As a federal judge in Texas may decide the fate of abortion medication as soon as this week, supporters fear that the ruling may limit access to the pill nationwide.
The lawsuit filed in the Amarillo division of the Northern District of Texas asks a judge to reverse the U.S. Food and Drug Administration (FDA) approval for mifepristone, the first medication abortion pill in a two-dose regimen.
With the drug misoprostol, mifepristone can be used to end a pregnancy before the end of the first trimester. In the U.S., medication abortion accounted for more than half (54%) of all pregnancy terminations in 2020, according to the Guttmacher Institute data.
The ruling will be made by a single judge, Trump-appointee Matthew J. Kacsmaryk, known for his conservative views.
Brought by a group of anti-abortion individuals and organizations, the lawsuit questions the FDA's decision to grant mifepristone accelerated approval in 2000.
The Plaintiffs also criticize later FDA's actions, including extending the permissible gestational age and changing the dosage of abortion medication, and the Biden administration's decision to allow obtaining the pills via telehealth.
In a January 13 court filing, the attorneys for the FDA and Human Services (HHS) wrote that a ban on selling mifepristone would undo "a longstanding scientific determination based on speculative allegations of harm."
While the lawsuit claims that the FDA "disregarded the substantial evidence that chemical abortion drugs cause more complications than even surgical abortions," studies show that medication abortion is safe and effective about 95% of the time.
A systematic review from 2012 found that medical abortions with mifepristone and misoprostol have a 0.4% risk of major complications requiring hospitalization or blood transfusions, while an associated mortality rate is 0.00064%
Some doctors, however, are concerned about the soaring demand for unregulated abortion pills from third countries after Roe v. Wade was overturned and say that taking such medications may lead to severe health risks.
Abortion rights supporters worry that the ruling in the Alliance for Hippocratic Medicine v. FDA may have wider implications nationwide. If the court ruled in favor of the Plaintiffs' request, access to medication abortion would end across the country, even in the states where abortion rights are protected, according to the Center for Reproductive Rights analysis.
"In a nutshell, this case is an attempt to have a nationwide ban on medication abortion," says Jenny Ma, senior counsel at the Center for Reproductive Rights. "This lawsuit may have nationwide effects and an even greater effect than when the Supreme Court overturned Roe."
The deadline to finish filing briefs in the case is February 10, 2023.
Recent surveys suggest that most Americans support the right to abortion or at least want to have a say in deciding whether pregnancy termination should be legal.
For example, a poll from January shows that 70% of Americans favor establishing and maintaining the right to abortion in their state. Another poll reveals that 69% support their state using a ballot measure to decide state-level abortion rights.
- Guttmacher Institute. Medication Abortion Now Accounts for More Than Half of All US Abortions.
- Alliance For Hippocratic Medicine. Alliance For Hippocratic Medicine Complaint.
- National Library of Medicine. First-trimester medical abortion with mifepristone 200 mg and misoprostol: a systematic review.
- Center for Reproductive Rights. Nationwide Threat to Medication Abortion.