US Appeals Court Preserves Limited Access to Abortion Pill

An appeals court in the United States has ruled that the abortion pill, mifepristone, will continue to be available in the country, but with significant limitations, including a condition for in-person doctor consultations to acquire the medication. On Wednesday, the 5th U.S. Circuit Court of Appeals, located in New Orleans, partially suspended a previous court order to suspend the approval of the drug by the U.S. Food and Drug Administration (FDA) while a lawsuit is heard by anti-abortion groups, who are seeking to ban it.

The Biden administration and the makers of brand-name mifepristone, Danco Laboratories, quickly requested for an emergency stay of that order after it was issued. However, the appeals court declined to stop portions of the previous order, which essentially reimposed limits on the distribution of the pill, restrictions which had been lifted since 2016. These limitations include the drug being limited to use within the first seven weeks of pregnancy as against the current ten weeks, and the drug can only be prescribed and dispensed after an in-person consultation with a medical practitioner.

The previous order made by the court is set to become effective on Friday. The ruling on Wednesday was made by three judges from the 5th Circuit, two of whom were appointed by former President Donald Trump, and one by George W. Bush, both Republicans. Judge Catharina Haynes, who was appointed by Bush, partially dissented from the ruling, stating that she would have suspended Kacsmaryk’s order in its entirety.

The emergency stay will remain valid until the 5th Circuit hears the Biden administration’s appeal of Kacsmaryk’s order in full, and that appeal may be heard by a different panel. The Biden administration, anti-abortion groups, or both might also choose to appeal immediately to the U.S. Supreme Court.

The lawsuit before Kacsmaryk was filed against the FDA in November by four anti-abortion medical associations led by the recently formed Alliance for Hippocratic Medicine and four anti-abortion doctors. They argue that the agency used an improper process when it approved mifepristone in 2000 and that it did not fully account for the drug’s safety when used by girls under age 18 to end a pregnancy.

The ruling by Kacsmaryk Alfeld with the 5th Circuit Court of Appeals led to conflicting decisions, as another federal judge had issued a declaration last Friday directing the FDA to maintain access to mifepristone with no new restrictions in 17 states and the District of Columbia.

The lawsuit above was brought by a group of Democratic-led states protesting against federal safety restrictions for mifepristone. Dozens of legal briefs have been filed in the two lawsuits, with scientific and medical associations like the American Medical Association and American College of Obstetricians and Gynecologists, as well as abortion rights groups and Democratic politicians, questioning the drug’s approval. Anti-abortion groups and Republican politicians oppose the use of the medication.

Mifepristone is one of two drugs administered together, along with misoprostol, to carry out a medication abortion within the first 10 weeks of pregnancy. The drugs account for more than 50% of all abortions in the country. According to some abortion providers, if mifepristone is unavailable, they would switch to a misoprostol-only regimen, which is not as effective. However, it is unclear how widely it would be available. Democratic-led states have begun stockpiling the drugs since Kacsmaryk’s ruling.

Abortion has emerged as a contentious political issue in the United States since Roe v. Wade. A landmark ruling in 1973 recognized a constitutional right to abortion, leaving the issue to be determined by individual states. A Kansas state constitutional amendment opposed to abortion failed in August, and Wisconsin voters recently shifted the state’s supreme court to a liberal majority after an abortion campaign.