What’s Happening With the Abortion Pill Ban?

mifepristone abortion pill

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The Supreme Court on April 21 granted a full stay to the case regarding the abortion pill mifepristone. This means there will be no change to the access or availability of the pill in the foreseeable future.

The battle to revoke access to the abortion pill mifepristone is happening in the U.S. courts right now. A Texas judge on April 7 issued a controversial ruling that blocked the FDA approval of mifepristone, which would eliminate access to the drug in every state. The decision was put on hold for a week to allow for appeals. At the same time, a judge in Washington state ordered the FDA to do nothing that would restrict access to the pill.

The conflicting rulings have left the status of abortion pill access ambiguous and confusing. In the following weeks, we can expect more legal drama and changing rules over mifepristone.

How Does Medication Abortion Work?

Medication abortion consists of two medications: mifepristone and misoprostol. Mifepristone, the first drug in the regimen, blocks a hormone called progesterone and stops a pregnancy. Misoprostol is then used to empty the uterus.

What Is the Most Current Status of the Abortion Pill?

The Supreme Court on April 21 granted a full stay to the case regarding mifepristone. This means there will be no change to the access or availability of the pill anytime soon.

Earlier last week, an appeals court ruled that mifepristone could remain available but banned the drug from being sent by mail. The judges in this court said the new ruling would hold until the full case is heard. 

The court had ordered a rollback of the FDA’s expanded access measures from 2016, which would mean that mifepristone could only be used until seven weeks of pregnancy instead of 10. In some states, the pill can be prescribed by health providers other than physicians, but that ruling required mifepristone to be dispensed under the supervision of a qualified physician. The three in-person office visits requirement would also be restored if the 2016 changes were reverted.

Where Is Medication Abortion Legal?

A total of 12 states have banned medication abortions so far, including Alabama, Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, South Dakota, Tennessee, Texas, and West Virginia. Abortion is technically legal in Wisconsin, but abortion providers in the state have stopped offering all services temporarily until there's more clarity on an old law.

Medication abortion remains available in other states with the new legal restrictions.

Why Are the Courts Fighting About Mifepristone?

The original lawsuit was brought on by anti-abortion groups that accused the FDA of approving mifepristone without studying its safety thoroughly. 

However, since mifepristone was approved in 2000, medication abortion has proven to be safe and effective. According to the FDA, out of 5.6 million medication abortions, 28 deaths associated with mifepristone have been reported, but none of these cases could certainly attribute the cause of death to mifepristone. In Canada, where mifepristone has been widely available since 2017, a large study showed that medication abortion with both mifepristone and misoprostol is safe.

What Might Happen Next?

The Supreme Court's temporary stay order will expire at midnight on Wednesday, April 19.

Justice Samuel A. Alito Jr. has ordered the anti-abortion groups that are challenging the FDA's approvals of mifepristone to file their brief by Tuesday. The Supreme Court will then decide whether to leave the FDA approvals in place.

2 Sources
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  1. Food and Drug Administration. Mifepristone U.S. Post-Marketing Adverse Events Summary through 06/30/2022.

  2. Schummers L, Darling EK, Dunn S, et al. Abortion safety and use with normally prescribed mifepristone in CanadaN Engl J Med. 2022;386(1):57-67. doi:10.1056/NEJMsa2109779

By Daphne Lee
Daphne Lee is a senior news editor at Verywell Health.