(NewsNation) — The U.S. Supreme Court on Tuesday heard arguments in a case over mifepristone, with judges seemingly agreeing that access to it should be preserved.
Abortion opponents are asking justices to ratify a ruling from a conservative federal appeals court that would limit Mifepristone’s accessibility. Mifepristone is one-half of a pair of pills used to provide medication abortions.
Solicitor General Elizabeth Prelogar, who represented the Department of Justice during oral arguments, said the Food and Drug Administration deemed mifepristone to be safe and effective.
“It’s maintained that judgment across five presidential administrations, and millions of Americans have used mifepristone safely in their pregnancies,” Prelogar said.
The court should make it clear, Prelogar argued, that organizations disputing the FDA’s relaxation on mifepristone don’t have the legal standing to do so.
Lawyer Erin Hawley, of the conservative group Alliance Defending Freedom, argued that the FDA failed to comply with federal regulations.
“Ruling against respondents on standing here would allow federal agencies to conscript non-regulated parties into violating their consciences and suffering other harm without judicial recourse,” Hawley said.
Even conservative justices Amy Coney Barrett, Neil Gorsuch and Brett Kavanaugh, who had been in the majority that overturned Roe v. Wade in June 2022, questioned whether abortion opponents had grounds to sue, however. Barrett expressed doubt that doctors cited by Hawley showed people were actually harmed by the FDA’s actions.
“The difficulty, to me, is that the affidavits do read more like conscience objections,” Barrett said.
Abortion access has been constitutionally challenged since the Supreme Court overturned the constitutional right to abortion. 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.
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. 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.
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 someone’s most recent menstrual period or if they have an ectopic pregnancy; someone is being treated with long-term corticosteroid medications; is allergic to either drug or similar drugs; has a history of bleeding issues or are taking a coagulant; has inherited a rare condition called porphyria; or has an intrauterine device in place.
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. In light of that risk, the FDA used to require prescribers 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 Associated Press, 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.