US Supreme Court Rules to Preserve Access to Mifepristone in Medication Abortions

The US Supreme Court has issued a ruling on access to mifepristone, a drug widely used in medication abortions.[0] The case was brought to the high court after a federal judge decided earlier this month that the Food and Drug Administration (FDA) improperly approved the medication 23 years ago.[0] The court put on hold a lower court’s ruling in favor of anti-abortion groups, which said the FDA was wrong to make the drug mifepristone more widely available.[1] The decision from the court, which has a 6-3 conservative majority, came in the most significant case involving abortion since it overturned Roe v. Wade less than one year ago, a ruling that threw the legal landscape into chaos and led to near-total bans on abortion in more than 12 states.[2]

Mifepristone is used in more than half of US abortions, according to the Guttmacher Institute, a group that supports abortion rights. In the absence of mifepristone, abortion providers will be left with the options of performing surgical abortions exclusively or administering a medication abortion regimen that solely comprises of misoprostol.[1] More than half of abortions in the country are now performed using a two-drug regimen that includes Mifepristone. Over five million women in the US have utilized it to terminate their pregnancies.[3] Medication abortion is a super common method that accounts for more than half of all terminations done in medical settings (54 percent, to be exact, in 2020).[4] Misoprostol is a drug that can be taken alone, but it is typically taken with Mifepristone.[5]

A lawsuit was filed by a group of medical societies against the FDA in November, claiming that mifepristone's safety was not thoroughly examined during its initial approval in 2000 and when further restrictions were lifted in 2016, due to their anti-abortion stance. The lawsuit, which had flaws, was deliberately presented to Judge Matthew Kacsmaryk, who was appointed by Donald Trump and showed sympathy towards the anti-abortion movement. As expected, the judge granted the plaintiff's request and instructed the FDA to revoke its approval of mifepristone, which had been granted for two decades.[6] In 2000, the FDA approved mifepristone for use, but Alliance Defending Freedom, a group of doctors and organizations opposed to abortion, claims that proper protocols were not followed and safety concerns were not adequately assessed. The group also argues that the FDA has not taken appropriate regulatory actions since then. According to medical professionals, the assertions are questionable and disregard numerous medical studies spanning decades, which demonstrate that mifepristone is a secure and efficient means of terminating a pregnancy.[4]

In the past fortnight, there has been an abundance of commotion in this matter, with conflicting orders and decisions ultimately resulting in Kacsmaryk's April 7 order, which would override the FDA's regulations on mifepristone.[7] The Fifth Circuit Court of Appeals was requested by the Department of Justice to put a stop to Kacsmaryk's order.[7] The Fifth Circuit ruled partially against the DOJ on April 12, primarily restoring the stricter FDA regulations established in 2016.[7] The Justice Department made an appeal to the Supreme Court, urging it to put a stop to the rulings of the lower courts in order to carry on with the battle over this case.[7]

The Supreme Court’s decision to preserve access to mifepristone while the legal battle continues is a significant win for reproductive rights advocates, but the fight is not over. The appeals court is scheduled to hear oral arguments in the case on May 17.[4]

0. “Supreme Court weighs in on abortion case — leaves it to 5th Circuit for now” NPR, 21 Apr. 2023, https://www.npr.org/2023/04/21/1170742958/u-s-supreme-court-blocks-lower-court-decision-in-fda-approval-of-abortion-pill-c

1. “Supreme Court retains access to abortion pill mifepristone” The Washington Post, 21 Apr. 2023, https://www.washingtonpost.com/politics/2023/04/21/mifepristone-abortion-pill-access-supreme-court/

2. “What to know about the abortion pill mifepristone” Al Jazeera English, 21 Apr. 2023, https://www.aljazeera.com/news/2023/4/21/what-to-know-about-the-abortion-pill-mifepristone

3. “Mifepristone: US Supreme Court preserves abortion drug access” BBC, 22 Apr. 2023, https://www.bbc.com/news/world-us-canada-65356390

4. “US supreme court to decide on abortion pill access after extending deadline” The Guardian, 21 Apr. 2023, https://www.theguardian.com/world/2023/apr/21/supreme-court-abortion-pill-deadline

5. “Supreme Court Blocks Abortion Pill Restrictions—Likely a Temporary, Strategic Move” Jezebel, 21 Apr. 2023, https://jezebel.com/supreme-court-blocks-abortion-pill-restrictions-likely-1850349980

6. “Supreme Court Slaps Down Rogue Judge’s Effort to Ban Abortion Pill” Rolling Stone, 21 Apr. 2023, https://www.rollingstone.com/politics/politics-news/supreme-court-abortion-pill-mifepristone-access-1234717048/

7. “What to Watch for in the Supreme Court's Mifepristone Ruling” The New Republic, 20 Apr. 2023, https://newrepublic.com/article/172087/watch-supreme-courts-mifepristone-ruling

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