The most crucial thing to understand in the aftermath of Friday's decision to rescind the FDA approval of Mifepristone by Donald Trump-appointed Judge Matthew Kacsmaryk is this: It is not a ban on medication abortion in the U.S. Pill-induced abortions will still be available, even if this decision is allowed to stand. They will continue to be safe. But aborting a pregnancy without Mifepristone will just be a more miserable experience than it was before the far-right district court judge ignored all law and science to impose his anti-choice ideology on the health care access of millions of Americans.
"We're already talking about switching over to Misoprostol-only regimens," Dr. Kristyn Brandi, an ob-gyn who serves as the board chair of Physicians for Reproductive Health, told Salon. The World Health Organization has long approved of Misoprostol-only abortions.
Right now, the standard practice is for a patient to take Mifepristone, which causes the pregnancy to stop developing, followed by Misoprostol, which expels it. However, Misoprostol-only abortions are "incredibly safe and effective," Dr. Brandi continued, just "not our first choice." That's because Misoprostol-only abortions "have more side effects." She explained that "It causes people to feel really crampy and uncomfortable. It can cause people to throw up and have fevers." It's also more likely to result in an incomplete abortion, requiring a patient to return for more follow-up care.
In other words, Kacsmaryk's decision, which the Justice Department asked a federal appeals court to block on Monday, serves no other purpose but to punish patients who seek abortion by making the process more miserable than it needs to be. That's it. It doesn't make abortion illegal. It doesn't make patients less likely to seek an abortion. It doesn't reduce the need for abortion. It certainly doesn't make abortion safer. This is only about the sadistic desire of Republicans to inflict unnecessary pain on abortion patients. It is pure misogyny, done only because Republicans haven't figured out a legal way to flog women in public for having sex.
Kacsmaryk's decision serves no other purpose but to punish patients who seek abortion by making the process more miserable than it needs to be.
Extreme bad faith has always been the dominant feature of the anti-choice movement. Its leaders love to claim opposition to abortion is about "life," a facile claim easily disproved by the right's opposition to any other policies — from universal health care to an expanded social safety net to free contraception — that would reduce the need for abortion. But even by the basement-level standards of the religious right, Kacsmaryk's 67-page decision is a whirlwind of dishonesty. He falsely claims his decision to block the use of Mifepristone "is justified and necessary to protect the public's health." He grouses that the "side effects" include "cramping and bleeding."
But, as Dr. Brandi explained to Salon, Mifepristone reduces the amount of cramping and bleeding patients experience. The drug exists to make abortion safer, quicker, and less painful. Kacsmaryk pretends he wants women to avoid "cramping and bleeding," but by imposing this rule, he has only insured that women will endure more cramping and bleeding. For women who abort — and make no mistake, women will continue to get abortions whether Kacsmaryk likes it or not — the process will suck more. For women who continue pregnancies, well, giving birth is not the choice for those who would like to avoid cramping and bleeding.
The main impact of this abortion pill decision will be to increase the amount of unnecessary suffering women endure. Despite that obvious and easily verifiable fact, the New York Times is still carrying water for the religious right, publishing a puff piece about Kacsmaryk on Friday that downplays the malice underpinning his decision and falsely implies he means well by women. The article heavily quotes Sherri Statler, who receives donations from Kacsmaryk for her anti-abortion center. "I just know he just has a real tender spot for caring for women," Statler claimed to the New York Times.
This, of course, is the opposite of the truth.
The New York Times writer, Abbie VanSickle, elides it, but there's a substantial public record indicating that Kacsmaryk is motivated mainly by a far-right belief that non-procreative sex is sinful, and the government should punish people for having it. As the Texas Tribune reports, before he was a judge, Kacsmaryk was a lawyer for the First Liberty Institute and was heavily involved in filing lawsuits to prevent women from using health insurance to pay for contraception. He also opposes LGBTQ rights and has argued that health care workers should be able to deny people care simply because they're queer.
Extreme bad faith has always been the dominant feature of the anti-choice movement.
Kacsmaryk has a favorite term to smear anyone who believes women and LGBTQ people have a right to sexual autonomy: "sexual revolutionaries." In 2015, he condemned the "sexual revolutionaries" who believe that it's okay to have sex without "procreation." In the same piece, he denounced the 1965 Supreme Court decision that legalized contraception. He goes back to the phrase again and again, when condemning legal abortion, same-sex marriage, and accepting trans people. Anything that's not procreation-oriented sex inside a marriage is, in Kacsmaryk's long writing career, a "sexual revolutionary."
Kacsmaryk's definition of "sexual revolutionary" is so expansive, in fact, that it captures nearly every adult American. In 2006, statistics showed that 95% of Americans have sex outside of marriage by the age of 44, a number that has likely only risen since then. Over 99% of sexually active women have used contraception. To be a non-revolutionary in Kacsmaryk's topsy-turvy worldview, you would have to be part of a minority so tiny as to be statistically insignificant.
These statistics matter because it really underscores how, despite all the successful spin Republicans put on the anti-choice movement in the press, it's actually a small minority of radical fundamentalists. It helps illustrate how much this movement is not about "life" and certainly not about helping. It's a movement rooted in a deeply sadistic urge to inflict pain on other people for having very normal, natural, and universal desires, such as the desire to have sex without making babies. Kacsmaryk can't turn women into what he wants them to be, which is desire-free dolls who only tolerate sex in order to procreate. But he can make them needlessly suffer for the "sin" of being human. Sadism and misogyny are what fuel the anti-choice movement, and this abortion pill decision is crystal clear proof of that.
