Scenes outside pharmacies could foreshadow next phase in U.S. abortion battle

We're about to witness a tangible example of what the coming generation of abortion battles might look like in a post-Roe v. Wade United States.

The scene: Local drugstores.

In the coming days and weeks, anti-abortion activists are set to protest across the U.S. outside dozens of pharmacies whose chains intend to sell abortion pills.

It's their attempt to recreate the familiar decades-long demonstration scenes outside abortion clinics, updated to a new target.

Different groups plan to stand outside, hold signs, chant and inform customers that their pharmacy will be distributing abortion medication.

A tandem of new realities explains this unusual protest setting: As red states race to prohibit abortion following a Supreme Court ruling in June 2022 that overturned Roe v. Wade — a 1973 decision that enshrined the right to an abortion — pills have become the leading method of terminating pregnancies in the U.S.

And these pills, available online, shipped by mail and soon to be sold in participating pharmacies in pro-choice states, threaten to surmount these new restrictive walls.

'Roe was the pre-season to the real fight'

Hence the muted sense of celebration this year at the annual anti-abortion march in Washington, D.C., the first since abortion restrictions took effect in two dozen states.

Participants described their battle as only just beginning.

"Roe was the pre-season to the real fight," activist Caroline Smith said in an interview at the annual March for Life rally on Jan. 22.

"Some people were like, 'Do we even need to march [this year], like, what's the point?' It is really, really important to still have this because we have to show people the fight is still going."

Smith works with an anti-abortion group whose members have been charged in Michigan and Washington with blocking clinics, including one confrontation where a nurse stumbled and sprained her ankle.

That latter case led to police seizing fetuses from the fridge of one group member, held as part of a purported plan to ensure burials for 115 fetuses.

Now anti-abortion activists are setting their sights on pharmacies.

The fight for Smith's group, Progressive Anti-Abortion Uprising, increasingly, involves the pills mifepristone and misoprostol.

WATCH | U.S. Supreme Court ruling leads to focus on abortion pills:

Why are pharmacies next?

Those products have become the leading source of abortions in the U.S., officially overtaking surgical abortions during the COVID-19 pandemic.

The Biden administration is now moving to simplify distribution of the pills: In states where abortion is legal, it's letting retail pharmacies carry the pills, and in other states, it's instructed the postal service not to halt shipments.

The anti-abortion movement, meanwhile, is suing the federal government to block the pills nationally, while also pushing states to ban online prescriptions.

Percentage of abortions that are medication abortions

A sustained pressure campaign is envisioned against major national pharmacy chains like CVS and Walgreens that have agreed to distribute the pills. It includes a boycott drive — and awkward scenes on sidewalks.

Demonstrations are planned in several cities on Feb. 4, at Walgreens' headquarters in suburban Chicago on Feb. 14 and at more pharmacies on March 4.

"If I was a manager of a CVS, I wouldn't want us [standing] outside," said Smith, who lives in Washington and will protest there. "That's the social pressure and the tension, and it has to continue until that happens."

In Smith's view, her movement faces the real threat that after investing decades in shutting clinics one by one, hundreds of pharmacies are sprouting up in their place to offer abortion pills.

Biden administration: 'We are fighting back'

At a mournful event on Jan. 22 for the 50th anniversary of the now-defunct Roe v. Wade decision, U.S. Vice-President Kamala Harris announced a new presidential order instructing federal agencies to seek additional ways to make the pills accessible.

Harris referred to the human impact of anti-abortion laws — like the 10-year-old girl in Ohio who was sexually assaulted and had to go to another state to get an abortion, leading to death threats against the provider.

Or the Texas woman who nearly died of sepsis because she was having a miscarriage and was refused in her first three attempts to get an emergency abortion.

Or the 14-year-old girl in Arizona with severe arthritis and osteoporosis who struggled to get critical treatment because her pills can cause pregnancy loss; her pharmacy feared being prosecuted.

Harris referred to new state anti-abortion laws as being designed by extremists. "Today we are fighting back," she said, as she announced Joe Biden's presidential order.

An irony of the pharmacy protests is that one of the groups involved, Smith's, would actually agree with progressive Democrats on some topics.

Her Progressive Anti-Abortion Uprising describes itself as left-leaning; its members use the language of the left — they refer to an abortion "industrial complex" and to "Big Pharma" as preying on "pregnant people."

Sonja Morin, a graphic designer who works for that group and other anti-abortion organizations, said she'll be protesting near Boston.

She said protest tactics will need to adjust to some of the evident differences between a giant pharmacy outlet and an abortion clinic.

"It's obviously going to be trickier," Morin said.

"You're not going to be going up to someone and saying, 'Hey, are you picking a medication abortion today for your prescription?' Like, you don't do that," she said.

"We'll have signage, we'll have different things that say very blatantly, 'Keep abortion out of our pharmacies.'"

Major chains say they want to participate

Morin said her goal is to start conversations as a way to inform passersby of recent developments: On Jan. 3, the Biden administration announced that abortion pills, previously distributed by medical providers and by some organizations online, would be available in popular retail pharmacies at the prescription counter.

Several major chains have said they'll apply to participate in the plan — albeit only in states where it's allowed by authorities.

Morin's colleague in the anti-abortion movement, Melanie Salazar, lives in Texas, a state where pharmacies won't dispense the pills.

Yet she'll be protesting, too, because some of the same pharmacy chains observing the laws in her anti-abortion state will still be selling those pills in other states.

People living in no-abortion states could get prescriptions filled in participating stores in other states; they can also order from overseas, even though the U.S. Food and Drug Administration has recommended against doing this.

"We need to stand in unity," Salazar said. "We must protect life in all circumstances. And this includes speaking out and boycotting your local big pharmacy."