It has been less than a year since the overturning of Roe v. Wade and the legal ramifications of this decision are already rippling across the country.
Judge Matthew Kacsmaryk, a federal judge in Texas, ruled against the FDAs' approval of the abortion pill mifepristone on April 7. The lawsuit, brought forth against the FDA by The Alliance for Hippocratic Medicine, a coalition of anti-abortion groups and four anti-abortion doctors, claimed mifepristone causes harm to patients and forces doctors to redirect medical resources that would have been used for other patients.
This ruling sets a precedent since no judge has ever ordered the federal government to pull its approval of a drug, let alone one that's been available for over 20 years. The Biden administration appealed the decision the same day it was announced. The case will move to the conservative-leaning 5th U.S. Circuit Court of Appeals in New Orleans.
The ban will force the FDA to withdraw mifepristone from the national
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"Mifepristone is used in more than half of abortion procedures nationwide now," says Kristen Rowe-Finkbeiner, executive director and CEO of social welfare organization and advocacy group MomsRising. "Taking it off the market devastates access to reproductive healthcare across the country, including in states that have secure access to abortion care."
This is a point echoed by an opposing ruling on mifepristone announced the same day as Kacsmaryk's decision. A Washington state federal judge, Thomas O. Rice, ruled that the FDA cannot restrict access to mifepristone in 17 Democratic-led states and the District of Columbia, all of which filed a collective lawsuit against the FDA for attaching too many limitations on the prescription and distribution of the drug. While Rice did not loosen current restrictions on mifepristone, he blocked the FDA from banning the abortion pill in the states that sued. Washington's attorney general believes patients in these states should still have access to the pill, at least until higher court rules otherwise.
The Washington ruling will likely go to the liberal 9th U.S. Circuit Court of Appeals in San Francisco, with the case of abortion pills at large likely on its way to the Supreme Court — the same court that overruled Roe v. Wade last year, in a five-to-four vote.
While at the center of this debate, mifepristone itself is universally viewed by science and medical communities as a safe abortion method. According to several medical associations, including the American College of Obstetricians and Gynecologists and the American Medical Association, mifepristone rarely causes substantial harm to patients. Adverse effects like blood loss, hospitalization and infection happen to less than 0.3% of patients. Studies have proven the pill's side effects to be comparable to over-the-counter drugs like ibuprofen. Additionally, mifepristone has a 99.6% success rate and can be used as soon as the patient realizes they're pregnant or within 70 days of the first day of their last period.
"Every leading medical association has said that mifepristone is safe and effective and causes fewer major medical complications than Tylenol or Viagra," says Rowe-Finkbeiner. "Five million people in the United States have used it to safely end their pregnancies. No judge should second-guess the FDA or overturn its scientific decisions."
Yet, the Alliance for Hippocratic Medicine claims the doctors themselves have been negatively impacted due to having to treat patients for bleeding after they took mifepristone. They went as far as to say that as doctors, they had to go against their morals by performing a surgical procedure because the pill was unsuccessful. Essentially, the plaintiff's arguments hinged on being able to prove the drug had caused them harm in some way. However, the FDA argued this harm is not a direct consequence of the agency's approval of mifepristone.
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Dr. Mary Jacobson, an OB-GYN and the chief medical officer at digital healthcare company Hello Alpha, doesn't believe this case is founded in proof of harm, but rather, it's one of many cases that will try to further strip women of their reproductive rights. And this case does so on a national level.
"Rigorous testing, FDA approval and years of use all support the conclusion that mifepristone is safe and effective," says Dr. Jacobson. "The plaintiffs in the case in Texas are asking the court to second-guess the FDA's decision-making and make mifepristone unavailable to millions of women around the country — women who do not live in Texas."
Even Judge Kacsmaryk, who was appointed to the Northern District of Texas by former President Donald Trump, knows there is no precedent for this case and asked the plaintiff's lawyer what gives the court the authority to reverse FDA approval.
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"Let's be clear: the anti-abortion extremists who brought this case and cherry-picked an anti-abortion judge to hear it, care nothing at all about science or health," says Rowe-Finkbeiner. "No judge should second-guess the FDA or overturn its scientific decisions."
Rowe-Finkbeiner underlines that this case will harm over 64 million women, namely mothers from low-income backgrounds already struggling to support their families.
"Without question, a ruling to overturn the FDA's approval of mifepristone would cause enormous harm to moms, pregnant people who need an abortion and their families," she says. "Keep in mind that most people who have abortions in this country are moms."
In fact, six in 10 women who have abortions are already
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In the meantime, Dr. Jacobson encourages employers to work with third parties to provide access to abortion services, whether that's in the form of financial stipends to travel out-of-state for the procedure or even legal representation if an employee finds themselves in trouble. For privacy and legal purposes, she warns
Dr. Jacobson and Rowe-Finkbeiner have not lost hope but know there is a dangerous road ahead.
"The courts are no longer protecting our right to access abortion," says Rowe-Finkbeiner. "Despite overwhelming public opposition to the overturning of Roe v. Wade, anti-abortion forces are emboldened and doing everything they can to take away our access to reproductive health care."
