Abortion pills take the spotlight as states impose abortion bans

Many patients choose medication abortion because it is less expensive, less invasive and affords more privacy than surgical abortions — the pills can be received by mail and taken at home, or anywhere, after an initial consultation with a doctor by video, phone, in person or even just by filling out an online form.

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The patient must participate in the consultation from a state that allows abortion, even if it simply involves being on the phone in a car just over the border. The IP address of the computer or phone they use allows the clinic to identify where they are.

For states that ban all forms of abortion, medication abortion is likely to provide significant enforcement challenges. It is one thing to shut down a clinic; it is much harder to police activities like sending or receiving pills through the mail or traveling to a state where pills are legal to have a consultation and pick them up, legal experts say.

“When people say we’re going back to the days before Roe, there’s no such thing as a time machine — we have a very different pharmaceutical landscape,” said Katie Watson, a constitutional scholar and medical ethicist at the Feinberg School of Medicine at Northwestern University.

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