Anti-abortion groups -- who have long-considered medical, or pill abortions, to be one of the biggest threats to their movement's demonization of abortion and the women who seek them -- quietly opened a new front in state legislatures recently to de facto restrict or eliminate access to the less expensive, less risky pill abortion. And after achieving their aims in Ohio, they took the fight to Minnesota, where the Senate Thursday passed a bill to make obtaining such abortions so burdensome that advocates expect women will opt out.

Thanks to legislation passed in Ohio in 2004 and the subsequent court challenge, a woman there is now required to take both the first and the second dosage in the presence of a physician.

"Before this law was in place, you would get the abortion drug at the clinic and then you'd take the second drug at home, in private," said Jessie Hill, a law professor at Case Western University who worked the legal challenge. She said that now a medical abortion is "three times more expensive than it needs to be," unnecessarily increases the dosage despite the more painful side effects and requires four trips to the clinic instead of two, meaning anti-choice activists have more opportunities to confront women at the clinic.

Now anti-abortion activists are looking to export their success in Ohio to other states. A bill that passed the Minnesota House Thursday that would ban video web-conferencing for women seeking a medical abortion.

The bill was seemingly issued in response to a program that allows women who come to a Planned Parenthood Rochester clinic to receive her physician consultation with a doctor St. Paul by a secure teleconference line. The program served 47 women during its first year, said Jen Aulwes, Media Relations Director of Planned Parenthood of Minnesota, North Dakota and South Dakota. Democratic Gov. Mark Daton vetoed the bill on Monday, calling medical abortion "safe, accessible and cost-effective for patients."

A woman seeking a medical abortion would have had to make the trip four times: first when the doctor prescribes the drug; once for each of the two separate pills; and then again as a follows-up to make sure the abortion occurred.

Aulwes said, "Women very much prefer medication abortion when it's an option to them. It can be done very early in pregnancy. It's less invasive than a surgical abortion. It can be done in the privacy of their own home. Having this option available through this particular program to women in southern, rural Minnesota, even though it reaches a small number, it's really important to those individual women."

According to data collected by the Guttmacher Institute, 34 percent of women of reproductive age live in one of the 87 percent of counties that do not have an abortion clinic. Such telemedicine programs help efforts of abortion clinics to expand access.

Toni Thayer of Preterm, a women's clinic in Ohio, said she's seen the barriers to access firsthand. "It makes a safe, reasonable medical procedure more difficult to obtain. We've seen our numbers for medical abortions go way down," she said. "It takes us back in time and doesn't do anything to make it safer."

Ashley Thompson, a pro-choice activist in Ohio, said the litany of restrictions causes confusion for patients. "I have a friend who works in appointments and a lot of people assumed [medical abortion] was completely illegal," she said.

Minnesota Citizens Concerned for Life's (MCCL) Bill Taylor doesn't see it that way. "It's a very cost effective way for Planned Parenthood to expand their abortion business," he said. Anti-abortion groups tout such restrictions as "common sense" requirements that protect women's health.

But according to Auwles, that's something the evidence doen't support. "Medical abortion is very safe and effective and it's also legal," she said. "[It] has been associated with fewer deaths than either Tylenol or Viagra and is safer than a full-term pregnancy."

Gov. Dayton stands in the way of this bill becoming law in Minnesota, but anti-abortion groups are likely to keep pushing the bill in future legislative sessions and continue the campaign other states, where a pro-choice governor may not stand in the way.

Updated 4/30/2012 at 4:57 p.m. Eastern: Gov. Mark Dayton vetoed the bill on Monday.

[Women holding pill via vovan / Shutterstock]