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Just the Pill Promised to Revolutionize Abortion Care Delivery. What Happened?
Laid off employees told me the organization I had previously profiled wasn't all its founders made it out to be.
‘The people who handled money in our organization … were all nepotism hires’
Those who’ve followed my work for a while might remember this feature about mobile abortion clinics I wrote for Cosmopolitan, published in fall 2022.
In a dark and chaotic time full of very bad abortion news in the wake of the Supreme Court’s decision to overturn Roe v. Wade—to the point that many editors told me outright they didn’t want any more abortion stories because they were all too sad—an organization called Just the Pill seemed to offer a ray of sunshine: They were going to deploy a fleet of mobile abortion clinics in Colorado, which could drive right up to the borders of abortion ban states and make it easier for people there to cross into legal states for care. They hoped to expand from Colorado to every ban state border area in the country.
There were a lot of outlandish abortion care ideas in the immediate aftermath of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. As I’ve reported previously, some were outright scams, and a lot of others just weren’t all that helpful. But if any of these wannabe innovators could pull their idea off, it seemed Just the Pill could.
As a reporter, being a skeptic is my job. But Just the Pill had hired a lot of experienced abortion care workers. And from what they told me, they had a lot of legal and logistical support in place to help get their idea off the ground.
Cut to January of this year, when Just the Pill abruptly laid off nearly three-quarters of its staff.
It’s a tough time; abortion clinics and funds are really struggling, and initially, I assumed that was the core of the issue. But then I started talking to former employees, who painted a picture of rampant nepotism and mismanagement at the organization.
What’s more, “Just the Pill has purposely misrepresented what we’ve done to the media,” one employee told me. And by the media, they meant… me.
Read more about what I learned really went on inside Just the Pill—and what it says about funding priorities in the reproductive rights and justice movements—in my story.
Trump stuff
There’s too much to summarize succinctly here, though my colleague Natasha Roy at Rewire News Group is writing very helpful weekly summaries of activities in Trumpland. Here is this week’s edition.
Sticking to my area of focus, this week’s biggest news points are that the Senate appears poised to confirm Robert F. Kennedy Jr. to be the Secretary of Health and Human Services. In addition to this being terrifying news because of RFK’s general anti-vaccine and anti-science views—and the fact that he stands to profit from some of his own regulatory decisions in the position—RFK also said in multiple confirmation hearings that he wants to “review the science” on one of the pills used in medication abortion, mifepristone.
The science is exceedingly clear: Mifepristone is safer than penicillin, Tylenol, Viagra, and a host of other common over-the-counter a prescription medications. The anti-abortion movement’s bid to portray mifepristone as dangerous is pure disinformation, and RFK is the perfect health secretary to validate it. During his confirmation hearings, RFK repeatedly said that he considers every abortion a tragedy and that he’ll “execute President Trump’s policies.” So, at the very least, expect new restrictions on medication abortion.
Trump also issued an executive order this week to “eradicate anti-Christian bias.” In it, he mentions his recent pardons of anti-abortion clinic invaders who violated the Freedom of Access to Clinic Entrances (FACE) Act. The order also suggests that there is a widespread pattern of attacks on Christian churches and “crisis pregnancy centers,” and that the Department of Justice wasn’t taking these seriously under Biden. In truth, the DOJ was applying the FACE Act in these (rare) cases.
The order also calls for the establishment of a government-wide task force dedicated to protecting Christians. During Trump’s first term, a similar task force led to the development of the anti-abortion Geneva Consensus Declaration, an international agreement the U.S. has already re-entered. More context on that in my recent story about the global gag rule.
Finally, this week the Department of Justice sent a letter to the Supreme Court saying, essentially, that the present administration would not have brought the case United States v. Skrmetti, and that it does not believe Tennessee’s ban on gender-affirming care for those under 18 discriminates on the basis of sex. (You can read my analysis of oral arguments in the case, about gender-affirming care and the dignity of risk, here.)
The original plaintiffs—families affected by the ban, represented by the American Civil Liberties Union—are still involved in the case and made their own arguments before the Supreme Court back in December, meaning that the lawsuit isn’t necessarily dead even if the Court allows the DOJ to back out. That said, this is a very unusual move considering that the case has already been argued and submitted, and there’s no telling exactly how the Court may respond.
I expect a similar move in United States v. Idaho, in which the Biden administration argued Idaho’s abortion ban violates the Emergency Medical Treatment and Active Labor Act (EMTALA). In preparation, St. Luke’s Health, a major Boise-area hospital, has filed its own lawsuit in at attempt to keep the case alive if and when the DOJ drops it.
Stay safe out there, y’all.
Things to Know After Week 1 of Trump 2
Trump reinstates the global gag rule and pardons abortion clinic invaders. Plus: turmoil at repro orgs continues.
Donald Trump does Project 2025 (shocker)
Last week, we got our first Friday night news dump of the second Trump administration—likely the first of many.
First, Trump signed an executive order repealing two orders Joe Biden signed in the wake of the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization. In practice, these orders didn’t do all that much, but among other things, they did lead to the Biden administration’s guidance on the Emergency Medical Treatment and Active Labor Act (EMTALA), which has been at the center of an ongoing challenge to the full enforcement of Idaho’s abortion ban.
It has been widely expected that, once Trump took office, the Department of Justice would drop this legal challenge and look the other way while states enforce abortion bans that violate EMTALA. This executive order all but confirms that eventuality.
Trump also reinstated the global gag rule, a policy that bans foreign NGOs that receive U.S. international aid funds from conducting any abortion referrals, counseling, or advocacy.
Every Republican president since Reagan has enacted this policy, but during his first term, Trump expanded it in unprecedented ways. It’s this expanded version that he reinstated, and along with a 90-day pause on all foreign aid, a withdrawal from the World Health Organization, and a likely withdrawal from the United Nations Population Fund, Trump appears to be following Project 2025 word for word. That has experts concerned that more limits are coming—specifically, broad limits on speech about reproductive and sexual health, on the part of government agencies and NGOs alike. You can learn more in my story about the gag rule and what’s likely next.
Trump pardons domestic terrorists
You probably heard that Trump pardoned a bunch of people who were involved in the January 6 Capitol attack. Last week, he also pardoned numerous people convicted of violating the Freedom of Access to Clinic Entrances (FACE) Act—though the exact number of pardons is curiously unclear.
At least ten people convicted of invading a Washington, D.C. abortion clinic in 2020—an event described in this story I wrote for ELLE in 2022—were pardoned. Among them is Lauren Handy, who was found to be in possession of five sets of fetal remains when she was arrested in 2022. Handy and many of the others involved in this blockade were repeat FACE Act violators, meaning they faced more stringent penalties.
Trump called them peaceful protesters. They weren’t—one healthcare worker was injured during the clinic invasion and a pregnant patient was prevented from entering the building while experiencing contractions. Plus, the anti-abortion movement has killed 11 people since the 1990s. When clinic invasions happen, workers and patients rightfully worry their lives are in danger.
I’ve reported a lot on this type of violence over the years. I think the most important things to understand about it are that the anti-abortion movement has deep ties to the broader fascist movement in the U.S.—including the groups that stoked the insurrection—and that violence at clinics increased during the first Trump adminstration and will likely increase again now.
More repro org turmoil
Shortly before Trump’s inauguration, I reported exclusively that the National Network of Abortion Funds (NNAF) had decided not to renew the contract of its executive director, Oriaku Njoku.
NNAF has ballooned in size and budget post-Dobbs, and I’ve heard a lot about growing pains from the leaders of local abortion funds, many of whom have become increasingly frustrated with the national organization—particularly since cuts from other national organizations put increased strain on local funds starting over the summer.
Njoku is a well-liked, well-respected member of the reproductive justice movement and a longtime abortion fund leader. My sources said the problem was that she had the right ideas, but wasn’t able to push back against organizational inertia effectively enough.
Njoku “might have been the head of the org, but they weren’t the neck,” one source told me.
Gender-Affirming Care and the Dignity of Risk
Some Supreme Court justices are preoccupied with trans kids possibly regretting gender-affirming care. But is it good policy to "protect" against risk?
Last week, the Supreme Court heard oral arguments in the case United States v. Skrmetti, which asks whether the state of Tennessee should be allowed to enforce its ban on gender-affirming care for youth.
Throughout arguments, several themes appeared in the questions coming from the Court’s conservative justices. One of these was the supposed risk of gender-affirming care.
“If the treatment’s barred, some kids will suffer because they can’t access the treatment. If the treatment is allowed … some kids will suffer who get the treatment and later wish they hadn’t and want to detransition,” Justice Brett Kavanaugh said. “And so there are risks both ways in here … it’s a difficult judgment call as a matter of policy.”
American Civil Liberties Union attorney Chase Strangio—who happens to be the first openly trans person to argue a case before the Supreme Court—appeared on behalf of the case’s original plaintiffs, several families and one physician. He pointed out that many of the figures about regret and detransition cited to justify bans on gender-affirming care are old, and often come from studies of very young children. At issue in Skrmetti are treatments like puberty blockers and hormones, which don’t apply to children who haven’t reached puberty.
“The evidence shows that once an adolescent reaches the onset of puberty, their likelihood to ultimately desist and identify with their birth sex is very low,” Strangio told the Court. In fact, according to more recent, better-designed studies, that rate is about one percent—or less.
But even if risks and rates of regret were higher, would banning gender-affirming care really be good policy? According to many bioethicists, the answer is no.
This is thanks to a concept called the dignity of risk, which arose from the disability rights movement in the 1970s.
“Overprotection,” wrote disability rights advocate Robert Perske in a 1972 paper, undermines a person’s “individuality and growth potential,” smothers them emotionally, and prevents them from “experiencing the normal taking risks in life which is necessary for normal human growth and development.”
The Limits of a Tragic Story
Why weren't stories of abortion denial—some of which resulted in death—enough to sway the U.S. presidential election?
In the early morning hours of October 28, 2012, a dentist named Savita Halappanavar died in Galway, on the west coast of Ireland.
Actually, she had been dying for days.
In a report released the following year, medical investigators found that Halappanavar, who was 17 weeks pregnant, had been showing signs of a possible pregnancy-related infection since her first visit to the hospital a week earlier.
But even after the amniotic sac ruptured—meaning that Halappanavar’s pregnancy couldn’t possibly be viable, and that her risk of developing a life-threatening infection was increasing by the hour—doctors failed to do the one thing that might have saved her life: give her an abortion. By the time Halappanavar miscarried on her own, it was too late. The infection had already invaded her blood. She died four days later.
Does this story sound familiar?
Maybe that’s because you’ve heard it before—or because it’s so similar to the stories of Josseli Barnica, Amber Thurman, and Candi Miller, three U.S. women whose abortion ban-related deaths were recently reported by ProPublica.
In Texas, where a near-total abortion ban went into effect in 2021, pregnancy-related deaths increased by 56 percent between 2019 and 2022, dramatically surpassing the national increase of 11 percent during that time. Barnica is just one of the names behind those numbers. There are many more names we don’t know, and may never know, in more states beyond just Texas.
Then there are the stories of people like Kate Cox, Amanda Zurawski, Lauren Miller, Lauren Hall, Anna Zargarian, Ashley Brandt, and at least 15 other U.S. women represented by the Center for Reproductive Rights who were denied abortions they needed for medical reasons. These women didn’t die, but they could have—just like countless others who have bled in parking lots, had care unnecessarily delayed in cases nearly identical to Halappanavar’s, or been life-flighted out of abortion-hostile states over the last few years.
In the wake of the U.S. presidential election, many readers have asked me: Why aren’t these stories of delays and denials of care enough? Why haven’t they affected Americans the way Halappanavar’s death seemed to affect the Irish?
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