Supreme Court Takes Up Abortion Pill Case This Week

Justices could roll back availability of mifepristone
By Newser Editors and Wire Services
Posted Mar 24, 2024 8:23 AM CDT
Supreme Court Takes Up Abortion Pill Case Tuesday
Boxes of the drug mifepristone sit on a shelf at the West Alabama Women's Center in Tuscaloosa, Ala.   (AP Photo/Allen G. Breed, File)

The US Supreme Court will take up a case Tuesday that could impact how women get access to mifepristone, one of the two pills used in the most common type of abortion in the nation. The central dispute in the case is whether the FDA overlooked serious safety problems when it made mifepristone easier to obtain, including through mail-order pharmacies, per the AP. Legal briefs filed with the court describe the pill's safety in vastly different terms: Medical professionals call it "among the safest medications" ever approved by the FDA, while the Christian conservative group suing the agency attributes "tens of thousands" of "emergency complications" to the drug.

  • Background: The FDA approved mifepristone in 2000 as a safe and effective way to end early pregnancies. There are rare occasions when mifepristone can cause excessive bleeding that requires emergency care. Because of that, the FDA imposed strict safety limits on who could prescribe and distribute it—only specially certified physicians and only as part of three mandatory in-person appointments with the patient getting the drug. Over the years, the FDA reaffirmed mifepristone's safety and repeatedly eased restrictions, culminating in a 2021 decision doing away with any in-person requirements and allowing the pill to be sent through the mail. Tuesday's court case could restore stricter limits on availability.
  • Effectiveness: Mifepristone results in a completed abortion 97.4% of the time, according to US studies cited in the FDA label. But in 2.6% of cases, a surgical intervention is needed. And 0.7% of the time, the pregnancy continues. That's compared to a procedural abortion in a clinic, where the chance of the procedure failing to end a pregnancy "is extremely, extremely low," probably less than 0.1%, said Dr. Pratima Gupta, a board member for the American College of Obstetricians and Gynecologists.
  • Problems: Abortion opponents say the more lax restrictions resulted in many more "emergency complications." But that argument lumps together women experiencing a range of issues with mifepristone—from the drug not working to people who may simply have questions or concerns but don't require medical care. OB-GYNs say a tiny fraction of patients suffer "major" or "serious" adverse events after taking mifepristone.
  • Retractions: Earlier this year, a medical journal retracted two studies that claimed to show the harms of mifepristone. The studies were cited in the pivotal Texas court ruling that brought the matter before the Supreme Court. The publisher cited conflicts of interest by the authors and flaws in their research, although the studies' lead author called the retractions a baseless attack.
Read the full AP story.
(More mifepristone stories.)

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