AMY GOODMAN: “The biggest attack on abortion since the end of Roe” — that’s what reproductive rights activists are calling Friday’s federal appeals court decision ordering the Food and Drug Administration, the FDA, to impose a nationwide restriction on the highly prescribed abortion pill mifepristone, which is used in roughly two-thirds of all abortions in the United States.

The decision came after Louisiana officials sued the FDA to restrict access to the safe and effective drugs, saying its availability by mail had allowed abortions to continue unabated despite the state’s near-total abortion ban. A three-judge panel sided with Louisiana, saying the healthcare providers may only prescribe mifepristone after seeing patients in person. The decision immediately disrupts delivery access to mifepristone, restricting abortion providers nationwide from prescribing the pills by telemedicine and sending them to patients by mail, even in states where abortion remains legal.

On Saturday, two mifepristone manufacturers petitioned the U.S. Supreme Court to immediately restore full access to the medication, putting the issue of reproductive rights in front of the conservative-majority court in a midterm election year.

Well, for more, we go to Boston, where we’re joined by Amy Littlefield, The Nation magazine’s abortion access correspondent, a journalist who focuses on reproductive rights, healthcare and religion, her new book titled Killers of Roe: My Investigation into the Mysterious Death of Abortion Rights.

Amy Littlefield, welcome back to Democracy Now! Can you talk about the significance of the court decision on Friday?

AMY LITTLEFIELD: So, this court decision takes aim at what has become a lifeline for abortion access, especially in states like Louisiana, where abortion is banned. The huge surge in unplanned pregnancies resulting in births that we had anticipated after the Dobbs decision, after the reversal of Roe v. Wade four years ago, has been much lower than people predicted. And that’s largely because of innovative ways of sending medication abortion through the mail, that have really been a lifesaver for people in these states, like Louisiana, who need to get their hands on medication abortion.

So, what you have here is three conservative justices on the 5th Circuit Court of Appeals — this is one of the most notoriously conservative courts in the country — taking aim at a Biden-era regulation that allowed mifepristone, which is one of two drugs used in the typical medication abortion protocol, to be sent through the mail. This means that people will have to go in person to get mifepristone instead of getting it in their mailbox, as has been happening for years.

I also want to mention what this court ruling does not do, however, Amy. What this court ruling does not do, it does not restrict misoprostol, which is the second drug that’s used in a typical medication abortion protocol and which is a powerful abortion drug that can be taken on its own, and, in fact, is taken on its own all around the world in countries where mifepristone is not available. It does not affect clinics that were dispensing mifepristone in person, so people can still go to a clinic and get the regular medication abortion protocol.

It also does not affect the wide swaths of the abortion access infrastructure in this country that are completely beyond the reach of U.S. courts. And this, I think, is the critical difference with this court decision versus where we were four years ago when the Supreme Court overturned Roe v. Wade. The abortion rights movement is far more prepared for a catastrophic decision like this.

And as a result, what we’re seeing is telehealth providers that have been shipping medication abortion all around the country, including in states where it’s banned, they’re pivoting to a misoprostol-only protocol, which might not be ideal, it can be slightly less effective, it can be more uncomfortable, produce more side effects, but it does work, and there is a World Health Organization recommended protocol for it. So we’re seeing telehealth providers pivoting to that.

And we’re also seeing community support activists, that have been circulating these pills by the thousands, stepping up and saying, “We knew that the courts were never responsible for our liberation. We were never going to look to the Supreme Court or the 5th Circuit Court of Appeals to decide what happens with our abortion access.” And so, we’re seeing these networks, and international providers, as well, that are beyond the reach of U.S. law and the courts, that are going to be going about business as usual this morning.

And so, the message I want to send to people who might need an abortion in this country is that these options are still available, because the abortion rights movement this time around had what we could call a Plan C. PlanCPills.org is the most popular website for information about these methods of getting a medication abortion, no matter what the courts do.

AMY GOODMAN: In March, Republican Senator Josh Hawley of Missouri posted this video on social media.

SEN. JOSH HAWLEY: Seventy percent of abortions in the United States, 70%, are caused by mifepristone. And that number goes up every year. There are more abortions now than there were when Roe v. Wade was still the law of the land. The fight for life is the fight to stop mifepristone from turning every mailbox in America into a Planned Parenthood.

AMY GOODMAN: “From turning every mailbox in America into a Planned Parenthood.” Amy Littlefield, your response? I think a lot of people will be surprised to know that abortion is up since the Supreme Court overturned Roe v. Wade.

AMY LITTLEFIELD: Yes, and I have to say Hawley is right about that, right? He is right that abortion has gone up every year since the Dobbs decision overturned the constitutional right to abortion. That’s true, even though 13 states today ban abortion outright, even though four more states have bans at about six weeks of pregnancy. And the reason that that’s true is that you have brave clinicians in states like New York who are mailing medication abortion by the thousands into states where abortion is banned. They’re operating under so-called shield laws that have been passed by states like New York and Massachusetts that protect clinicians in those states from extradition when they’re mailing these pills into states like Texas and Louisiana.

Now, that has made abortion opponents like Josh Hawley really mad, because their bans are not working. They are not driving down the number of abortions. And so, they’re pulling out all the stops to try to stop the unstoppable, to try to stop the flow of abortion pills through the mail, to try to stop these pills that can be pressed into one person’s hand from another, that can be dropped off in someone’s mailbox by a community support activist — right? — that can be ordered online from international pharmacies that are well beyond the reach of U.S. law. They’re trying to stop the unstoppable. And as a result, these restrictions are pretty draconian and increasingly absurd, right?

I want to note, Josh Hawley is, you know, part of a power couple from the abortion rights movement’s nightmares here. He is introducing legislation in the Senate, in Congress, to try to roll back the allowance of abortion pills by mail. Meanwhile, his wife, Erin Hawley, who works for Alliance Defending Freedom, the Christian right law firm that’s largely responsible for the Dobbs decision overturning Roe v. Wade, she is working with Louisiana to bring this court case that’s resulted in this 5th Circuit decision restricting access to mifepristone. So, I would love to be, you know, at their dinner table overhearing their conversations about the abortion pill every night. It seems that the best messaging they could come up with was “a Planned Parenthood in every mailbox,” which, I mean, honestly, I think, isn’t the worst tagline if the abortion rights movement wanted to run with that. That’s the future that progressives want: a Planned Parenthood in every mailbox, a taco truck on every corner. Why not?

But, you know, on a more serious note, I think what we’ve seen is there has been an increase in people bringing pregnancies to term that are unwanted after the Dobbs decision. I don’t want to discount that, right? There has been an increase in maternal mortality, right? A study that just came out from Johns Hopkins researchers that found a 9% rise in pregnancy-related deaths in states that ban abortion. So, what we’re seeing is that abortion bans do not seem to be very effective at driving down the number of abortions, because the number of abortions has gone up. In fact, what they seem to be effective at doing is killing women. Right? And so, you know, I want to note that, and we should pause just for a second and reflect on the 68 additional deaths that this study found that resulted by the end of 2023. That’s 68 people who might be alive today, if not for these restrictions on abortion that are killing people, you know, who are going to the hospital because they’re having a miscarriage, or who are going to the hospital because they have a rare complication from an abortion and need treatment and they’re not getting it in time because of these abortion restrictions.

AMY GOODMAN: Amy —

AMY LITTLEFIELD: So, that’s where our focus needs to be, close to four years after Dobbs.

AMY GOODMAN: I want to turn to Katie Glenn Daniel, the director of legal affairs for Susan B. Anthony Pro-Life America. This is Daniel speaking to the Catholic news outlet EWTN earlier this year.

KATIE GLENN DANIEL: Well, it’s so clear that these pills are deadly for unborn children. They’re also extremely dangerous for mothers. The FDA today, right now, could take these drugs out of the mail. We hope they do. They’ve said that they’re going to do a safety review, and we’re confident that if that review is done honestly, they will find that these drugs have no business being on shelves or available in the United States. They are so harmful. They’ve killed millions of children. But we hope that they see the urgency that we see, and they act — at least, at a minimum, get these drugs out of the mail, so that predators and abusers cannot get access to them, as we frequently see.

AMY GOODMAN: So, Amy, if you can respond and also talk about what is next, as the mifepristone companies, the makers, have also appealed the decision?

AMY LITTLEFIELD: So, abortion rights supporters will, of course, point out there have been more than a hundred studies demonstrating that mifepristone is safe and effective. It’s been on the market in the United States for more than 20 years. During that time, by the FDA’s own numbers, with about 6 million uses of this drug, they have counted only 32 deaths, of which only about half were actually attributable to the abortion. So, it’s just simply not true that this is a dangerous pill for people to take.

In fact, the reason that we’re seeing attempts to restrict it, including from, you know, Republican appointees on the conservative 5th Circuit Court of Appeals, the reasons are political, right? The reasons have to do with ideological opposition to abortion. They have nothing to do with women’s health. Importantly, of course, the Trump FDA could have restricted access to mifepristone and has not done so. Instead, the FDA is conducting this safety review of mifepristone. Anti-abortion operatives, like Josh Hawley, are very frustrated with the pace of that review, and it’s widely understood that the Trump administration had been trying to wait until after the midterm elections to restrict mifepristone. That will tell you everything that you need to know about how popular abortion rights are in this country. However, this court decision sort of forces the Trump administration’s hand and will put the issue of abortion access back before voters and make it top of mind once again in a midterm election year.

AMY GOODMAN: Amy Littlefield, I want to thank you for being with us, The Nation’s abortion access correspondent, focusing on reproductive rights, healthcare and religion. Her new book is Killers of Roe: My Investigation into the Mysterious Death of Abortion Rights. To see our interview on the book, go to democracynow.org.

Up next, the latest on the Global Sumud Flotilla. Stay with us.

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AMY GOODMAN: “Al-Ras ’Aly,” “Heads Held High,” performed in New York by the NYC Palestinian Youth Choir.