The Handmaid’s Tale could become reality in the US at midnight tonight

Millions around the world have taken mifepristone to terminate a pregnancy – myself included

Make no mistake, anti-abortion ideologues in the US want one thing, and one thing only: To ban abortion across the so-called free world. And to be fair to them, they are doing well at turning their sick, sadistic dream into reality. America looks like a very different place since the US Supreme Court changed the course of the history when it overturned Roe v Wade – the landmark decision legalising abortion nationwide in 1973 – in June last year. To put it simply, the dismantling of Roe immediately robbed millions of women of their legal right to have an abortion.

Almost a year later, we are now in a situation where most pregnancy terminations are banned in 13 US states. Moreover, most of the US states who have eagerly curtailed abortion in the wake of Roe’s overturning have chosen not to allow abortions in cases of rape or incest. This is a very sinister and dark situation to be in. Abortion providers and campaigners might have prophesied the overhauling of Roe v Wade but to see it chaotically, catastrophically play out is like watching a dystopian novel come to life.

But it is worth noting things could be about to get dramatically, unthinkably worse for abortion access in the US. This is because abortion pills are under dogged attack from the anti-abortion movement. Matthew Kacsmaryk, a Trump-appointed conservative US district judge in Texas, ruled against a key abortion drug across the US on 7 April - suspending the Food and Drug Administration’s 20-year approval of the abortion drug mifepristone. In doing so, Kacsmaryk essentially triggered a US-wide ban of mifepristone. However, in the space of just minutes, a different district judge issued the polar opposite ruling in the state of Washington, while the White House promised to challenge Kacsmaryk’s ruling.

Having a medical abortion involves taking two tablets, with mifepristone being the first of these. Millions around the world have taken the drug to terminate a pregnancy over recent decades - myself included. I took mifepristone last year and wrote about my nightmare struggle to get an abortion here in the UK. Mifepristone is one of the most scrupulously studied drugs in the world. The UK’s largest study into abortions previously found that at-home early medical abortions pose no greater risk and allow women to have the procedure much earlier on in their pregnancy. Medical abortions constitute more than half of all abortions in America. Nevertheless, Axios has found almost half of US states have either totally banned or restricted access to abortion pills.

Elements of Kacsmaryk’s terrifying decision were upheld on appeal, sparking the Biden government to issue an emergency request to the Supreme Court. Danco Laboratories, which produces mifepristone, as well as the justice department, urged the Supreme Court to get involved in the case, requesting the highest court in the US to rid the drug of any restrictions while the lower appeals court assesses the case. Samuel Alito, US Supreme Court Justice, ordered a provisional block on constraints on the drug until Wednesday this week. While the Supreme Court was supposed to rule on whether mifepristone should continue being sold while the lower appeals court assesses the case on Wednesday this week, they extended the decision deadline at the eleventh hour - instead changing it to Friday at 23:59. In short, today is a momentous day.

But what will the consequences of today’s decision be? Well, if the Supreme Court chooses to make no decision by the deadline or backs the 5th Circuit Court of Appeals, tight limits on rules around accessing mifepristone will instantly come into force. You will no longer be able to receive the drug in the mail, and you will have to take the drug in the first seven weeks of pregnancy, whereas currently, you have ten weeks to take it. Moreover, the drug will have to be taken while a doctor is there. This also affects those living in states where abortion is legal. In short, the drug will become far more difficult to obtain, creating needless, dangerous barriers to abortion.

Moreover, later on in the legal process, if Kacsmaryk’s ruling comes into force, abortion providers will only be able to conduct surgical abortions or medical abortions which only use the second abortion drug misoprostol. Despite the fact abortions carried out by such means still work, they inflict more pain and take more time. Moreover, while surgical abortions are wholly safe, they are more dangerous than medical abortions. Ultimately, they are a totally different entity to medical abortions as they involve going into theatre for surgery - thus they are far more expensive to conduct, as well taking far longer, and being far more painful.

This would be a terrifying situation for America to be catapulted into. The clash over mifepristone is the most significant battle over abortion rights since Roe v Wade was toppled. When I say what is happening in the US feels like watching a dystopian novel or film come to life, the clearest example which comes to mind is The Handmaid’s Tale - with many onlookers comparing modern-day America to Margaret Atwood’s dystopian novel since Roe was overhauled. The Handmaid’s Tale is set in New England in the US in a future where women have been reduced to breeding machines, with their reproductive rights firmly clamped down on. The Republic of Gilead, a dystopian Christian fundamentalist theocratic system of rule, has toppled the government, with so-called “handmaids” forced to procreate for the “commanders”.

The views of anti-ideologues are frightening and cruel. Take the lawmakers in the US who routinely compare abortions to the Holocaust and other modern genocides - rightfully prompting outrage from Jewish organisations and abortion rights groups, or those anti-abortion activists who link abortion to satanism, or those who are against sex and anti-birth control.

If mifepristone is banned in the US, women and people of marginalised genders will needlessly, unduly suffer, and some will die. The data shows banning abortions does not stop pregnancies from being terminated. Instead, it pushes women to have dangerous, backstreet abortions. Such procedures are extremely risky; 47,000 women in the world die every single year as a consequence of getting an unsafe abortion, while five million women are estimated to have to go hospital for bleeding or an infection or some other dangerous health issue. For all of the above and more, the parallels between contemporary America andThe Handmaid’s Tale are becoming starker by the day.