Gov. Kristi Noem announced that she had asked a legal adviser, who she calls her office’s “unborn child advocate,” to look for ways to make South Dakota’s abortion laws even more strict.
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Why did Kristi Noem sign an executive order prohibiting telemedicine abortion if South Dakota already prohibits telemedicine abortion? Political optics.

South Dakota Gov. Kristi Noem signed an executive order last Tuesday banning telemedicine abortion, even though South Dakota law already effectively bans telemedicine abortion.

“[The Biden Administration is] working right now to make it easier to end the life of an unborn child via telemedicine abortion. That is not going to happen in South Dakota,” the Republican governor said in a statement.

Noem’s executive order:

  • requires medication abortion be prescribed by a physician licensed in South Dakota after an in-person examination
  • makes it illegal to deliver abortion pills via courier, telemedicine, or mail
  • prohibits medication abortion from being dispensed at schools or on state grounds
  • orders the health department to collect more data on the incidence of medication abortion in the state

Let’s be clear about something: Medication abortion using mifepristone and misoprostol is a common and safe way to terminate a pregnancy in the first trimester. (A similar protocol is also commonly used for miscarriage management.) Telemedicine offers increased abortion access to pregnant people, particularly those living in abortion deserts.

Medication abortion is the future, and restricting medication abortion is—like all abortion restrictions—an attack on access for the most marginalized people.

Access to abortion by mail became even more critical during the ongoing COVID-19 pandemic, and in April the Biden administration lifted federal restrictions on providing abortion medication by mail for the duration of the public health crisis.

The thing with Noem’s order, though, is that it’s mostly for political optics.

South Dakota law already effectively blocks the use of telemedicine for abortion care, as Susan Rinkunas wrote for Rewire News Group last December:

The state requires patients to undergo counseling 72 hours before their procedure, not including weekends and holidays—the most restrictive waiting period in the country. That counseling must be done in person, which effectively bans prescribing abortion medication via telemedicine, and the physician providing the abortion, not a nurse or another staffer, must do the state-mandated counseling.

Days before issuing the executive order, Noem announced on Twitter that she had asked a legal adviser (who she calls her office’s “unborn child advocate”) to look for ways to make South Dakota’s abortion laws even more strict, in the wake of the Supreme Court allowing a six-week abortion ban to go into effect in Texas.