The future of an abortion medication, approved more than two decades ago, is uncertain following a ruling last week from a federal judge in Texas.
On Friday, U.S. District Judge Matthew Kacsmaryk suspended the Food and Drug Administration's longtime approval for Mifepristone, the first in a two-drug regimen for medication abortion, citing safety concerns.
"This is clearly a politically motivated attack against sexual and reproductive health care," said Jennifer Welch, the president and CEO of Planned Parenthood of Illinois.
The ruling has provided uncertainty for providers and patients, especially in light of a second ruling from a federal judge in Washington state that protects access to the drug in 17 states and Washington D.C.
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"I do have questions about how this one court’s decision will be interpreted and enforced by the FDA," Welch said. "Ultimately it’s the FDA as a health care provider, I will follow their instructions."
As PPIL and other clinics, including Carafem, await further instruction, they are preparing for the drug's possible removal.
"We have been providing a secondary option for medication abortion through misoprostol, which is one of two drugs for medication abortion in the U.S.," said Carafem Chief Operating Officer, Melissa Grant.
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Carafem, which operates an abortion clinic in Skokie, is a network of sexual and reproductive health care clinics that also provide virtual services.
"Traditionally we use both mifepristone and misoprostol, but overseas it's common to use misoprostol alone," said Grant.
Both organizations also say they have the ability to scale up surgical procedures as needed, which may be preferred for some out-of-state patients with time constraints.
"When you use mifepristone and misoprostol together, you take mifepristone, followed by one to two doses of misoprostol in order to complete an abortion," said Grant. "With miso by itself, you take three to four doses. It does take more doses, a longer regimen."
Welch with PPIL says the misoprostol-only regimen is slightly less effective.
"It does change the procedure a little bit," she said. "Patients would need to stay in Illinois a little longer, or go to another state where the medication is protected."
Abortion advocates are concerned the Texas decision could set a dangerous precedent.
"I am certain that if this is allowed to go ahead, they will come next for other important drugs, whether it’s birth control or gender-affirming care. We know they will continue to attack our patients."
Welch says those likely to be affected are already the most vulnerable.
For now, medication abortion remains legal in Illinois, but advocates call the environment "cloudy."
"Communication is essential right now," said Grant. "Talking to our providers, making sure we’re as transparent as possible with the information we receive from our legal resources. We would like to hear exactly from the FDA as to what they think this means."
In response to the Texas ruling, Illinois Right to Life Executive Director Kate Zander told NBC 5:
"Twenty eight women have died as a result of legal use of Mifepristone and countless more have been injured," she said. "It is absolutely the right move to halt the availability of this drug, particularly in light of the FDA’s recent rule changes which remove a doctor’s direct involvement in its distribution and administration."
Welch says "over five million patients over the last two decades" have successfully used Mifepristone.
The Department of Justice on Monday filed a request in a federal appeals court seeking to block the Texas judge's ruling to allow more time for the case to go through the appeals process.
If the appeals court does not grant the request, the government's only option would be to ask the Supreme Court to intervene. The government asked the appeals court to act by noon on Thursday.
