointment, around 30% of abortions last year were medication abortions, said Executive Director Jinelle Hobson.

If medication abortion becomes harder to get, “we could see an increase in surgical abortions, which is an increase on staffing,” she said. “You know, it's a domino effect, right? And we'll see longer wait times for individuals to come in and have a surgical procedure.”

For now, Hobson is reminding patients that no new restrictions have taken effect.

“Nothing has changed,” she said. “We are still are providing medication abortion. It is still legal. It is still effective. It is still approved by the FDA.”

Paul Cuno-Booth covers health and equity for NHPR. He previously worked as a reporter and editor for The Keene Sentinel, where he wrote about police accountability, local government and a range of other topics. He can be reached at pcuno-booth@nhpr.org.