Legal challenges keep NC abortion law in flux
By Rachel Crumpler
More than a year after state lawmakers passed Senate Bill 20, adding new abortion restrictions in a late-night vote overriding Gov. Roy Cooper’s veto, the status of the law dictating access to the procedure in North Carolina remains in flux. That’s because the law has been entangled in two lawsuits that challenge some of the requirements lawmakers implemented.
A federal judge’s ruling on June 3 in the first case loosens restrictions on how medication abortion pills can be provided in North Carolina. The same judge will soon determine the fate of two other contested provisions in a second case.
U.S. District Judge Catherine Eagles in Greensboro issued her judgment, which struck down several of North Carolina’s rules on dispensing medication abortion pills. She ruled that the state’s new restrictions exceeded what the U.S. Food and Drug Administration requires. In an April written opinion, she explained her reasoning that state lawmakers cannot overrule the federal agency’s regulatory authority by mandating patients only obtain medication abortion pills from a physician in person — requirements the FDA specifically determined are unnecessary for safe use.
Now midwives, nurse practitioners and physician assistants will be able to prescribe mifepristone and provide medication abortions, opening a new pool of providers for abortion care in the state. These advanced practice clinicians and physicians can also prescribe medication abortion pills via telehealth, allowing patients to take mifepristone at home.
Eagles also struck down the requirement imposed by the N.C. General Assembly that patients schedule an additional in-person follow-up visit when obtaining a medication abortion — a requirement that meant three appointments for patients in North Carolina.
“Politicians in North Carolina cannot interfere with the FDA’s authority and impose medically unnecessary restrictions on medication abortion care,” said lead plaintiff Amy Bryant, a Chapel Hill-based obstetrician-gynecologist, in a statement after the ruling.
Eagles’ ruling opens up more options for providing and obtaining medication abortion pills in North Carolina — options that have been available for years in Virginia and other states.
Now, it’s up to abortion providers and clinics to work through the logistics of implementing the new options that could increase access to the procedure.
“We’re looking into ways that these new law changes will help us expedite and make more efficient care plans in the clinic,” said Calla Hales, executive director at A Preferred Women’s Health Center, which operates two abortion clinics in North Carolina.
Hales said she’s cautiously optimistic that the changes to medication abortion access in the state may help expand capacity, which she said is sorely needed to meet the demand of North Carolinians seeking care, as well as an influx of patients from other states in the South.
“There’s a lot of possibility and potential for expanding access, but kind of in that same vein, it’s one of those things that you have to build the support around to see the change,” Hales said. “It’ll be an interesting couple of months as we see this really kind of take hold.”
Expanded access
Jenny Black, president and CEO of Planned Parenthood South Atlantic, said in a statement that the ruling is a “victory for thousands of patients statewide, particularly in rural areas, who have been deprived of full access to medication abortion.”
Abortion opponents decried the ruling.
“This decision puts women’s health and safety at risk so the abortion industry can fast-track dangerous chemical abortions and maximize profits,” said NC Values Coalition head Tami Fitzgerald. “In-home abortions leave women and girls to give birth to their dead babies at home alone without the assistance of a doctor, often long after the 10-week limit the FDA recommends.”
Medication abortion using a two-drug regimen of mifepristone and misoprostol is the primary way people access abortion nationwide. In North Carolina, abortion using pills — commonly known as medication abortion — accounts for nearly 70 percent of total resident abortions, according to the latest state data, with 19,967 medication abortions being provided in 2022.
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