艾玛·埃尔南德斯(Emma Hernandez)是反抗的，即使她担心这个国家在堕胎问题上的斗争的最新阶段可能会出现什么:扩大禁止安全和合法的方式来结束意外怀孕，包括获得堕胎药丸。
两名联邦法官对堕胎药物米非司酮的可获得性做出的竞争性裁决给埃尔南德斯和无数其他坚持必须保证可获得性的美国人带来了恐慌和困惑。其他人庆祝一名法官的裁决，将限制这种访问，但承认战斗还远远没有结束。
埃尔南德斯的担忧在周五加剧，当时特朗普在德克萨斯州阿马里洛任命的美国地区法官马修·卡兹马里克(Matthew Kacsmaryk)否决了数十年的科学批准，并暂停了联邦政府对米非司酮的批准，米非司酮是两种用于终止妊娠的药物之一。法官立即将裁决延期一周，以便联邦当局可以提出质疑。
几乎在同一时间，在华盛顿州的斯波坎，奥巴马任命的美国地区法官托马斯·o·赖斯(Thomas O. Rice)指示联邦官员不要在至少17个州阻止该药物的使用，民主党人在这些州提起诉讼，以保持该药物的可用性不受影响。这个问题可能会由美国最高法院解决，最高法院去年废除了Roe v. Wade案，这是最高法院1973年具有里程碑意义的决定，确立了堕胎的宪法权利。
“作为一个经历过多次药物流产的人，我们知道药物本身是安全有效的，”30岁的德克萨斯州居民埃尔南德斯说，他为“我们作证”组织工作，该组织为人们提供了一个分享堕胎故事的渠道。
“这些限制是故意制造混乱，将我们的选择限制在一个点上，我们被要求接受任何堕胎选择仍然可用，”她周六说。
阿肯色州生命权组织的执行董事罗斯·明姆斯等堕胎反对者对德克萨斯州的决定表示欢迎。
“这真的会给全国的堕胎行业带来很大的冲击，(但是)我确实希望它会被上诉，”米姆斯说。
虽然像她所在的一些州已经大幅减少了堕胎的机会，但她希望对可以通过邮件递送的堕胎药物进行更严格的控制，即使在堕胎非法或受到严格限制的州也是如此。
在他的裁决中，Kacsmaryk提到了一些团体是如何削弱一个州管理堕胎的能力的。他特别提到了纽约的五月天健康组织，这是一个提供如何获得药物信息的非营利组织。
五月天健康组织的执行董事詹妮弗·林肯博士敦促女性开始储备米非司酮，以防它被禁用。她说药丸可以通过邮件从国际供应商那里获得。
“你现在就可以订购，像保留泰诺一样保留米非司酮。它的保质期大约为两年，”俄勒冈州波特兰市的妇产科医生林肯说。
每月约有一百万人访问该组织的网站。林肯说，在得克萨斯州的裁决之后，访问次数变得更加活跃。
“我们知道，当人们看到安全的医疗保健受到威胁时，这些数字将会攀升，”她说。
“我们作证”的创始人兼执行董事雷尼·布里斯·谢尔曼说，她“对堕胎护理的获得岌岌可危感到沮丧”
虽然米非司酮和米索前列醇(另一种诱导堕胎的药物)在美国仍然可以买到，但谢尔曼称围绕这些药物的法庭斗争和辩论是走向彻底禁止任何形式堕胎的“非常危险的一步”。
纽约州州长Kathy Hochul周六在接受美国有线电视新闻网(CNN)采访时表示，她将推动立法，要求保险公司承保米索前列醇，米索前列醇可以单独使用，但与米非司酮合用更有效。
“我们也关心下一阶段，”Hochul说。“我们正试图找出所有不同的方法来解决这个问题。”
赫尔南德斯说，近年来，反对堕胎的人取得了重大胜利，他们在进一步侵蚀堕胎途径的努力中变得更加大胆。
“这是我们在转弯处看到的东西，”她说。“我知道我们一直在为这些时刻做准备，并了解我们如何让人们以他们所在地区可用的任何方式访问。”
越来越多的限制尤其会伤害到那些没钱去加州和纽约等地进行诊所堕胎的人。
埃尔南德斯回忆起她21岁时的第一次流产。她不想向任何人透露她怀孕了;为了保护隐私，她依靠药物流产。如果没有车，她就没有去诊所的便捷方式。
“对我来说，这是最好的选择，因为它不需要任何镇静，”埃尔南德斯说。“我没有一个支持系统可以帮助我往返于诊所进行堕胎手术。”
Competing abortion pill rulings sow broad alarm, confusion
Emma Hernandez is defiant even if she fears what may come in the latest stage of the nation's fight over abortion: a widening prohibition to safe and legal ways to end unwanted pregnancies, including access to abortion pills.
Competing rulings by two federal judges over the availability of the abortion drug mifepristone are sowing alarm and confusion for Hernandez and countless other Americans who insist that availability must be guaranteed. Others celebrated one judge's ruling that would restrict that access but acknowledge the battle is far from over.
Hernandez’s concerns were heightened Friday when U.S. District Judge Matthew Kacsmaryk, a Trump appointee in Amarillo, Texas, overruled decades of scientific approval and put on hold federal approval of mifepristone, one of two drugs used in combination to end pregnancies. The judge immediately stayed his ruling for a week so federal authorities could file a challenge.
At about the same time in Spokane, Washington, U.S. District Judge Thomas O. Rice, an Obama appointee, directed federal officials not to hinder access to the drug in at least 17 states where Democrats sued to keep the drug’s availability intact. The issue will likely be settled by the U.S. Supreme Court, which last year repealed Roe v. Wade, the 1973 landmark Supreme Court decision that had established a constitutional right to abortions.
“As a person who’s had multiple medication abortions, we know that the medication itself is safe and effective,” said Hernandez, a 30-year-old Texas resident who works for We Testify, an organization that provides an outlet for people to share their stories about abortions.
“These restrictions are intentionally creating confusion and limiting our options to a point where we’re being asked to accept whatever abortion option remains available,” she said Saturday.
Abortion opponents like Rose Mimms, the executive director of Arkansas Right to Life, welcomed the Texas decision.
“That’s really going to put a big dent in the abortion industry across the country, (but) I do expect it will be appealed,” Mimms said.
While some states like hers have sharply curtailed access to abortions, she wants stricter controls over abortion-inducing medications that can be delivered through the mail, even in states where abortion is illegal or severely restricted.
In his ruling, Kacsmaryk noted how some groups are undermining a state's ability to regulate abortion. He specifically mentioned New York-based Mayday Health, a nonprofit that provides information on how to obtain the medication.
Mayday Health's executive director, Dr. Jennifer Lincoln, urged women to begin stockpiling mifepristone in case it is banned. She said pills can be obtained from international suppliers through the mail.
“You can order them now and keep mifepristone like you would keep Tylenol. It has a shelf life of about two years,” said Lincoln, a Portland, Oregon, obstetrician and gynecologist.
About a million people every month visit the organization's website. Following the Texas ruling, Lincoln said, the number of visits has become even more brisk.
“We know those numbers will climb when people see that safe healthcare is threatened,” she said.
Renee Bracey Sherman, founder and executive director of We Testify, said she is “frustrated that access to abortion care is hanging on by a thread.”
While mifepristone and misoprostol, another abortion-inducing drug, remain available in the U.S., Sherman calls the court battle and debate over the drugs “a very slippery slope” toward an outright ban on abortion in any form.
New York Gov. Kathy Hochul said during an interview Saturday on CNN that she would push legislation that would require insurance companies to cover misoprostol, which can be used alone but is more effective when taken with mifepristone.
“We’re also concerned about the next phase,” Hochul said. “We’re trying to figure out all the different ways we can get ahead of this.”
In recent years, abortion foes have won major victories, and they have become more emboldened in their efforts to further erode access to abortions, said Hernandez.
“It’s something that we saw around the bend,” she said. “I do know that we’ve been preparing for these moments and understanding how we can get people to still have access in whatever way is available in their region.”
The growing restrictions could particularly hurt people who don't have the resources to travel to such places as California and New York to get in-clinic abortions.
Hernandez recalls her first abortion when she was 21. She didn't want to reveal her pregnancy to anyone; to retain her privacy, she relied on medication to abort her pregnancy. Without access to a car, she would not have had a convenient way to get to a clinic.
“For me it was the best option because it did not require any sort of sedation," Hernandez said. “And I did not have a support system that could assist me in traveling to and from a clinic for an abortion procedure.”
