It is a critical time to re-examine the gatekeeper framing of the abortion right considering the dramatic conservative shift in the Supreme Court that threatens Roe, and in the midst of a pandemic, which—in a complete reversal of the Roe period—renders in-person care by a provider potentially dangerous. In January, the Supreme Court’s first abortion decision since President Trump’s appointment of three justices, FDA v. American College of Obstetricians & Gynecologists (“ACOG”), doubled down on the medical gatekeeper model by reinstating an FDA requirement that medication abortion pills must be dispensed in person by a provider. Re-examining the historical, social, and technological assumptions that animate the current framing of the abortion right is vital to thinking of new ways to frame and expand abortion access.
Today’s online medical and pharmaceutical marketplaces reveal that the Court’s confined vision of the abortion right was informed by the social and technological realities of its time—social and technological realities that no longer exist. If Roe’s cramped vision of the abortion right has run its course, as I argue here, then the movement to protect access to abortion must include direct consumer access to abortion. Empirical evidence reveals widespread use of self-managed medication abortion in the face of abortion restrictions. The shuttering of clinics as “non-essential services” during the COVID-19 pandemic and the unnecessary increased risk of clinic-based care for procedures that can be safely managed at home only amplify the need for direct-to-consumer access to abortion care. As state legislatures seek to make it easier to prosecute individuals suspected of terminating their own pregnancies, it is a crucial moment to reconsider the constitutional foundation of the abortion right and the right to self-managed care as a matter of criminal and reproductive justice and public health.
To read this Article, please click here: When Patients Are Their Own Doctors: Roe v. Wade in an Era of Self-Managed Care.