Stephanie Ho and her staff scrambled to call patients, canceling appointments for the women who had sought the two-pill medical abortions that the Fayetteville Health Center offered.


It was moments after the U.S. Supreme Court declined Tuesday to hear a case challenging an Arkansas law that effectively prohibits medical abortions in the state, and Ho’s practice needed to ensure the women knew that option was no longer available to them. Women in Arkansas who had sought to take what is commonly known as “the abortion pill” now would have to travel to the only abortion clinic in Arkansas that offers surgical abortions, in Little Rock.


“As a physician, I want my patients to be able to make the best decision for them based on what’s most affordable and comfortable for them,” Ho said. “Many women prefer the pill because they are less invasive and they can rest at home. It’s incredibly frustrating when politicians are inserting themselves into what a woman can do to her own body.”


Arkansas has argued that medical abortions are unsafe, in large part because women take the second pill at home, allowing potential complications to arise while not in the direct care of a doctor. Abortion rights activists say the law is a major setback because it specifically restricts what a woman can do to her own body, and they worry that it threatens the promise of ease and privacy that the pills afford. The law requires doctors who provide medical abortions to have a contract with a second doctor who has admitting privileges at a hospital.


Ho said the real impact is that the law puts up hurdles to obtaining an abortion; she said medical abortions are “very safe, safer than a colonoscopy.” The medication, allowed in the United States since 2000, allows women to terminate a pregnancy within the first nine weeks.


With Arkansas being the first state to restrict its use and the Supreme Court effectively allowing the law to stand - though the case will now go to a lower court, possibly for trial - other states could follow suit. Planned Parenthood has asked a federal court for a restraining order, in the meantime, to block the Arkansas law.


Missouri has a similar case and, last month, a U.S. District judge in Oklahoma said that Christian universities do not have to provide the abortion pill, reversing an Obama-era rule.


Grazie Pozo Christie, a doctor and policy adviser for the Catholic Association, said abortion activists ignore the dangers of inducing a late-first-trimester pregnancy and said something as “complicated and risky” should not be allowed with just cursory oversight.


She said activists “insist that the convenience of a do-it-at-home procedure outweighs the dangers, especially for rural and low-income women. But if legalizing abortion was meant to benefit women by bringing the procedure out of the back alley and into the safer and cleaner environments of doctors’ offices, medical abortion is a step back in safety.”


Advocates say the Arkansas restriction will disproportionately impact rural women - who often must drive long distances to get an abortion. Poor women who work hourly jobs and would need to take off work for the more expensive surgical procedure also face a deterrent when the medical abortion option is unavailable to them.


“We are stepping into dangerous territory here when folks are saying a woman can’t use an option that exists,” said Monica Raye Simpson, executive director of the SisterSong Women of Color Reproductive Justice Collective. “Do they realize they are impacting women of color, low-income rural folks and young people? They aren’t taking into account that these women have jobs, they may need child care, they aren’t letting a woman do what’s right for her.”


Medical abortions involve two pills. The woman takes the first one at an abortion clinic and the second at home. In 2014, medical abortions accounted for 45 percent of all U.S. abortions that occurred during the first nine weeks of pregnancy, abortion providers said in court papers. Arkansas said 14 percent of the state’s abortion patients used the procedure.