• Home
  • Health & Wellness
  • Disclaimer
    • Terms of Use
    • Privacy Policy
    • DMCA Notice
  • Home
  • Health & Wellness
  • Disclaimer
    • Terms of Use
    • Privacy Policy
    • DMCA Notice
24/7 Health News
No Result
View All Result
Home Article

How will the Supreme Court’s decision on mifepristone affect abortion access? 4 questions answered

April 24, 2023
in Article
How will the Supreme Court’s decision on mifepristone affect abortion access? 4 questions answered
The legal battle over mifepristone could have far-reaching effects on reproductive health care.

AP Photo/J. Scott Applewhite

On April 21, 2023, the U.S. Supreme Court ruled that the abortion pill mifepristone, which is used in more than half of all abortions in the U.S., could remain accessible without restrictions – at least for now. The decision is temporary, however, buying time as an appeals court weighs the challenge to mifepristone brought by a Texas judge in early April 2023.

That ruling blocked the use of the drug in medication abortions and sought to remove it from the market altogether, questioning its safety. Days later, a U.S. appeals court reversed the suspension on mifepristone but placed tighter restrictions on it, including preventing it from being sent through the mail.

The Conversation asked twin sisters Jamie Rowen, a legal scholar, and obstetrician and gynecologist Tami Rowen to put into perspective what the Supreme Court’s decision means for access to the drug moving forward and how it came under legal scrutiny to begin with.

Table of Contents

  • 1. What led up to the Supreme Court’s ruling on mifepristone?
  • 2. What comes next in the courts?
  • 3. What does this mean for abortion access moving forward?
  • 4. What are the implications for other medications?

1. What led up to the Supreme Court’s ruling on mifepristone?

In September 2022, several groups of anti-abortion doctors sued the Food and Drug Administration, arguing that they were harmed because the FDA’s 2000 approval of mifepristone was flawed and that it did not adequately test the drug for safety, among other claims. The plaintiffs also claimed harm from the FDA’s 2016 and 2021 changes that lifted several restrictions on how the drug could be used or administered.

The doctors brought the case in Texas, where a federal district judge ordered that, while the case was pending, mifepristone should be off the market.

The FDA appealed to the 5th Circuit, asking it for an emergency “stay,” or a hold on, the district court’s order. The 5th Circuit ordered that, while the case is being decided, mifepristone can be on the market but only with its original restrictions from 2000. Under this order, mifepristone could only be used up to seven weeks of pregnancy and required an in-person visit and prescription from a doctor.

The FDA, along with mifepristone’s manufacturer Danco Laboratories, immediately asked the Supreme Court to stay the 5th Circuit’s order. Supreme Court stays are granted when at least five justices agree that the applicants – in this case the FDA and Danco – are likely to succeed, among other considerations.

The majority did not explain its decision in favor of the FDA and Danco. The two dissents – from Samuel Alito and Clarence Thomas – provide little insight into how the different justices might rule on the case if they decide to review the 5th Circuit’s forthcoming opinion.

The Supreme Court ruling provided at least temporary relief to many providers who view mifepristone as the gold standard for abortion care.

2. What comes next in the courts?

The Supreme Court’s decision means that mifepristone will remain available until there is a final decision in this case. For now, the case returns to the 5th Circuit. Depending on the outcome of that case, either the plaintiffs or the defendants may ask the Supreme Court to hear the case. If the Supreme Court decides to hear the case, then the final decision on whether mifepristone should be taken off the market or have stricter requirements for use will come from the Supreme Court. If not, the final decision will come from the 5th Circuit.

Although the 5th Circuit is scheduled to hear the case on May 17, 2023,, there is no fixed time by which it must make its decision. In short, it will likely take at least a year for the case to be decided. Regardless of these lower court decisions, the fact that at least five justices chose to stay the 5th Circuit’s emergency order suggests that the Supreme Court will want to make the final determination in this case.

3. What does this mean for abortion access moving forward?

The Supreme Court’s decision to preserve full access to mifepristone until the case concludes leaves the FDA’s current rules in place. These rules allow mifepristone to be administered up to 10 weeks of pregnancy without an in-person visit to a clinic or hospital, through the mail and by a certified pharmacy as an alternative to a doctor’s prescription.

Given the legal uncertainty and the amount of time it takes for a case like this to conclude, the Supreme Court’s April 21, 2023, decision enables ongoing access to mifepristone for the foreseeable future. Roughly 90,000 medication abortions are performed annually in the U.S., the vast majority of which rely on mifepristone as part of a two-medication regimen that also includes the drug misoprostol.

Mifepristone blocks the hormone progesterone, which is needed for a pregnancy to continue. Misoprostol, which is approved for use in the treatment of gastric ulcers, also causes uterine contractions and ends the pregnancy.

Extended hand holding two bottles of abortion pills, one mifepristone and the other misoprostol.
Mifepristone is used in concert with misoprostol in the two-pill regimen. Misoprostol can also be used by itself in a one-pill medication abortion.
AP Photo/Charlie Neibergall

If the ultimate decision is in favor of the plaintiff doctors, the effects on pregnant people could be felt immediately. Taking mifepristone off the market until the FDA makes safety findings that are sufficient to the court, or restricting access to it through additional requirements, would lead people seeking medication abortions to use a misoprostol-only regimen or to seek surgical abortions. Though safe and effective, the misoprostol-only alternative would lead to higher rates of incomplete abortions that require additional, usually surgical, intervention. These procedures would exacerbate harms to those electing or experiencing abortion, including risks to subsequent pregnancies.

Likewise, forcing people to delay their abortions imposes numerous health risks. Even Supreme Court justices ambivalent about legal rights to abortion have expressed a desire for abortions to occur as early as possible.

Limiting access to mifepristone could have additional harmful effects. Mifepristone also helps women complete a miscarriage at a much higher success rate than the standard medical regimens that do not use mifepristone, sparing the risk of a surgical procedure and complications if the pregnancy remains in the uterus.

For now, the Supreme Court has created a buffer to help reduce such obstacles and adverse events while the lower courts, and likely the Supreme Court itself, decide the case.

4. What are the implications for other medications?

The Supreme Court did not explain whether it thinks the plaintiffs will be successful in their argument that the FDA should not have approved mifepristone in 2000 or changed the rules around its use in subsequent years.

When questioning an administrative agency, such as the FDA, a court asks whether the regulation was “arbitrary and capricious.” The 5th Circuit agreed with the district court that the 2016 regulation change was arbitrary and capricious because there was no study showing the effects of removing multiple restrictions on the medication at once. The FDA did review multiple studies that showed lifting these individual restrictions was indeed safe for those taking mifepristone.

Second-guessing the agency’s scientific determination in this way challenges the nuts and bolts of the FDA’s process and certainty in the drug manufacturing market.
This is particularly true for medicine that may have higher risks but can be lifesaving for patients. Undermining the FDA’s authority could also carry over to controversial medications like the COVID-19 vaccine or even the vaccine against human papillomavirus, or HPV, the most common sexually transmitted infection in the U.S. Given parental concerns about vaccine safety and the belief that making sex medically safer for young people encourages them to have sex, the HPV vaccine has faced heightened scrutiny from vaccine opponents about its safety record.

Leaders from across the scientific, pharmacologic and business world have sounded the alarm at the implications of these decisions on approved drugs and those in development.

Finally, the legal wrangling over mifepristone will no doubt affect ongoing research into the many potential uses of this medication beyond abortion. These legal challenges delayed the introduction of mifepristone to the U.S. market decades ago, and they continue to impair studies on mifepristone’s potential to help prevent certain cancers, uterine infections and other illnesses affected by progesterone.

For now, the Supreme Court has put off a decision that could profoundly change the regulation of medicines in the U.S.

The Conversation

Jamie Rowen receives funding from National Science Foundation and Humanity United.

Tami S. Rowen does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

ShareTweetSharePin
Next Post
Ethical non-monogamy: what to know about these often misunderstood relationships

Ethical non-monogamy: what to know about these often misunderstood relationships

Most Read

What causes stuttering? A speech pathology researcher explains the science and the misconceptions around this speech disorder

What causes stuttering? A speech pathology researcher explains the science and the misconceptions around this speech disorder

December 15, 2022
morning back pain

Morning Again Ache Trigger Is Not the Mattress

October 11, 2021

Why Circadian Rhythms Matter for Your Health

July 30, 2024
lower back pain relief exercises

5 decrease again ache aid workouts

October 11, 2021

4 steps to building a healthier relationship with your phone

January 28, 2025
3 years after legalization, we have shockingly little information about how it changed cannabis use and health harms

3 years after legalization, we have shockingly little information about how it changed cannabis use and health harms

October 15, 2021
Nasal vaccines promise to stop the COVID-19 virus before it gets to the lungs – an immunologist explains how they work

Nasal vaccines promise to stop the COVID-19 virus before it gets to the lungs – an immunologist explains how they work

December 14, 2022
bleeding in gum

When The Bleeding in gum Is Severe ?

October 11, 2021
Good Night Sleep

6 Causes of Good Evening Sleep

October 11, 2021
Kick up your heels – ballroom dancing offers benefits to the aging brain and could help stave off dementia

Kick up your heels – ballroom dancing offers benefits to the aging brain and could help stave off dementia

January 3, 2023
Biden is getting prostate cancer treatment, but that’s not the best choice for all men − a cancer researcher describes how she helped her father decide

Biden is getting prostate cancer treatment, but that’s not the best choice for all men − a cancer researcher describes how she helped her father decide

May 20, 2025
Ten small changes you can make today to prevent weight gain

Ten small changes you can make today to prevent weight gain

October 12, 2021

COVID vaccines: how one can pace up rollout in poorer international locations

October 5, 2021

This Simple Hygiene Habit Could Cut Your Risk of Stroke, New Research Reveals

February 1, 2025

Multiple sclerosis: the link with earlier infection just got stronger – new study

October 12, 2021
Support and collaboration with health-care providers can help people make health decisions

Support and collaboration with health-care providers can help people make health decisions

December 16, 2021
Greece to make COVID vaccines mandatory for over-60s, but do vaccine mandates work?

Greece to make COVID vaccines mandatory for over-60s, but do vaccine mandates work?

December 1, 2021
Five ways to avoid pain and injury when starting a new exercise regime

Five ways to avoid pain and injury when starting a new exercise regime

December 30, 2022
woman covered with white blanket

Exploring the Impact of Sleep Patterns on Mental Health

August 4, 2024

Maximize Your Performance – Sync with Your Circadian Rhythms

August 9, 2024
Why are some people faster than others? 2 exercise scientists explain the secrets of running speed

Why are some people faster than others? 2 exercise scientists explain the secrets of running speed

April 29, 2024
Backlash to transgender health care isn’t new − but the faulty science used to justify it has changed to meet the times

Backlash to transgender health care isn’t new − but the faulty science used to justify it has changed to meet the times

January 30, 2024
News of war can impact your mental health — here’s how to cope

Binge-eating disorder is more common than many realise, yet it’s rarely discussed – here’s what you need to know

December 2, 2022
As viral infections skyrocket, masks are still a tried-and-true way to help keep yourself and others safe

As viral infections skyrocket, masks are still a tried-and-true way to help keep yourself and others safe

December 14, 2022
GPs don’t give useful weight-loss advice – new study

GPs don’t give useful weight-loss advice – new study

December 16, 2022
Nutrition advice is rife with misinformation − a medical education specialist explains how to tell valid health information from pseudoscience

Nutrition advice is rife with misinformation − a medical education specialist explains how to tell valid health information from pseudoscience

January 28, 2025
FDA limits access to COVID-19 vaccine to older adults and other high-risk groups – a public health expert explains the new rules

FDA limits access to COVID-19 vaccine to older adults and other high-risk groups – a public health expert explains the new rules

May 21, 2025
Four ways to avoid gaining weight over the festive period – but also why you shouldn’t fret about it too much

Four ways to avoid gaining weight over the festive period – but also why you shouldn’t fret about it too much

December 22, 2022
Nurses’ attitudes toward COVID-19 vaccination for their children are highly influenced by partisanship, a new study finds

Nurses’ attitudes toward COVID-19 vaccination for their children are highly influenced by partisanship, a new study finds

December 2, 2022
How hot is too hot for the human body? Our lab found heat + humidity gets dangerous faster than many people realize

How hot is too hot for the human body? Our lab found heat + humidity gets dangerous faster than many people realize

July 6, 2022
  • Home
  • Health & Wellness
  • Disclaimer

© 2020 DAILY HEALTH NEWS

  • Home
  • Health & Wellness
  • Disclaimer
    • Terms of Use
    • Privacy Policy
    • DMCA Notice

© 2020 DAILY HEALTH NEWS