Rev. Love Holt, a mother of five, was rushed to the hospital for severe blood loss on January 20.
Just before, her mother had found her sitting in her car, halfway unconscious with blood dripping down her legs.
As she sat in a wheelchair in the Missouri hospital, all Holt could think of was avoiding jail time.
Holt knew she was having an abortion; her blood and tissue loss was the result of a medication abortion. But sharing that information with doctors could implicate her in criminal activity because Missouri had banned abortions except in life saving situations.
“I almost lost my life that day,” Holt said. “I would have left my children – my Black children – alone in this world to navigate it alone. Nobody to protect them.”
Holt, the community engagement director at Pro-Choice Missouri, shared her story at a roundtable discussion with House Oversight Democrats on Monday, highlighting why access to abortion can be life-saving.
Rep. Cori Bush (D-Mo.) led the discussion with Rep. Jasmine Crockett (D-Texas) and ranking member Jamie Raskin (D-Md.).
The roundtable highlighted the consequences of attempts to restrict abortion access as part of Republican-led efforts to impose a national abortion ban.
Mifepristone was approved by the Food and Drug administration in 2000, but since the Supreme Court’s decision in Dobbs v. Jackson, which overturned the federal right to an abortion, anti-abortion legislation has targeted the use of the pills with the same veracity as medical abortions.
“The Dobbs decision is a death sentence for thousands of Black women and birthing women,” said Holt.
More than half of all U.S. abortions in 2020 were medication abortions, according to the Guttmacher Institute.
Mifepristone, in combination with misoprostol, was the most commonly used pill in these abortions, accounting for 98 percent of medication abortions.
During her opening remarks, Bush held up a pack of abortion pills and said, “This is what an abortion looks like.”
“Medication abortion is a lifeline,” Bush added. “It’s a lifeline for the person working multiple jobs who can’t afford to take the day off work because wages are too low or they don’t have paid sick leave. It’s a lifeline for the mom of two who can’t afford childcare or who can’t find that affordable childcare. It’s a lifeline for the person who lives hundreds of miles away from the nearest clinic and does not have reliable transportation. It’s a lifeline for the trans folks who face transphobia and bigotry because of anti-LGBT+ laws and outrageous bans on gender affirming care.”
Nationwide, Black women are three to four times more likely to die from pregnancy or childbirth than white women. These disparities persist regardless of education or income.
“In restrictive states like mine,” Bush said, “medication abortion quite literally saves lives. Forced birth can be deadly. Every person should be able to decide for themselves whether to carry a pregnancy to term or to seek abortion care.”
While abortion rates have been on the decline for some time, according to the Guttmacher Institute, Black women seek abortions at almost five times the rate as white women. But with abortion no longer federally protected, advocates have expressed concern that Black mortality rates will increase, as well as incarceration rates for Black women.
Though some prosecutors have pledged to avoid enforcing abortion bans, lawmakers are looking to find ways to skirt these challenges with legislation that could circumvent the local prosecutor.
In Georgia, Indiana, South Carolina and Texas, lawmakers this year have introduced bills allowing state officials to bypass the local prosecutors or even dismiss them if abortion-related enforcement is determined to be too lenient.
Meanwhile, challenges to the abortion pill continue, with one lawsuit looking to outlaw the medication. The lawsuit, brought by five doctors, argues against the drug’s safety and FDA approval.
In April, the Supreme Court blocked decisions that would have banned the abortion pill, but it left the substance of the case with the Fifth Circuit of Appeals.
Dr. Jamilla Perritt, president and CEO of Physicians for Reproductive Health, said restrictions to abortion access can open people up to criminalization and surveillance. She warned against googling or even texting others about seeking abortion care.
“All of those things have been used to criminalize people for taking care of themselves,” said Perritt. “The prosecution of people for self managing their own care is discriminatory, it is discretionary and it is circumstantial. If people are suspected of doing something … they are most likely to look like me. And so we see that these prosecutions universally are people living on low incomes, almost always they are people of color, almost always they are young people.”
Bush in February reintroduced the Protecting Access to Medication Abortion Act with Sen. Tina Smith (D-Minn.)
The act defends access to medication abortion by protecting women’s access to mifepristone through telehealth and certified pharmacies, including mail-order services. The law would only apply in states where abortion remains legal.
Twenty-one states currently allow for medication abortion, while the mifepristone-misoprostol combination is currently legal in 36 states and Washington, D.C.
In January, the FDA finalized a rule to allow pharmacies to fill prescriptions for medication abortions.