US judge limits access to abortion pills

August 2023 Update: The Fifth Circuit Court of Appeals ruled against the FDA, saying that it would restrict access to mifepristone. The decision is on hold pending appeal to the Supreme Court.

In April of 2023, the future of abortion access in the United States became uncertain after a US District Judge blocked the FDA’s approval of mifepristone, one of the two medications used in a medication abortion. 

Abortion medication is still available. The ruling was appealed, and was put on hold as the case move through the courts.

A competing ruling, in Washington State, ordered the FDA to maintain the status quo on mifepristone in 17 states. The case is likely to reach the Supreme Court.

Demand for safe abortion care has increased in the states where it is legal since the overturning of Roe v. Wade last summer. But on April 7, 2023, US District Judge Matthew Kacsmaryk, an appointee of former President Donald Trump with no medical credentials, overturned the US Food and Drug Administration (FDA)’s approval of the most commonly used abortion drug, mifepristone.

Mifepristone has been approved for more than 20 years. It is so safe and effective that the FDA had recently removed restrictions on its use, citing a recent study which used data from research conducted by MSI in the United Kingdom.  

An MSI provider shows a pack of abortion medications. The large pill is mifepristone; the four smaller pills are misoprostol. Together, they are more than 99% effective at ending a pregnancy.

Medication abortion is safe and effective  

Medication abortion has become an increasingly popular option for women in the early stages of pregnancy, both here in the United States and around the world. Instead of waiting for a medical procedure, women simply take two pills before the 10th week of their pregnancy.  

In the US, the first pill, mifepristone is generally taken under the supervision of a doctor in a clinic. During Covid, that requirement was relaxed and both it and misoprostol, a second medication taken up to 48 hours later, were taken at home.  In other parts of the world, both pills have been taken at home without risk for years.   

Medication abortion is very safe, with extremely low rates of complication whether taken in a facility or at home. At MSI, we provide medication abortion both in-facility and in women’s homes, depending on local policies. About 60% of our abortion clients chose medication abortion with mifepristone and misoprostol. 

Standing up to anti-choice restrictions 

While abortion can be safely and effectively completed using just misoprostol, this decision subverts the Food and Drug Administration’s authority, restricting access to mifepristone even in states where abortion is still legal. MSI’s global medical director, Dhammika Perera, said:  

“Be under no illusion, Roe v Wade was not the endpoint, it was just the beginning. As the organized rollback of reproductive healthcare and women’s rights continues in the US, we urge the Biden administration to act decisively and appeal this dangerous decision.”   

Our experience around the world shows that medication abortion is preferred by many clients and is proven to be safe and effective. That’s why we’ll keep working to ensure this option is available to the women we serve.  

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