(NewsNation) — The U.S. Supreme Court on Tuesday is set to weigh in on a case that could have major implications for the accessibility of mifepristone, one half of a pair of medications used to provide medication abortions.
Abortion opponents have continually challenged access to the procedure after the Supreme Court overturned the constitutional right to abortion in June 2022. At least 14 states now have near-total bans on abortion, while 15 restrict access to medication abortion, according to the reproductive rights nonprofit Guttmacher Institute.
National use of the pill climbed as legal questions poured in surrounding who could undergo an abortion and what conditions they would need to follow.
In 2020, medication abortion accounted for about 53% of abortions in the U.S., according to the Guttmacher Institute.
It now accounts for 54% of all abortions in the country.
What is mifepristone?
Mifepristone blocks progesterone and when used with another medication called misoprostol, it can end a pregnancy through 10 weeks of gestation, according to the FDA.
The Food and Drug Administration approved mifepristone for medical abortions in September 2000. At the time, it was approved through seven weeks of gestation and later extended to 10 weeks in 2016.
It has long been the preferred method in the U.S. for ending a pregnancy, even before the Supreme Court effectively overruled Roe v. Wade in June 2022. It now accounts for more than half of all abortions in the U.S., according to the Guttmacher Institute.
What has the FDA said about it?
The FDA considers mifepristone safe when used as directed. The administration’s periodic reviews since its approval haven’t found any new safety concerns when someone is taking the medication as intended.
Mifepristone isn’t recommended in use with misoprostol to end a pregnancy if more than 70 days have passed since the first day of their most recent menstrual period or if they have an ectopic pregnancy, are being treated with long-term corticosteroid medications, are allergic to either drug or similar drugs, have a history of bleeding issues or are taking a coagulant, have inherited a rare condition called porphyria, or have an intrauterine device in place. An IUD must be removed before taking mifepristone, according to the FDA.
What is the challenge in court now?
Abortion opponents are asking the court to reexamine the FDA’s decision-making in 2016 and 2021, which led to the medication becoming more widely available.
Mifepristone can cause rare but dangerous bleeding and in light of that risk, the FDA used to require prescribers to be specially certified and mandated that patients come in for three in-person visits.
With time, however, the FDA reaffirmed the medication’s safety and began easing restrictions. The pill has been allowed to be shipped by mail and without in-person visits since 2021.
According to The AP, several medical organizations, including the American College of Obstetricians and Gynecologists, filed a legal brief stating: When used in medication abortion, major adverse events — significant infection, excessive blood loss, or hospitalization — occur in less than 0.32% of patients, according to a highly regarded study with more than 50,000 patients.
What happens if the approval is overturned?
The case could determine whether mifepristone can be shipped in the mail and would assign a narrower window for use. Instead of the current 10-week window, users would need to take the medication within the first seven weeks of pregnancy.
Although justices aren’t expected to consider the original FDA approval of the drug in 2000, stricter regulations could make the pill harder to come by. In that hypothetical scenario, some providers have said they would change course and use only misoprostol, though it is less effective in ending pregnancies, according to the AP.
The Associated Press contributed to this report.
