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When Layidua Salazar went to the doctor in 2013, she expected it to just be a regular annual exam.
But when the nurse came in, she said Salazar wouldn’t be having a pap smear. She was pregnant.
Salazar was on birth control and felt sure the nurse had the wrong room. But they had run the test three times. “We are sure you’re pregnant,” the nurse told her.
There was another complication. Just days before, Salazar, who came to the U.S. from Mexico City without documentation when she was 5 years old, had received a deportation letter saying she had only eight months left in the country.
“I felt like the air was sucked out of me,” said Salazar, then 27 years old. “I felt like I was sinking.”
It was clear to Salazar she did not want to be pregnant in the midst of a deportation case.
“That deportation letter became completely real in that moment,” she said. “And I knew I did not want to have a child in that degree of uncertainty.”
She decided her best option: medication abortion.
OTHER LAWSUITSWith eyes on Texas mifepristone case, 2 other abortion pill lawsuits ‘flying under the radar’
As government approval of the major abortion pill mifepristone faces legal threats, abortion rights advocates fear access to medication abortion may be restricted nationwide. In the latest step in the case, a panel of three federal court judges heard arguments this month in a lawsuit aiming to withdraw the drug’s approval. After the panel makes its decision, the ruling will likely be appealed to the U.S. Supreme Court.
Amid the legal saga, people who’ve had medication abortions told USA TODAY the ability to choose mifepristone felt life-saving and gave them a sense of flexibility and control over their abortion experiences.
“It felt like coming up for air,” said Salazar, now 36 and living in Oakland, California after her DACA application was approved in 2015 and her deportation case was administratively closed. “When I found out I was pregnant, I felt like I was drowning. When I confirmed my appointments and got my medication, I felt like I could breathe again.”
ABORTION PILLSupreme Court sides with the Biden administration, halts restrictions on mifepristone
Is mifepristone safe?
The Alliance for Hippocratic Medicine, a coalition of anti-abortion groups, is suing the FDA to reverse approval of mifepristone, claiming the drug comes with medical risks that have landed women in emergency rooms and that its approval process was rushed. As a result, the plaintiffs say the drug should be pulled from the market.
But health experts and leading medical associations, including the Department of Health and Human Services, the American Medical Association and the American College of Obstetricians and Gynecologists, call mifepristone safe and effective for abortion and miscarriage care, pointing to the drug’s decadeslong safety record and studies showing it to be safer than common drugs such as Tylenol and Viagra.
Studies show major adverse reactions to the drug are “exceedingly rare,” occurring in about 0.3% of cases, according to the AMA. The FDA approved the drug in 2000 after three phases of clinical trials that began in 1983, a longer process than the agency’s average review time of about six months for similar drugs.
“This medication has been used safely and effectively in the United States by over 5 million pregnant people for the past 23 years and today accounts for more than half of all abortions in the United States,” said Ushma Upadhyay, a professor of obstetrics and gynecology at the University of California, San Francisco, who studies contraception and abortion care. “Study after study demonstrates the strong safety rating of over 99%.”
Medication abortion care in the U.S. typically involves a two-step regimen made up of the abortion drugs mifepristone and misoprostol. Amid uncertainty over the future of mifepristone access, many abortion providers are rushing to shift to misoprostol-only regimens, which have been used globally for years as a safe alternative when mifepristone isn’t available. But studies show it is less effective than the two-step regimen.
MIFEPRISTONE ‘SAFER THAN TYLENOL’Experts say amid court battle over major abortion pill
Choosing medication abortion
Salazar said she chose a medication abortion because she was able to get an appointment more quickly; it was cheaper than an in-person, surgical abortion, and was more accessible to her because she didn’t have a car.
After taking the pills, Salazar rested in her own bed while binge watching “Scandal.” She said she felt at peace in the comfort of her home, knowing this was “the right choice for me.”
“When I needed an abortion, it was a very difficult period in my life,” she said. “The least complicated of everything that was happening was getting my abortion. It was routine. It was uneventful. It was boring. That’s how every abortion should be.”
“It feels devastating to know that people are having their options limited in this way,” she added.
‘NO DRUG IS SAFE’Mifepristone court battle could threaten access to other FDA-approved drugs
Larada Lee-Wallace was a 19-year-old college sophomore when they had an abortion. Now state campaign manager for abortion access at the national nonprofit Advocates for Youth and based in the San Francisco Bay area, Lee-Wallace said accessing abortion care is “like the worst game of Tetris.”
“There are constant barriers – taking time off, scheduling appointments, traveling, costs, finding childcare,” she said. “Some people are facing intimate partner violence and may not be able to safely leave the house for a period of time to get a surgical abortion. It’s a really complicated process for so many people. So if there is an option available that will be easier or feel more comfortable to them in getting the care they need, that should be celebrated.”
For them, medication abortion felt like the safest option when they got an abortion during “the height of the COVID-19 pandemic” when most clinics had closed. It also allowed them to be surrounded by loved ones, including their sister.
“It was really beautiful, actually, to be in the comfort of my own home, to be with my sister and to have that love and support,” she said. “There are so many things outside of your control, so having some level of control over what I wanted to do, where I wanted to do it was huge.”
STATES RESPOND TO MIFE THREATSSome states stockpile abortion pills after Texas judge’s ruling on mifepristone
Jack Qu’emi, 32, also chose medication because it was cheaper and “felt more comfortable.” Qu’emi said access to medication abortion may be especially important to trans and nonbinary patients like them because of a deep history of medical trauma from health care settings where they may be misgendered, outed, disrespected or harassed.
“You may not feel safe in that space,” said Qu’emi, who is based in Los Angeles. “I don’t even want to go to the gynecologist because it feels invasive and because many of us have complicated relationships with our body. I thought self-managed options would be less invasive and feel more comfortable to me.”
As they wait to see what the future holds in terms of access to mifepristone, Qu’emi said they are scared and don’t know what they would have done if they didn’t have access to the drug a decade ago.
“I’m so grateful I had that choice and that option,” they said, “and I can’t imagine what other people are going through, having bits and pieces of their rights taken away from them one little chunk at a time.”
‘CHAOS AND CONFUSION’Abortion rights advocates across US speak out after latest setback
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