Honoring Service: Cecile Richards

This morning, Cecile Richards, who fought for the rights of American women as the president of Planned Parenthood, passed away. Our lives as women, as families, as Americans are so much better because she was a part of them. She was wise, fearless, and relentless; really the best of us, unafraid to champion an often unpopular issue—women’s ability to make their own choices about their own bodies—that put her at personal risk.

Her family asked people to celebrate her life with New Orleans jazz, gatherings with friends and family over a good meal, and remembering something she said a lot over the last year: “It’s not hard to imagine future generations one day asking: ‘When there was so much at stake for our country, what did you do?’ The only acceptable answer is: ‘Everything we could.’”

That is how she lived her life.

Cecile was our guest for Five Questions in March of 2024, as the Supreme Court considered ending women’s access to medication abortion. She had some things to say then, as she continued to relentlessly pursue good works while fighting her own fight. The original column is here, but I’ll include them here, as we honor her life and say goodbye to a great American hero.

Joyce: How big of a problem is it for access to abortion if the Supreme Court approves measures that roll back access to mifepristone? How would that affect women's health?

Cecile: Medication abortion is now by far the most common method for ending a pregnancy in the United States. Last year, it accounted for nearly two-thirds of all abortions in the country. Walgreens and CVS, the two biggest pharmacy chains in the country, just received their certification to start filling prescriptions for mifepristone in their stores, which is a significant step forward for access and an indicator of the rising demand for medication abortion.

One reason for that increased demand? Abortion restrictions. After the leak of the Dobbs decision, online searches for information about abortion pills skyrocketed, especially in states hostile to abortion. (The need to make sure folks are getting accurate, up-to-date information online about all available resources, including abortion pills, was one of the driving forces behind the founding of Charley, a chatbot that provides information about abortion options in every zip code in the U.S.)

The anti-abortion activists who brought this case are asking the court to return to FDA guidance from nearly a decade ago. Right now, telemedicine gives people an affordable way to consult virtually with a licensed clinician in the U.S., and receive pills in the mail to take at home. Thanks to shield laws that protect health care providers located in certain states from criminal liability if they prescribe abortion pills to people in states where abortion may be illegal, medication abortion is one of the last remaining options for people in the 21 states that have banned or severely restricted abortion since Roe was overturned. It’s also crucial for people in rural areas who would otherwise be forced to travel hundreds of miles just to pick up medication. Losing this resource would be devastating.

The potential impact of this decision extends far beyond women’s health. Putting the political agenda of anti-abortion activists ahead of science, evidence, and medicine would undermine innovation and make other critical, lifesaving medications unavailable – which is why patient advocacy groups including the American Cancer Society, public health researchers, and pharmaceutical companies have spoken out so strongly against it.

Joyce: What outcome do you expect from this case? Will the Justices approve a full-on ban on mifepristone or something else?

Cecile: This is a baseless case that shouldn’t even be before the Court to begin with. It lacks any legal merit and relies on junk science. In fact, this February, an academic journal had to retract two of the studies at the heart of the case against mifepristone due to factual errors and “a lack of scientific rigor.” Mifepristone has been used safely and effectively by more than 5 million people over the last two decades and rigorously tested by more than 100 scientific studies. It’s safer than Tylenol, Penicillin, or Viagra. A majority of people in this country, including a majority of Republicans, believe abortion pills should stay accessible. If the Court wants to preserve any last shred of legitimacy, they’ll rule against anti-abortion extremists in this bogus case.

Joyce: With this Court, there always seems to be something worse yet to come. Dobbs reversed Roe v. Wade and purported to leave access to abortion for each state to decide. Now, we see litigation to restrict access to women across the country, no matter what their state decides. Where does this go next, and should we be concerned with legal action, legislative action, or something else? Is a national ban a real prospect?

Cecile: Ending access to medication abortion would amount to a national abortion ban.

As always, any new abortion restrictions will fall most profoundly on people who are already hardest hit by abortion bans: people of color, people with low incomes, and people living in states that are hostile to abortion.

But for anyone who has been operating under the assumption that you’re safe because you live in a state like New York or California, nothing can be further from the truth. Changing the way medication abortion is prescribed and distributed will negatively impact 64.5 million women of reproductive age in America. So no matter where you live, this case should be on your radar.

Joyce: Is it realistic to think we could pass a national measure to guarantee access to abortion?

Cecile: This is not a matter of convincing the American people that abortion is an important health care issue. A majority of Americans believe abortion should be legal, and a poll conducted a year after Roe was overturned found that one in four Americans said state efforts to ban or restrict abortion have made them more supportive of abortion rights, not less. Every time abortion has been on the ballot – including Kansas, Ohio, and Kentucky – abortion rights have won. These are matters that cross party lines, geography, race, and income.

One of the things giving me hope right now is the courage and resilience of people who are fighting to protect abortion rights – from health care providers to networks of determined people helping abortion seekers to get the care they need, whether that’s abortion pills by mail or rides to clinics in other states. In Tennessee, Allie Phillips was denied an abortion and set out to change state law so that what happened to her would never happen to anyone else. When her representative doubled down on abortion bans, she decided to run against him. If you haven’t watched Eva Burch, a state senator in Arizona, speak about her experience ending a wanted pregnancy in the state, I highly recommend taking 10 minutes to do that. And I’m still thinking about Brittany Watts, who was arrested and brought before a grand jury for having a miscarriage. After the charges against her were dropped, she said: “I want to thank my community, Warren, Ohio. I was born here. I was raised here. I graduated high school here. And I’m going to continue to stay here because I have to continue to fight.” Everywhere I go, people are channeling their collective grief and fury into collective action.

Joyce: If we don’t get, or being optimistic, if it takes some time to pass national protection for abortion rights, how can we protect them in the meantime? What does effective activism look like and what is the best messaging for us to use to make sure this issue is on the minds of voters heading into the election?

Cecile: The Supreme Court overturning Roe wasn’t like the Titanic hitting the iceberg, a one-time event. This is an ongoing crisis, and as we’re already seeing, it’s not going to age well – whether that’s because of the impact on fertility treatment or examples like the ones in a new report out just this week from Louisiana of the ways in which the state’s abortion ban puts patients and health care providers at risk. I’ve had conversations with gynecologic oncologists who have told me they can no longer care for their patients, or advise their patients on the best medical options. With every story that surfaces about the harm abortion bans have caused, it becomes harder for the public to look away, because this is affecting families across the country. We have already had one case of a woman dying due to the lack of access to abortion care, and it’s only a matter of time before there are others.

Leaders in the Republican Party have been working for decades to ban abortion, and now, in 14 states across the country, that’s exactly what they have done. When Roe was the law of the land, they could talk about all of this in the abstract. Now, they have to answer for the devastating impact their efforts have had on people’s lives, their families, their health. Abortion restrictions are driving obstetricians out of hostile states, with fewer medical students applying to OB/GYN residencies, which creates maternity care deserts. According to one study, women living in states that have banned or restricted access to abortion since Roe was overturned are three times more likely to die in pregnancy, childbirth, or the postpartum period.

Politically, one of the most important things any of us can do right now is bring attention to the lived experiences of people in states that have banned or restricted abortion. And practically, we can make sure people are familiar with all of their options for abortion care, including pills by mail. Whatever the Supreme Court decides, the genie is out of the bottle on this one – if people can no longer legally receive medication abortion via telemedicine from clinicians in the U.S., they’re going to find another way.

---

Sadness upon sadness this morning.

We’re in this together,

Joyce