Almost two years after the US Supreme court made the decision to overturn Roe v. Wade, the Court will hear another major case on Tuesday, March 26th that has the potential to reshape abortion access across the country.
The Supreme Court's decision will be released in June of 2024.
What's at stake?
Abortion access
The case challenges FDA approval of the medication abortion drug, Mifepristone. Not only is the medication exceptionally safe and highly effective, but it's currently used in over half of U.S. abortions.
Revoking the medication's approval would be devastating, as it would mean Mifepristone could not be accessed at pharmacies or via telehealth. Those seeking medication abortion would still have options, but those alternatives are less effective and would only be available for 7 weeks instead of 10.
If legally forced, we are prepared to offer an alternative regimen for medication abortion with misoprostol alone, but this single medication is less successful and has more side-effects than in combination with Mifepristone.
FDA credibility
The FDA was established as an independent organization, to utilize the best evidence and science to determine and dictate the safety and efficacy of new medications. If courts can second-guess and undermine FDA approvals and regulatory decisions, that would upend the current process for drug approval and regulation and potentially endanger health and safety more broadly. We have checks and balances in our judicial system, specifically for these extreme circumstances: to prevent one rogue Judge from having the power to disrupt reproductive freedom for millions.
Case background
On April 7, 2023 Judge Matthew Kacsmaryk issued a decision to rescind the FDA's approval of Mifepristone in Alliance for Hippocratic Medicine v. FDA. The immediate impact of the court’s decision was delayed for seven days to allow the Biden Administration to file an emergency appeal.
Then on April 13th, 2023 the Fifth Circuit Court of Appeals issued a decision that refused to block the order from the lower court, unleashing further chaos and confusion. Later the same day, the Department of Justice filed an appeal to the Supreme Court asking them to restore full access to mifepristone following the Fifth Circuit’s decision.
Mifepristone is safe and effective
We all know the decision by Judge Kacsmaryk is not based in medicine or science.
Since Mifepristone’s initial approval in 2000, it has been used by millions of people to end their pregnancies. This real-world experience coupled by more than 100 research publications in peer-reviewed journals supports Mifepristone’s well-documented safety record. In addition, leading medical and scientific organizations, including the World Health Organization, the American Medical Association, the American College of Obstetricians and Gynecologists, and the American Academy of Physicians, have continued to recognize the safety and efficacy of Mifepristone and recommend its use in obstetric and abortion care.
At FPA Women’s Health, we have not made any changes to our clinical protocol for medication abortion and are optimistic that our country’s system of checks and balances will function as designed to legally protect our provision to patients of the safest and most effective regimen for medication abortion. That which includes Mifepristone.
Medication abortion is crucial
Fourteen states are enforcing total abortion bans, with many other states imposing severe restrictions on abortion access. Still, individuals are seeking abortion.
Data from the Guttmacher's Monthly Abortion Provision Study show substantial increases in the number of abortions from 2020 to 2023 in states that border those where abortion is banned. 
This shows us that abortion restrictions and bans do not stop them from happening. Instead, they increase the financial and logistical costs of obtaining an abortion, disproportionately impacting marginalized groups.
Therefor, revoking FDA approval for Mifepristone would not prevent abortions. The decision would, however, take away an efficient and cost-effective option for those seeking them.
Our conclusion
This case is bigger than Texas, bigger than abortion. This case will clarify whether as a nation, we believe that scientists and doctors can practice according to science and evidence or whether we believe the political leaders can decide the fate of our health based on their own moral compass. We are hopeful justice will prevail.
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