Supreme Court

What is mifepristone and what does the SCOTUS ruling mean? Here's an explanation

The U.S. Supreme Court made its first abortion decision since overturning Roe v. Wade two years ago

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The U.S. Supreme Court made its first abortion decision since overturning Roe v. Wade two years ago. This time, however, the court ruled unanimously to preserve access to an abortion pill deemed the most common way to end a pregnancy.

The pill is known as mifepristone.

So what does the ruling mean and what happens next?

Here's an explanation:

What is mifepristone?

Mifepristone blocks the hormone progesterone and primes the uterus to respond to the contraction-causing effect of a second drug, misoprostol. The two-drug regimen has been used to end a pregnancy through 10 weeks gestation.

The FDA approved mifepristone in 2000 as a safe and effective way to end early pregnancies. Last year the pill was used in more than six in 10 of the abortions in the U.S.

What did the Supreme Court rule?

In a unanimous decision, the high court ruled that abortion opponents who challenged the the Food and Drug Administration's approval of the medication, and subsequent actions to ease access to it, lacked the legal right or standing to sue.

The abortion opponents had argued in court papers that the FDA’s decisions in 2016 and 2021 to relax restrictions on getting the drug were unreasonable and “jeopardize women’s health across the nation.”

The court notes that the doctors and groups suing the FDA "do not prescribe or use mifepristone," nor is the FDA requiring them to do so.

"Rather, the plaintiffs want FDA to make mifepristone more difficult for other doctors to prescribe and for pregnant women to obtain," Justice Brett Kavanaugh wrote for the court's opinion. Kavanaugh was part of the majority to overturn Roe.

The “federal courts are the wrong forum for addressing the plaintiffs’ concerns about FDA’s actions," the opinion states, adding that "given the broad and comprehensive conscience protections guaranteed by federal law, the plaintiffs have not shown — and cannot show — that FDA's actions will cause them to suffer any conscience injury."

What does the ruling mean?

The decision “safeguards access to a drug that has decades of safe and effective use,” Abigail Long, a spokeswoman for Danco, which makes mifespristone, said in a statement.

The case had threatened to restrict access to mifepristone across the country, including in states where abortion remains legal. Health care providers have said that if mifepristone is no longer available or is too hard to obtain, they would switch to using only misoprostol, which is somewhat less effective in ending pregnancies.

In the end, Kavanaugh wrote, the anti-abortion doctors went to the wrong forum and should instead direct their energies to persuading lawmakers and regulators to make changes.

Those comments pointed to the stakes of the 2024 election and the possibility that an FDA commissioner appointed by Republican Donald Trump, if he wins the White House, could consider tightening access to mifepristone.

What was the reaction to the ruling?

In Illinois, where abortion remains legal, Gov. J.B. Pritzker called the ruling "a small victory in our fight to protect reproductive rights."

“It means that mifepristone, a safe and widely used medication, will remain available for the millions of women who need it. But we know that unless we remain vigilant, this ruling will only be a temporary roadblock to MAGA extremists waging war against women’s rights," Pritzker said. "To fully protect reproductive freedom, we must ensure MAGA extremists never again control the White House or Congress. Attacks on science and on Americans’ personal freedoms will only end if voters show up and fully defeat their agenda at every level of government.”

Nancy Northup, president and CEO of the Center for Reproductive Rights, expressed relief at Thursday's decision, but also expressed frustration that the case made it the court at all, calling it “meritless.”

“Unfortunately, the attacks on abortion pills will not stop here — the anti-abortion movement sees how critical abortion pills are in this post-Roe world, and they are hell-bent on cutting off access,” she said.

Meanwhile, Pro-Life Action League executive director, Eric Scheidler, said "if a group of concerned physicians can't sue the FDA over the utterly politicized manner in which they approved and then expanded the availability of abortion pills, then who can?"

"That's the unanswered question in today's ruling. How did a drug that sends one in 25 women who use it to the ER ever get approved? How did the FDA agree to allow it to be given to women without a physical examination?" Scheidler asid. "If —as it appears — no one can sue the FDA, then Congress must act to rein in the agency, which clearly cares more about shielding abortion providers than keeping American women safe."

Planned Parenthood Federation of America President and CEO Alexis McGill Johnson called the ruling the "bare minimum" and echoed Pritzker's concerns about the future of reproductive rights, saying "the fight is not over."

“As we breathe a sigh of relief for now, we cannot forget that the court is deciding another case about abortion this term. We also can’t forget this is the same court that overturned Roe, leaving millions of people across the country unable to access abortion — all to advance a dangerous anti-abortion agenda," McGill said. "At no point is a lawmaker or judge more qualified than you or your health care provider to make decisions about your body, life, and future. Threats to sexual and reproductive health care remain, and we continue our commitment to ensuring people everywhere can get the care they need.”

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