A dangerous new chapter of post-Roe America is here

0:03 up quietly on Friday night at first glance,

0:06 it's going to sound like a story about one state that already bans abortion.

0:11 But there's a ripple effect that's going to roll

0:13 back abortion access nationwide and it's by design.

0:16 Here's what happened.

0:17 Louisiana sued the food and drug administration

0:20 over a rule that allowed the abortion pill,

0:22 Mifepristone, to be prescribed and dispensed via telehealth.

0:27 The state's argument was that mail order access

0:29 to abortion medication undermined that state's abortion BAN ON FRIDAY,

0:34 A FEDERAL APPEALS COURT PANEL AGREED AND ISSUED

0:38 A RULING TEMPORARILY BLOCKING MAIL ORDER ACCESS,

0:40 NOT JUST IN LOUISIANA, ACROSS AMERICA.

0:44 NEARLY TWO-THIRDS OF ALL ABORTIONS IN AMERICA ARE MEDICATION ABORTIONS.

0:48 IT'S IMPORTANT TO UNDERSTAND THAT THIS RULING IS GOING TO BE

0:50 DEVASTATING FOR PATIENTS WHO LIVE IN STATES WHERE ABORTION IS BANNED,

0:53 BUT IT WILL AFFECT PATIENTS IN STATES WHERE ABORTION RIGHTS ARE STILL PROTECTED.

0:57 STARTING NOW AND FOR AS LONG AS THIS RULING is allowed to stand,

1:00 it will be harder for anyone seeking a medication abortion to access one.

1:04 It's one more medically unnecessary roadblock for women who are

1:07 trying to access safe and reliable health care across the country.

1:11 The drugmaker that makes Miffy Pristone has already asked the Supreme Court

1:15 to step in and reverse the appeals court ruling on an emergency basis.

1:18 But for now, it is in effect, which means medication abortion is less accessible

1:23 to everyone in America who might need it,

1:25 and particularly to those women who cannot go in person

1:28 to a doctor to get it because their state bans abortion.

1:31 The end of Roe was always the beginning

1:33 and not the end of the anti-abortion movement's agenda,

1:36 and it's not going to stop until abortion is unavailable,

1:40 inaccessible or illegal everywhere.

1:42 And here's the thing, it doesn't stop with abortion.

1:46 The very same radical movement to control women's bodies is also going after

1:50 birth control and it's getting no small

1:51 amount of help from the Trump administration,

1:54 which is quietly rewriting the rules of a decades-old federal

1:57 program that gave access to birth control to millions of Americans.

2:01 In 1970, Congress created Title 10, which expanded access to contraception

2:08 and reproductive health care for low-income families.

2:10 As of 2023, roughly 2 .8 million people received services through Title 10,

2:17 85% were women, 48% were people of color.

2:21 72 of those who got care through Title 10

2:24 say they used the contraception they received for family planning.

2:29 But now they could lose that access because the Trump administration

2:32 is shifting the program to focus on so-called natural family planning.

2:37 I'm going to say that again, natural family planning.

2:40 That pushes tracking menstrual cycles as a form

2:44 of pregnancy prevention instead of using birth control.

2:47 In its new guidelines for funding, Title X grants in 2027,

2:51 the Department of Human Services, Health and Human Services writes, quote,

2:54 we expect applicants to demonstrate how their Title X

2:57 projects will integrate non-invasive

2:59 evidence-based practices that promote health,

3:04 literacy, fertility awareness and reproductive health without

3:08 unnecessary medicalization or symptom suppression, end quote.

3:12 Unnecessary medicalization or symptom suppression.

3:16 In plain terms that means less birth

3:19 control more cycle tracking these new guidelines

3:23 could affect the funding that a clinic

3:25 gets when it reapplies for funding in 2027.

3:27 The shift comes even as the overwhelming

3:29 majority of Americans support access to contraception.

3:32 We don't talk about this a lot because it's not even close.

3:35 91% of Americans say they believe birth, they support birth control.

3:40 We're talking, we're not talking about abortion.

3:42 We're talking about contraception.

3:43 91% of Americans say it should be legal.

3:47 of Americans probably don't agree that it's Sunday today.

3:50 So why are we rolling back access to contraception?

3:53 University of California, Davis law professor, Mary Ziegler has an idea.

3:57 She says that as Trump's approval ratings continue to drop,

4:00 he's become eager to appeal to social conservatives at the fringe of his base.

4:04 She writes, quote, without the pill, contraception,

4:08 conservatives seem convinced that women would be

4:10 more likely to prioritize marriage and child rearing.

4:13 And if that happened, these advocates suggest we'd all be better off.

4:16 Then there is the rising influence of pro natalists who want to see

4:21 more babies being born and blame

4:22 contraception in part for declining birth rates.

4:25 Mary Ziegler joins me now.

4:27 She's a professor at the University of California Davis Law School.

4:30 She's the author of many books,

4:31 including Personhood, The New Civil War Over Reproduction.

4:34 Mary, it's great to see you again.

4:35 Thank you for being with us.

4:37 Thanks for having me.

4:37 I want to touch that last point.

4:40 The THE IDEA THAT IF YOU DON'T HAVE ACCESS TO CONTRACEPTION,

4:43 PEOPLE WILL HAVE MORE CHILDREN.

4:46 ALL ACROSS THE DEVELOPED WORLD, PEOPLE ARE HAVING LESS CHILDREN.

4:50 AND THERE ARE A MULTITUDE OF FACTORS INVOLVED IN THAT.

4:52 THE EDUCATION OF WOMEN, THE ACCESS that women have to the workforce,

4:56 the economy's needs, the cost of rearing children,

4:59 the availability of child care.

5:01 Condorception is but one part of a very large equation that we need to consider.

5:08 Yeah, absolutely.

5:09 And I think the other thing that makes the contraception point obviously

5:12 wrong is that Americans have had access to contraceptives for decades now.

5:17 Right.

5:18 And And we've seen a steady decline in birth rates,

5:19 not because we've had more access or different access to contraceptives.

5:24 There haven't been particularly new effective contraceptives on the market

5:28 in the United States since the early 2000s, right?

5:31 So, if we're seeing a change in birth rates in the United States,

5:34 it's not because we're seeing a change in contraceptives.

5:37 So this is, in some ways, I think more of an excuse to focus on birth

5:41 control than it is an actual change produced by birth control.

5:45 So what, why, why you write that contraception has gone

5:48 from politically untouchable to a real target on the right?

5:50 What's, what is that shift about?

5:53 Well, I think it's, it's two things, right?

5:55 So, you mentioned earlier, Ali,

5:58 that the Trump administration has not really done

6:00 as much as social conservatives want on abortion.

6:03 It's strange, right, that the abortion case headed to the Supreme

6:07 Court is Louisiana suing the Trump administration.

6:09 So, in part, the Trump administration is looking for a way to appease

6:13 social conservatives because it hasn't known how to approach the abortion issue.

6:16 At the same time, we've seen a lot of different Trump constituencies who

6:20 are unhappy with him on many other things unite on birth control, right?

6:25 So there's become a kind of new coalition politics of opposing contraception.

6:29 And the president is looking for a way

6:32 to reach those social conservative voters who are angry

6:35 with him about other things when the administration

6:37 still doesn't know how to approach the abortion issue.

6:40 Let's turn to this ruling on the abortion pill, Miffy Pristow.

6:44 And the court didn't ban it outright,

6:46 but it did restrict access through telemedicine and mail delivery,

6:50 which is the way in which many, many people get Miffy-Pristone.

6:54 Talk to me about how significant this change is

6:57 in the practice of how women will access as abortions?

7:00 Liz, it's really going to be, I think,

7:02 a bombshell in states where abortion is a crime because there's lots of data

7:07 to suggest that abortion rates have not really decreased in states with bans.

7:10 And the reason for that is a network

7:12 of what have been called shield laws, right?

7:14 Where doctors in states like California have been

7:17 able to mail pills into states like Louisiana.

7:19 But that whole system is predicated on the availability of telehealth.

7:24 And that's going to go away, at least with respect to mifepristone.

7:27 There's some sign that some providers may

7:28 pivot to other methods of medication abortion, but that remains to be seen.

7:34 At the moment, though,

7:35 we may see people in these states be forced to travel out of state,

7:42 to rely on less-proven medication abortion protocols or get surgical procedures.

7:47 And that's just in banned states, right?

7:49 I mean, people in other states who don't live near an abortion

7:52 clinic are now going to have to go in person, right?

7:54 There are almost half of counties in California,

7:57 which has the most clinics in the United States.

8:00 Half of those counties don't have a clinic, right?

8:02 So the ripple effects are going to be felt everywhere.

8:05 So public health experts say that this could have consequences

8:08 that go beyond abortion access if you start restricting telemedicine,

8:13 you know, in the uses of Miphypristone.

8:16 There's also an effect on miscarriage care or frankly,

8:20 pregnancy care in general.

8:22 Talk to me about patient safety.

8:24 Telemedicine was a very big advance for patient safety.

8:28 Yeah, absolutely.

8:30 So telemedicine, this sets a precedent.

8:33 Essentially, the argument is that telemedicine is more suspect and the FDA

8:36 has to be more careful

8:38 in authorizing telemedicine treatments involving key drugs.

8:42 And that's an argument that could I believe,

8:58 at least with respect to mifepristone and probably with other

9:00 treatments that we'd be looking

9:01 at particularly significant impacts with teenagers.

9:03 We have seen data that teenagers are

9:06 especially likely to use telehealth in some contexts.

9:10 So, So we're thinking about patient safety,

9:12 but also remembering that there are particular communities

9:15 of patients who are going to be especially affected.

9:17 Well, in your book, you examine personhood laws

9:20 and the push to expand rights to the unborn.

9:23 Talk to me about the connection between restricting

9:26 contraception and the anti-abortion agenda in that sense.

9:30 Yeah, well, so the anti-abortion movement,

9:32 in addition to believing that Americans have kind

9:36 of abandoned traditional family formations that we need to flourish,

9:40 also believes that a lot of common

9:43 contraceptives are in fact abortifacients, right?

9:45 So they believe that the birth control pill, IUDs,

9:48 that these are drugs or devices that actually

9:52 prevent the implantation of a fertilized egg.

9:54 And they believe that constitutional rights

9:56 begin the moment an egg is fertilized.

9:59 So if that's right, then contraception is something that violates human rights,

10:04 that is tantamount to murder the same way that abortion would be.

10:09 So that's part of what's driving this fight,

10:11 both against abortion and contraception and kind

10:14 of what the through line is between the two.

10:16 Mary, always great to talk to you.

10:18 Thank you for being with us this morning.

10:19 Mary Ziegler is an historian and law professor at UC Davis Law School.

10:23 She's the author of the book Personhood, The New Civil War Over Reproduction.