By Grace Ruane, Staff Writer
Photo Courtesy of Pixabay.com
On October 2nd, the Supreme Court began hearing cases for the new term and the docket is rich with hot-button issues (guns, free speech, etc.). While the decision in Dobbs v. Jackson Women’s Health Organization[1] curtailed women’s access to reproductive healthcare, a 5th circuit decision that would reinstate restrictions on access to mifepristone[2] leaves another threat to reproductive healthcare looming over the lives of American women. In April of 2021, the Supreme Court granted a request from the Biden administration and a drug manufacturer to put on hold a ruling by a federal judge in Texas that suspended the Food and Drug Administration’s approval of the drug.[3] This 5th circuit decision brings the issue back onto the Supreme Court’s radar, with the issue being forecasted to be heard in either 2024 or 2025.[4]
In March of 2023, 20 Republican state attorneys general, mostly from states where abortion is banned or heavily restricted, sent letters threatening Walgreens and other pharmacies with legal action if they dispensed mifepristone.[5] In a statement to NPR, Walgreens said that it has responded to all the attorneys general to assure them it will not distribute mifepristone in their states.[6] Not long after this, on April 7, a Texas federal judge ruled to suspend the FDA’s approval of mifepristone altogether – virtually banning the sale of pills nationwide.[7]
Mifepristone, colloquially known as “the abortion pill,” is the first of two medications used in a medical abortion.[8] In April of 2019, the Food and Drug Administration (FDA) approved the first generic form, following a review of the evidence that medical abortion is a safe, effective way to end an early pregnancy. The drug yielded a safety record of over 99%.[9] The controversy surrounding the drug derives from its association with one of the most polarized topics in American politics: abortion. However, mifepristone is not exclusively used to complete medical abortions. Mifepristone is also used for evidence-based indications in the medical management of miscarriage, cervical preparation for later second-trimester abortion, and management of second and third-trimester pregnancies when the fetus has died before birth.[10] In combination with misoprostol, mifepristone offers the most effective medication regimen for managing an early miscarriage, reducing the likelihood of patients needing an additional procedure.[11]
The bottom line? According to Jack Resneck Jr., M.D., Immediate Past President of the American Medical Association (AMA), in his statement in his response to the Fifth Circuit decision: “a reduction in access to this drug will almost certainly exacerbate the maternal mortality crisis in places that do not have access to this medication. It may also threaten access to mifepristone for use in medical management of miscarriage in states seeking to broadly ban its use.”[12]
Danco Laboratories, maker of the drug, and the Biden administration are asking the Supreme Court to reverse the Fifth Circuit decision, arguing that upholding the ruling would dramatically cut back access to the abortion pill in every state in the country, regardless of whether abortion is legal or illegal in the state.[13] Further, on a broader (perhaps less polarizing) scale, upholding the ruling would jeopardize the country’s longstanding regime of regulating pharmaceuticals.[14]
With all of this in mind, Americans (namely, American women) once again find themselves anxiously awaiting another decision on reproductive healthcare.
[1] https://www.oyez.org/cases/2021/19-1392.
[2] https://www.npr.org/2023/10/02/1201601347/supreme-court-new-term.
[3] https://www.scotusblog.com/2023/04/court-allows-abortion-pill-to-remain-widely-available-while-appeals-proceed/#:~:text=The%20Supreme%20Court%20on%20Friday,pregnancies%20in%20their%20early%20stages.
[4] https://www.politico.com/news/2023/08/16/abortion-pill-restrictions-00111499.
[5] https://www.npr.org/2023/03/04/1161143595/walgreens-abortion-pill-mifepristone-republican-threat-legal-action#:~:text=New%20York%20City.-,Walgreens%20says%20it%20won%27t%20sell%20mifepristone%20in%20states%20where,attorneys%20general%20threatened%20legal%20action.&text=Walgreens%20won%27t%20distribute%20abortion,is%20still%20legal%20and%20available.
[6] Id.
[7] https://www.politico.com/news/2023/04/07/texas-judge-halts-fda-approval-of-abortion-pill-00091096.
[8] https://www.plannedparenthood.org/uploads/filer_public/42/8a/428ab2ad-3798-4e3d-8a9f-213203f0af65/191011-the-facts-on-mifepristone-d01.pdf.
[9] Id.
[10] Id.
[11] Id.
[12] https://www.ama-assn.org/press-center/press-releases/ama-opposes-court-ruling-chipping-away-mifepristone-access#:~:text=Reduced%20access%20to%20mifepristone%20will,to%20broadly%20ban%20its%20use.
[13] https://www.npr.org/2023/10/02/1201601347/supreme-court-new-term.
[14] Id.
