Mifepristone ruling – latest: Supreme Court decision keeps medical abortion pill approval in place
The US Supreme Court has kept the government’s approval of a widely used abortion drug in place, while one of the biggest battles over abortion rights since the end of Roe v Wadecontinues in federal courts.
Justices on the nation’s highest court have paused a lower court ruling that challenge the government’s 23-year-old approval of mifepristone, part of a two-drug protocol for medication abortion, the most common form of abortion in the US.
Following an appeal from the Biden administration and drugmakers, the court paused a federal judge’s ruling that would strip the US Food and Drug Administration’s approval of mifepristone, which was first approved by the government agency in 2000.
A ruling to strike down the FDA’s approval of the drug would have drastically impacted access to abortion and miscarriage care for millions of Americans across the country, including in states where it is legally protected.
Key Points
Supreme Court preserves abortion drug approval as case continues
What is mifepristone?
How the challenge to mifepristone landed at the Supreme Court
Who is Matthew Kacsmaryk, the Trump-appointed judge trying to ban abortion drug?
Thursday 20 April 2023 15:06 , Alex Woodward
A Trump-appointed federal judge in Texas whose decision to halt approval of the most commonly used abortion drug in the US has trigged a legal battle posing the most significant threat to abortion rights since the Supreme Court revoked a constitutional right to abortion care last year.
Who is Trump-appointed judge Matthew Kacsmaryk trying to ban abortion drug?
The latest: Supreme Court delays decision in abortion drug case until Friday
Thursday 20 April 2023 15:07 , Alex Woodward
The US Supreme Court has extended its pause on a lower court ruling that would strip the government’s approval of a widely used abortion drug, which will remain available, at least for now.
An order from the nation’s highest court that put the ruling on hold was set to lapse at midnight on Wednesday. An order issued on Wednesday afternoon extended that hold until midnight on Friday.
Supreme Court delays decision in abortion drug case until Friday
Abortion advocates and providers brace for Supreme Court decision in major drug case
Thursday 20 April 2023 15:09 , Alex Woodward
Abortion providers, clinics and abortion rights advocates and patients are anticipating a US Supreme Court decision that could provide some clarity about the fate of a widely used drug at the centre of the biggest legal battle for abortion care since the fall of Roe v Wade last year.
Advocates and civil rights legal groups were stunned by lower court rulings that took aim at the FDA’s approval of mifepristone, decisions that they say are “unmoored” by both the law and science, including decades of research and guidance from major medical and public health organisations.
Abortion advocates and providers brace for Supreme Court decision in major drug case
How the challenge to mifepristone landed at the Supreme Court
Thursday 20 April 2023 15:30 , Alex Woodward
Following the Supreme Court’s decision to overturn Roe v Wade last year, marking a significant victory for the anti-abortion movement and Christian conservative legal groups who have fuelled that campaign, anti-abortion activists took aim at medication abortion, the most common form of abortion care in the US.
Here’s how the case played out over the last several months:
In November, the group Alliance Defending Freedom filed a lawsuit in US District Court in Amarillo, Texas on behalf of a group of anti-abortion activists incorporated at the Alliance for Hippocratic Medicine, which was organised that month with an address in Amarillo.
Judge Matthew Kacsmaryk – a former right-wing activist lawyer who was appointed to the federal judiciary by Donald Trump – held a hearing in the case on 15 March in Amarillo.
Earlier this month, Judge Kacsmaryk issued a ruling to suspend the FDA’s approval of mifepristone. His order was set to take effect a week later, pending a decision from on appeal.
But in a separate ruling in Washington state, a federal judge ruled that the FDA cannot change the status quo when it comes to mifepristone’s approval, setting up potentially duelling decisions over the drug.
Abortion rights advocates, providers, major medical groups and legal analysts condemned the ruling, and the US Department of Justice and Danco Laboratories, which manufactures mifepristone, filed an appeal.
That appeal landed at the US Court of Appeals for the Fifth Circuit, which has jurisdiction over the Amarillo court.
A three-judge panel on the Fifth Circuit blocked a part of the judge’s ruling, but struck against mail-in prescriptions and rules that expanded the drug’s approval for use up to 10 weeks of pregnancy.
The Supreme Court blocked the Texas ruling while it considers the case.
The latest: Florida’s latest anti-abortion law will nearly eliminate access across the South
Thursday 20 April 2023 16:15 , Alex Woodward
Abortion is effectively outlawed in more than a dozen states, mostly in the South, following the US Supreme Court’s decision to strike down the constitutional right to abortion care last June.
Shortly after the state’s Republican-controlled legislature passed the measure on 13 April, Florida Governor Ron DeSantis signed a bill into law that outlaws abortion at six weeks of pregnancy.
The law will strand Florida residents “in a vast abortion desert” and force patients to travel more than 1,000 miles for legal access to abortion care, according to Elisabeth Smith, director of state policy and advocacy at the Center for Reproductive Rights.
Florida’s latest anti-abortion law will nearly eliminate access across the South
Judge who wants to block mifepristone removed his name from anti-abortion article before Senate confirmation
Thursday 20 April 2023 16:45 , Alex Woodward
The judge presiding over a challenge to a widely used abortion drug reportedly failed to disclose to members of Congress that he authored an article attacking abortion rights and transgender healthcare in a right-wing legal journal while he was in the running for his Trump-appointed position on the federal judiciary.
Judge in mifepristone case failed to disclose writing anti-abortion article
What will the Supreme Court decide, and what happens next?
Thursday 20 April 2023 17:15 , Alex Woodward
The order from Supreme Court Justice Samuel Alito, who presides over the district where the mifepristone challenge was filed, was published on the so-called “shadow docket” where the court handles both procedural manners and emergency motions that can have profound implications.
Alito’s brief order to pause a federal court’s decision that would reverse the FDA’s approval for mifepristone keeps the status quo in place until midnight on Friday, at the latest.
But it is unclear what the court will do next.
The court will not be ruling on the merits of the case, but it will determine how or if mifepristone can be dispensed while the case continues to play out.
After the court makes a decision, the case returns to the Fifth Circuit Court of Appeals in Louisiana. Both parties will have a chance to file briefs, and the case will be argued before a three-judge panel on 17 May.
Republican lawmaker tells women to ‘get off the abortion conversation’ as future of critical drug in jeopardy
Thursday 20 April 2023 18:19 , Alex Woodward
A Republican congressman from Texas dodged questions about a federal court decision to revoke a more than 20-year-old approval for a commonly used abortion drug, instead suggesting that “women have a whole lot of other issues than just abortion” and the US should “talk about the other things that are happening in this world.”
US Rep Tony Gonzales told CNN’s State of the Union earlier this month that the issue was about “states’ rights,” but he stumbled when asked how that accounts for a federal court ruling that will have a dramatic impact to abortion access across the country if it goes into effect.
GOP lawmaker tells women to ‘get off the abortion conversation’ after drug ruling
The women suing Texas over the state’s ‘barbaric’ abortion restrictions
Thursday 20 April 2023 20:11 , Alex Woodward
Last month, five women who were denied abortions under several overlapping anti-abortion laws in Texas filed a lawsuit against the state, marking the first time that pregnant women have sought legal action themselves after a wave of restrictions following the US Supreme Court’s decision to strike down Roe v Wade.
The plaintiffs, two of whom are pregnant, told their stories outside the Texas capitol, warning that the state’s anti-abortion measures expose pregnant patients to severe risk of illness, injury and death.
Women denied emergency abortion care in Texas sue state over ‘barbaric’ restrictions
‘One of the most brazen attacks on Americans’ health'
Thursday 20 April 2023 20:45 , Alex Woodward
Federal court rulings that undermine the FDA’s two-decade approval of a widely used abortion drug could upend the government’s drug regulatory process into chaos in ways that extend far beyond the fight over mifepristone, according to Dr Jack Resneck Jr, presidentof the American Medical Assocation.
He writes in an essay for The New York Times on Thuesday that the political volatility surrounding the drug over the last few years could open up the FDA to challenges to “many vaccines, including those that reduce the risks of serious illness from Covid-19.”
“We should expect lawsuits against common types of safe and highly effective hormonal birth control, including emergency contraception,” he added. “Also at risk: drugs used to treat cancer and arthritis that can incidentally affect unexpected pregnancies, drugs to prevent or treat HIV, and medications aimed at providing gender-affirming care.”
What is mifepristone?
Thursday 20 April 2023 21:30 , Alex Woodward
The future of abortion access is back in the hands of the Supreme Court, which is reviewing a challenge from anti-abortion activists to reverse the federal government’s approval of mifepristone, a widely used drug for medication abortion procedures and miscarriage care.
Stripping the government’s approval could devastate access to abortion and miscarriage care for millions of Americans across the country, including in states where access is legally protected.
The widely used drug in the abortion rights battle at the Supreme Court
Supreme Court chief justice asked to testify before Senate on ethics rules after Clarence Thomas revelations
Thursday 20 April 2023 22:00 , Alex Woodward
US Supreme Court Chief Justice John Roberts has been summoned to appear before the Senate Judiciary Committee to testify about the court’s ethnics rules following recent revelations about Justice Clarence Thomas’ finances.
Senate Judiciary Committee Chairman Dick Durbin has asked Roberts to appear before the committee on 2 May.
Supreme Court chief justice asked to testify in Senate after Clarence Thomas scrutiny
Federal judge at centre of mifepristone case failed to disclose interviews with Christian talk radio shows
Thursday 20 April 2023 23:00 , Alex Woodward
US District Judge Matthew Kacsmaryk failed to disclose during his Senate confirmation process that he gave two interviews with a Christian talk radio programme where he discussed contraception and gay rights.
He referred to being gay as a “lifestyle” and claiming that social norms around “people who experience same-sex attraction” would lead to clashes with religious institutions, a collapse that began with “no-fault divorce” and “permissive policies on contraception,” according to CNN.
The comments were made in 2014 on Chosen Generation, a radio show that offers “a biblical constitutional worldview,” while Ms Kacsmaryk was deputy general counsel as conservative Christian legal group First Liberty Institute.
The revelation of his failure to disclose the appearances, as required during federal judicary hearings, follows reporting that he also failed to disclose that he drafted or helped draft an article attacking abortion rights and transgender healthcare in a right-wing legal journal.
‘Biden should order Clarence Thomas’s cases to be reviewed'
Friday 21 April 2023 00:00 , Alex Woodward
Noah Berlatsky writes:
Clarence Thomas allowing himself to appear compromised strikes at the heart of US democracy and makes a travesty of justice in this country. If the wealthy can wine and dine Supreme Court justices, what hope do ordinary people have of a fair hearing? Are we ruled by laws or by oligarchs? No one elected Harlan Crow to anything. Why should he get unlimited access to influence Clarence Thomas?
That’s why it’s imperative for President Joe Biden to immediately announce a review of all cases involving Thomas and identify ones in which there are egregious conflicts of interest. The administration should then consider refusing to enforce those decisions.
What Biden must do about Clarence Thomas | Voices
GOP megadonor leaps to defend Clarence Thomas over real estate disclosures
Friday 21 April 2023 01:00 , Alex Woodward
Republican megadoor Harlan Crow defended his friendship with Supreme Court Justice Clarence Thomas in an interview with The Dallas Morning News and denied any impropriety regarding their relationship.
Mr Crow’s friendship with the most-senior jurist on the Supreme Court has come under intense scrutiny ever since investigative news outlet ProPublica reported that Mr Thomas had vactioned in luxury on Mr Crow’s dime without disclosing it. ProPublica later reported that Mr Thomas sold a home to Mr Crow but did not disclose it, despite a 1978 law that required such transactions be disclosed.
GOP megadonor leaps to defend Clarence Thomas over real estate disclosures
Wyoming abortion clinic opens after arson attack and legal threats
Friday 21 April 2023 03:00 , Alex Woodward
Weeks after the state’s governor banned abortion drugs, becomgin the first state to do so, a full-service abortion clinic has opened in the state despite an arson attack and laws that could force it to shut down in a state with some of the most severe restrictions on care.
Wellspring Health Access clinic provide both medication abortions and procedural abortions and surgical abortions, at least for now.
The state’s law against mifepristone will take effect from 1 July. The law makes it illegal to “prescribe, dispense, distribute, sell or use any drug for the purpose of procuring or performing an abortion”.
The law states that doctors or anyone else found guilty of prescribing the medication could be charged with a misdemeanour, punishable by up to six months in prison and a $9,000 (£7,387) fine.
Abortion access has been nearly eliminated across the South
Friday 21 April 2023 05:00 , Alex Woodward
Abortion is effectively outlawed in more than a dozen states, mostly in the South, following the US Supreme Court’s decision to strike down the constitutional right to abortion care last June.
Florida Governor Ron DeSantis has signed a bill into law that bans abortions in the state at six weeks of pregnancy, before many people know they are pregnant.
Abortion patients will now have to travel more than 1,000 miles for legal access to abortion care in the region.
Florida’s latest anti-abortion law will nearly eliminate access across the South
What happens if mifepristone is not available?
Friday 21 April 2023 08:00 , Alex Woodward
Abortion providers and civil rights groups have warned of grave consequences to the loss of widely used abortion drugs from the market.
Providers could turn to a misoprostol-only medication abortion regimen, though that would be considered an “off-label” pharmaceutical use for the drug in the US. Misoprostol is currently approved by the FDA for the prevention and treatment of gastric ulcers but also is administered for other obstetric or gynecologic care.
Several Democratic-led states are stocking up on mifepristone and proposing legal protections for pharmacists and providers who dispense the drug.
A ruling that undermines the FDA’s drug approval process could also open the door for other activist-driven legal battles over other drugs, potentially inviting other destabilising lawsuits to Covid-19 vaccines, contraception, HIV medication, gender-affirming care, and other life-saving drugs.
The Biden administration will “continue to fight” for abortion rights regardless of the court’s decision, White House press secretary Karine Jean-Pierre told reporters on 19 April.
Can the FDA just ignore the ruling?
Friday 21 April 2023 09:00 , Alex Woodward
That’s what several members of Congress have argued, though President Joe Biden’s administration and abortion rights advocates have stressed that the case must play out in court and affirm the FDA’s ability to make such decisions.
Democratic senator Ron Wyden, the chair of the Senate Finance Committee, which oversees the FDA, has repeatedly argued that the administration ignore a ruling that undermines the FDA’s regulatory powers.
US Rep Alexandria Ocasio-Cortez has argued that an increasingly partisan-driven federal judiciary weaponised by right-wing activist groups has undermined its legitimacy in making such decisions.
Republican US Rep Nancy Mace also has suggested that a ruling that revokes the FDA’s approval of the drug should be ignored or tossed out.
Here is what the Supreme Court is doing about the mifepristone lawsuit
Friday 21 April 2023 10:00 , Alex Woodward
The order from Supreme Court Justice Samuel Alito, who presides over the district where the mifepristone challenge was filed, was published on the so-called “shadow docket” where the court handles both procedural manners and emergency motions that can have profound implications.
Justice Alito’s brief order to pause a federal court’s decision that would reverse the FDA’s approval for mifepristone keeps the status quo in place until midnight on 21 April, at the latest.
But it is unclear what the court will do next.
The court will not be ruling on the merits of the case, but it will determine how or if mifepristone can be dispensed while the case continues to play out.
After the court makes a decision, the case returns to the Fifth Circuit Court of Appeals in Louisiana. Both parties will have a chance to file briefs, and the case will be argued before a three-judge panel on 17 May.
Oregon secures 3-year supply of abortion pill ahead of SCOTUS ruling
Friday 21 April 2023 10:36 , Rachel Sharp
Oregon Governor Tina Kotek said Thursday she has directed the state to obtain a supply of the most commonly used abortion medication in the U.S. amid fears that a court ruling could restrict access to it.
The Democratic governor said regardless of the court’s decision about mifepristone’s availability, patients in Oregon will have access to it for years.
“I will make sure that patients are able to access the medication they need and providers are able to provide that medication without unnecessary, politically-motivated interference and intimidation,” Kotek said in a statement.
According to Kotek’s office, the state is partnering with Oregon Health & Science University to obtain 22,500 doses of mifepristone. The state joins Washington, California, New York and Massachusetts in buying bulk amounts of abortion medication in recent weeks.
How did mifepristone end up in front of the Supreme Court
Friday 21 April 2023 11:00 , Alex Woodward
In November, the right-wing legal group Alliance Defending Freedom filed a lawsuit in US District Court in Amarillo, Texas on behalf of a group of anti-abortion activists incorporated as the Alliance for Hippocratic Medicine, which was organised that same month with an address in Amarillo.
The Alliance Defending Freedom also led the challenge at the Supreme Court that ultimately struck down Roe v Wade.
US District Judge Matthew Kacsmaryk – a former right-wing activist lawyer who was appointed to the federal judiciary by Donald Trump – held a hearing in the case on 15 March in Amarillo.
Earlier this month, Judge Kacsmaryk issued a ruling to suspend the FDA’s approval of mifepristone. His order was set to take effect a week later, pending a decision from on appeal. But in a separate ruling in Washington state, a federal judge ruled that the FDA cannot change the status quo when it comes to mifepristone’s approval, setting up potentially duelling decisions over the drug.
Abortion rights advocates, providers, major medical groups and legal analysts condemned the ruling, and the US Department of Justice and Danco Laboratories, which manufactures mifepristone, filed an appeal.
That appeal landed at the US Court of Appeals for the Fifth Circuit, which has jurisdiction over the Amarillo court.
A three-judge panel on the Fifth Circuit blocked a part of the judge’s ruling, but struck against mail-in prescriptions and rules that expanded the drug’s approval for use up to 10 weeks of pregnancy.
The Supreme Court has blocked the Texas ruling while it considers the case.
VOICES: The problem with Walgreens and mifepristone
Friday 21 April 2023 11:30 , Rachel Sharp
When the company bowed to Republican pressure and said it wouldn’t provide abortion pills in 20 states — even states where the abortion pill is legal — all hell broke loose. Then California made a shock announcement. Holly Baxter reports
Walgreens failed to read the room. Now it faces a boycott
Supreme Court expected to weigh in on mifepristone case today
Friday 21 April 2023 12:00 , Alex Woodward
The US Supreme Court is expected to make a decision on an appeal in a case involving mifepristone at some point today.
The court will not be ruling on the merits of the case, but it will determine how or if mifepristone can be dispensed while the case continues to play out.
Earlier this month, US District Judge Matthew Kacsmaryk in Texas sided with a group of anti-abortion activists seeking to overturn the US Food and Drug Administration’s approval of mifepristone, was was first approved by the agency 23 years ago. The medicine is part of a two-drug protocol for medication abortion, which accounts for more than half of all abortions in the US.
It is unclear how the Supreme Court will rule on the appeal, though a ruling to strike down the FDA’s approval of the drug would drastically impact access to abortion and miscarriage care for millions of Americans across the country, including in states where it is legally protected.
What is mifepristone?
Friday 21 April 2023 12:30 , Rachel Sharp
A medication abortion procedure typically consists of a two-drug protocol of mifepristone and misoprostol. Mifepristone is used in more than half of all abortions in the US.
The drug was first approved for use by the US Food and Drug Administration in most cases up to 10 weeks of pregnancy in 2000. A vast majority of abortions occur within the first nine weeks of pregnancy. From 2019 through 2020, nearly 93 per cent of all abortions were performed before the 13th week, according to the US Centers for Disease Control and Prevention.
Mifepristone is also used to treat miscarriages. Roughly 10 per cent of clinically recognized pregnancies end in miscarriages, according to the American College of Obstetricians and Gynecologists.
The drug blocks the hormone progesterone, which helps support the uterus. A healthy uterine lining supports a fertilized egg, embryo and fetus. Without progesterone, the uterus will expel its contents.
Roughly 24 to 48 hours after a patient takes mifepristone, the patient then takes misoprostol, which helps empty the uterus.
The widely used drug in the abortion rights battle at the Supreme Court
Friday 21 April 2023 13:00 , Alex Woodward
Medication abortion typically consists of a two-drug protocol of mifepristone and misoprostol. Mifepristone is used in more than half of all abortions in the US.
The drug was first approved for use by the US Food and Drug Administration in most cases up to 10 weeks of pregnancy in 2000. A vast majority of abortions occur within the first nine weeks of pregnancy. From 2019 through 2020, nearly 93 per cent of all abortions were performed before the 13th week, according to the US Centers for Disease Control and Prevention.
Mifepristone is also used to treat miscarriages. Roughly 10 per cent of clinically recognized pregnancies end in miscarriages, according to the American College of Obstetricians and Gynecologists.
The widely used drug in the abortion rights battle at the Supreme Court
Texas judge at centre of abortion pill ruling said being gay was ‘a lifestyle’
Friday 21 April 2023 13:30 , Rachel Sharp
The Texas abortion judge who issued a ruling suspending access to mifepristone failed to disclose Christian talk radio interviews during his Senate confirmation process, it has been revealed.
In the interviews from 2014, Matthew Kacsmaryk claimed that being gay was “a lifestyle” and raised concerns that changes in norms around same-sex relationships would clash with religion.
It previously emerged that he had also failed to disclose to members of Congress that he authored an article attacking abortion rights and transgender healthcare in a right-wing legal journal.
The judge removed his name from the article before a judicial nomination process under then-President Donald Trump, according to The Washington Post.
Abortion advocates and providers brace for Supreme Court decision in major drug case: ‘Chaos, confusion, fear’
Friday 21 April 2023 14:00 , Alex Woodward
A ruling to strike down the FDA’s approval of the drug could drastically impact access to abortion and miscarriage care for millions of Americans across the country, including in states where it is legally protected.
Abortion rights advocates and civil rights legal groups were stunned by recent federal court decisions on mifepristone, which they say are “unmoored” by both the law and science, including decades of research and guidance from major medical and public health organisations.
Abortion advocates and providers brace for Supreme Court decision in major drug case
‘The Handmaid’s Tale is finally reality'
Friday 21 April 2023 14:30 , Alex Woodward
The Independent’s Maya Oppenheim writes:
If mifepristone is banned in the US, women and people of marginalised genders will needlessly, unduly suffer, and some will die. The data shows banning abortions does not stop pregnancies from being terminated. Instead, it pushes women to have dangerous, backstreet abortions. Such procedures are extremely risky; 47,000 women in the world die every single year as a consequence of getting an unsafe abortion, while five million women are estimated to have to go hospital for bleeding or an infection or some other dangerous health issue. For all of the above and more, the parallels between contemporary America andThe Handmaid’s Tale are becoming starker by the day.
The Handmaid’s Tale could become reality in the US at midnight tonight | Voices
Oregon governor buys up abortions pills ahead of Supreme Court ruling
Friday 21 April 2023 15:00 , Alex Woodward
Oregon’s Democratic Governor Tina Kotek has directed the state to obtain a supply of the most commonly used abortion medication in the US amid fears that a court ruling could restrict access to it.
“I will make sure that patients are able to access the medication they need and providers are able to provide that medication without unnecessary, politically-motivated interference and intimidation,” she said in a statement.
The state is among several Democratic-led states boosting supplies of mifepristone and misoprostole ahead of a potential decision from the US Supreme Court and lower federal courts that could pause access to the drug or strip the FDA’s approval entirely.
Oregon governor buys up abortions pills ahead of Supreme Court ruling
Texas judge behind abortion drug ruling didn’t disclose radio interviews where he said being gay was ‘a lifestyle’
Friday 21 April 2023 15:30 , Alex Woodward
The federal judge who suspended the US Food and Drug Administration’s approval of the abortion pill mifepristone failed to disclose two interviews where he discussed contraception and gay rights, CNN reported.
Matthew Kacsmaryk, a judge on the US District Court for the Northern District of Texas, made the remarks in two interviews with the Chosen Generation, a show that bills itself as having a “biblical constitutional worldview.”
The report follows revelations that Mr Kacsmaryk also failed to disclose to members of Congress that he authored an article attacking abortion rights and transgender healthcare in a right-wing legal journal.
Texas abortion judge didn’t disclose interviews calling being gay ‘a lifestyle’
Ohio lawmaker shuts down anti-abortion activist who attacked mother of 10-year-old rape victim
Friday 21 April 2023 16:00 , Alex Woodward
An Ohio state representative had sharp words for an anti-abortion advocate who made false claims about the now-infamous case of a 10-year-old from the state who had to travel to Indiana to receive an abortion after being raped because of Ohio’s near-total ban on the procedure.
Watch the exchange:
Ohio rep shuts down anti-abortion campaigner who attacked child rape victim’s OB-GYN
The first-ever testimony to Congress showing how to use abortion pills
Friday 21 April 2023 16:30 , Alex Woodward
Last year, as members of Congress held committee hearings about the aftermath of a decision to strike down Roe v Wade, several witnesses gave powerful testimony about their abortion experiences and the often complicated healthcare systems they had to navigate.
Renee Bracey Sherman, the founder of We Testify, which highlights stories from people who have had abortions, explained the regimen for medication abortion – the two-drug protocol that is overwhelmingly the most common form of abortion care.
It appeared to be the first time ever that a witness in Congress explained how to take abortion drugs.
Watch her testimony:
Witness tells Congress how to self-manage abortion with pills in powerful testimony
What is the Comstock Act and why is it involved in this case?
Friday 21 April 2023 17:00 , Alex Woodward
A puritanical Civil War-era federal law that sought to ban the mailing of “lewd” or “obscene” material is referenced in an anti-abortion activist group’s legal challenge to mifepristone that is now in front of the US Supreme Court.
The law has been repeatedly undermined by other laws and in the courts but it remains on the books, exploited by anti-abortion activists who are now using the law to argue why it is technically illegal to mail abortion drugs.
The US Department of Justice disputes that argument. Pharmacists or other providers who mail mifepristone have no idea whether it will be used illegally, and the medicine is also used in miscarriage care. Mifepristone was approved for use 23 years ago, and can be taken up to 10 weeks of pregancy, when the vast majority of abortions are performed. The drug is used similarly in dozens of countries.
But US District Judge Matthew Kacsmaryk argued that the Comstock Act forbids mailing abortion drugs. A three-judge panel at a federal appeals court also appeared to agree.
Mary Ziegler, a law professor at the University of California, Davis and an expert on reproductive health law, said anti-abortion activists have intentionally relied on the law as part of a broader strategy to criminalise abortion care,
“Because if you can prosecute anyone for putting anything in the mail related to abortion, there is no abortion in the United States that takes place without something put in the mail,” she told NPR. “There are no abortion providers making DIY drugs and medical devices.”
How the Supreme Court could act, according to an expert
Friday 21 April 2023 17:34 , Alex Woodward
Steve Vladeck, a University of Texas School of Law professor and keen observer of the nation’s high court, suggests a handful of scenarios from an imminent decision from the justices in the mifepristone case:
The court would either continue pausing a federal judge’s decision to block the FDA’s approval of the drug or allow the ruling to stand while the case continues to play out in the appeals court. The Supreme Court could also issue a mixed ruling, or issue no ruling at all. The justices might also kick the can down the road a second time, though that is unlikely.
Anything but the first option could have major impacts to mifepristone access, and providers and clinics are bracing for a scenario where they no longer will be able to acquire the drug.
“One way or the other, I expect that we get something from the full Court today — although *when* and *what* is anyone’s guess,” Vladeck said.
Here we go again:
Four possible #mifepristone rulings from #SCOTUS today:
1) Grant stay pending appeal;
2) Deny stay pending appeal;
3) Weird mixed ruling; or
4) No ruling.
(1) means no change to mifepristone access anytime soon; (2)-(4) mean big changes starting Saturday.— Steve Vladeck (@steve_vladeck) April 21, 2023
The states stockpiling mifepristone
Friday 21 April 2023 18:00 , Alex Woodward
Several Democratic-led states are boosting their supplies of mifepristone and protecting providers from criminal prosecution ahead of potential threats to the abortion drug’s access.
California has secured an “emergency” stockpile of misoprostol, which is used in medication abortion procedures along with mifepristone. Abortion providers across the US are also considering misoprostol-only abortion care if mifepristone’s access is limited.
Massachusetts Governor Maura Healy directed the University of Massachusetts and providers to buy $15,000 doses of mifepristone.
New York Governor Kathy Hochul said the state has a five-year supply of misoprostol on hand.
Oregon Governor Tina Kotek announced on Thursday that the state is working with Oregon Health and Science Universityto secure 22,500 doses of mifepristone, a three-year supply.
Washington Governor Jay Inslee also said the state purchased a three-year supply of mifepristone through the state’s Department of Corrections, which has a pharmacy license.
What is mifepristone? And why does it matter if the FDA’s approval is revoked?
Friday 21 April 2023 18:30 , Alex Woodward
A ruling to strip a commonly used abortion drug of its FDA’s approval could mean that its availability would violate the Food, Drug and Cosmetic Act. It is unclear if federal authorities would enforce the law against the drug if the court revokes its approval, but threatening access to mifepristone – especially in states that are hostile to abortion care – could jeopardise abortion access for millions of Americans.
The drug was first approved by the FDA 2000. Subsequent changes have allowed the drug to be used up to 10 weeks of pregnancy, a period when a vast majority of abortions in the US are performed.
A federal appeals court has blocked those changes, along with newer guidelines that allow the drug to be prescribed via telehealth appointments. The appeals court ruling also would mean the drug could only be used up to seven weeks, when most people are learning they are pregnant.
A previous ruling from a federal judge in Texas would not only roll back those changes but revoke the FDA’s approval entirely.
The Supreme Court has blocked those decisions, at least for now, while the legal challenges play out.
We should know by the end of the day what will happen next.
The widely used drug in the abortion rights battle at the Supreme Court
Matthew Kacsmaryk, the Trump-appointed judge who could threaten access to mifepristone
Friday 21 April 2023 19:10 , Alex Woodward
A decision from a single judge with a history of anti-abortion activism could determine reproductive healthcare decisions for millions of Americans, not just in states where abortion already faces severe restrictions but in states where access to care is legally protected.
Who is Trump-appointed judge Matthew Kacsmaryk trying to ban abortion drug?
What has the White House said about the case?
Friday 21 April 2023 19:45 , Alex Woodward
When the Supreme Court temporarily paused a lower court decision on mifepristone, White House press secretary Karine Jean-Pierre issued a statement stressing that “mifepristone remains available and approved for safe and effective use.”
President Joe Biden’s administration will “continue to stand by FDA’s evidence-based approval of mifepristone, and we will continue to support the FDA’s independent, expert authority to review, approve, and regulate a wide range of prescription drugs,” she added. “The stakes of this fight could not be higher in the face of ongoing attacks on women’s health, and we will continue to fight to restore the protections of Roe v Wade.”
In an earlier statement condemning Judge Kacsmaryk’s initial ruling, the president said that if “this ruling were to stand, then there will be virtually no prescription, approved by the FDA, that would be safe from these kinds of political, ideological attacks.” “The prescription medication in question in this case is used for medication abortion, and medication abortion accounts for over half the abortions in America,” he added. “The lawsuit, and this ruling, is another unprecedented step in taking away basic freedoms from women and putting their health at risk. ... It is the next big step toward the national ban on abortion that Republican elected officials have vowed to make law in America.” He also renewed his call for members of Congress to codify abortion rights protections affirmed by Roe v Wade into law.
Vice President Kamala Harris also criticised the appeals court ruling that backed parts of Judge Kacsmaryk’s decision.
“The Fifth Circuit’s decision – just like the district court’s – second-guesses the agency’s medical experts,” she said in a statement. “If this decision stands, no medication – from chemotherapy drugs, to asthma medicine, to blood pressure pills, to insulin – would be safe from attacks.” She added: “There is a reproductive health care crisis in America. Our Administration will continue fighting to protect women’s health and the right to make decisions about one’s own body.”
The judge who wants to block mifepristone removed his name from an anti-abortion article before his Senate confirmation
Friday 21 April 2023 20:37 , Alex Woodward
The federal judge who wants to revoke the FDA’s approval of mifepristone withdrew his name from a legal journal article about abortion that was drafted in the middle of his Senate confirmation process – something he failed to disclose to lawmakers who interviewed him.
Judge in mifepristone case failed to disclose writing anti-abortion article
How did mifepristone end up in front of the Supreme Court?
Friday 21 April 2023 21:10 , Alex Woodward
Here is a brief timeline of the latest case, which was filed a few months after the US Supreme Court struck down the constitutional right to abortion care last summer:
In November, the right-wing legal group Alliance Defending Freedom filed a lawsuit in US District Court in Amarillo, Texas on behalf of a group of anti-abortion activists incorporated as the Alliance for Hippocratic Medicine, which was organised that same month with an address in Amarillo.
The Alliance Defending Freedom also led the challenge at the Supreme Court that ultimately struck down Roe v Wade.
US District Judge Matthew Kacsmaryk – a former anti-abortion lawyer who was appointed to the federal judiciary by Donald Trump – held a hearing in the case on 15 March in Amarillo.
Earlier this month, Judge Kacsmaryk issued a ruling to suspend the FDA’s approval of mifepristone. His order was set to take effect a week later, pending a decision from on appeal. But in a separate ruling in Washington state, a federal judge ruled that the FDA cannot change the status quo when it comes to mifepristone’s approval, setting up potentially duelling decisions over the drug.
Abortion rights advocates, providers, major medical groups and legal analysts condemned the ruling, and the US Department of Justice and Danco Laboratories, which manufactures mifepristone, filed an appeal.
That appeal landed at the US Court of Appeals for the Fifth Circuit, which has jurisdiction over the Amarillo court.
A three-judge panel on the Fifth Circuit blocked a part of the judge’s ruling, but struck against mail-in prescriptions and rules that expanded the drug’s approval for use up to 10 weeks of pregnancy.
The Supreme Court has blocked the Texas ruling while it considers the case.
Just in: Judge at centre of mifepristone case concealed the sources of millions of dollars in stock holdings
Friday 21 April 2023 21:30 , Alex Woodward
The federal judge whose nationwide ruling could block the government’s approval of a widely used abortion drug appears to have redacted critical information from his financial disclosure forms, hiding millions of dollars in his personal fortune.
In 2020 and 2021 annual disclosures reviewed by CNN, US District Judge Matthew Kacsmaryk wrote that he held between $5m and $25m in “common stock” of a company.
But the name of the company is redacted. Federal law only allows redactions of information that could “endanger” a judge or their family member.
The redacted holding accounted for at least 85 per cent of Mr Kacsmaryk’s total reported wealth in 2021, CNN found.
Friday 21 April 2023 22:00 , Alex Woodward
Maya Oppenheim, The Independent’s women’s correspondent, underscores what is at stake with the Supreme Court’s imminent decision in the mifepristone case and the potential outcomes in federal courts:
Having a medical abortion involves taking two tablets, with mifepristone being the first of these. Millions around the world have taken the drug to terminate a pregnancy over recent decades - myself included. I took mifepristone last year and wrote about my nightmare struggle to get an abortion here in the UK. Mifepristone is one of the most scrupulously studied drugs in the world. The UK’s largest study into abortions previously found that at-home early medical abortions pose no greater risk and allow women to have the procedure much earlier on in their pregnancy. Medical abortions constitute more than half of all abortions in America. Nevertheless, Axios has found almost half of US states have either totally banned or restricted access to abortion pills.
Moreover, later on in the legal process, if Kacsmaryk’s ruling comes into force, abortion providers will only be able to conduct surgical abortions or medical abortions which only use the second abortion drug misoprostol. Despite the fact abortions carried out by such means still work, they inflict more pain and take more time. Moreover, while surgical abortions are wholly safe, they are more dangerous than medical abortions. Ultimately, they are a totally different entity to medical abortions as they involve going into theatre for surgery – thus they are far more expensive to conduct, as well taking far longer, and being far more painful.
Read more below:
The Handmaid’s Tale could become reality in the US at midnight tonight | Voices
Why this isn’t a ‘typical’ Supreme Court decision
Friday 21 April 2023 22:35 , Alex Woodward
The US Supreme Court did not take on the case of Alliance for Hippocratic Medicine v the FDA in the same way that other major cases before the court have appeared. There were no oral arguments in front of the court, where lawyers from both parties would make their case in front of the nine-member panel, which would then spend weeks or months considering the case and writing opinions and dissents.
Instead, the case before the court is a decision on an appeal from a lower court.
A federal court judge in Texas issued a ruling that revokes the FDA’s approval of mifepristone. That decision was appealed, and a federal appeals court kept some parts of the ruling and stripped away others. The Biden administration and Justice Department filed an emergency appeal to halt that decision with the Supreme Court.
So far, the Supreme Court has paused the lower court’s ruling while the court determines what to do next. That pause was set to expire at midnight tonight.
So what happens now? The Supreme Court’s decision on whether to keep that pause in place is expected some time before the court’s current pause expires.
Can the FDA just ignore the ruling?
Friday 21 April 2023 23:10 , Alex Woodward
That’s what several members of Congress have argued, though President Joe Biden’s administration and abortion rights advocates have stressed that the case must play out in court and affirm the FDA’s ability to make such decisions.
Democratic senator Ron Wyden, the chair of the Senate Finance Committee, which oversees the FDA, has repeatedly argued that the administration ignore a ruling that undermines the FDA’s regulatory powers.
US Rep Alexandria Ocasio-Cortez has argued that an increasingly partisan-driven federal judiciary weaponised by right-wing activist groups has undermined its legitimacy in making such decisions.
Republican US Rep Nancy Mace also has suggested that a ruling that revokes the FDA’s approval of the drug should be ignored or tossed out.
What happens if mifepristone is not available?
Friday 21 April 2023 23:30 , Alex Woodward
Abortion providers and civil rights groups have warned of grave consequences to the loss of widely used abortion drugs from the market.
Providers could turn to a misoprostol-only medication abortion regimen, though that would be considered an “off-label” pharmaceutical use for the drug in the US. Misoprostol is currently approved by the FDA for the prevention and treatment of gastric ulcers but also is administered for other obstetric or gynecologic care.
Several Democratic-led states are stocking up on mifepristone and proposing legal protections for pharmacists and providers who dispense the drug.
A ruling that undermines the FDA’s drug approval process could also open the door for other activist-driven legal battles over other drugs, potentially inviting other destabilising lawsuits to Covid-19 vaccines, contraception, HIV medication, gender-affirming care, and other life-saving drugs.
The Biden administration will “continue to fight” for abortion rights regardless of the court’s decision, White House press secretary Karine Jean-Pierre told reporters on 19 April.
Breaking: Supreme Court preserves abortion drug approval as case continues
Friday 21 April 2023 23:46 , Alex Woodward
The US Supreme Court has preserved access to a widely used abortion drug while legal challenges against mifepristone’s government approval continue.
The decision from the nation’s high court on 21 April preserves the US Food and Drug Administration’s approval of the drug, which is used in more than half of all abortions in the US, after a federal judge in Texas struck it down in a ruling that would have profound and potentially dangerous consequences for millions of Americans.
Mifepristone will remain legal and accessible, with the FDA’s approval intact.
Stay tuned with The Independent
Joe Biden issues statement after Supreme Court decision
Saturday 22 April 2023 00:05 , Alex Woodward
President Joe Biden said the Supreme Court’s decision blocks a ruling that “would have undermined FDA’s medical judgment and put women’s health at risk.”
“As a result of the Supreme Court’s stay, mifepristone remains available and approved for safe and effective use while we continue this fight in the courts,” he added.
“I continue to stand by FDA’s evidence-based approval of mifepristone, and my administration will continue to defend FDA’s independent, expert authority to review, approve, and regulate a wide range of prescription drugs,” the president continued.
“The stakes could not be higher for women across America,” he said. “I will continue to fight politically-driven attacks on women’s health. But let’s be clear – the American people must continue to use their vote as their voice, and elect a Congress who will pass a law restoring the protections of Roe v Wade.”
Major US abortion rights groups welcome Supreme Court decision but warn ‘we’re not out of the woods yet'
Saturday 22 April 2023 00:12 , Alex Woodward
Mifepristone will remain legal and accessible, with the FDA’s approval intact. The case now returns to the Fifth Circuit Court of Appeals in Louisiana, where both parties will have a chance to file briefs. The case will be argued before a three-judge panel on 17 May.
“The Supreme Court’s decision is a huge relief, but we’re not out of the woods yet,” said Nancy Northup, president and CEO of the Center for Reproductive Rights.
“The lower court ruling out of Texas has zero basis in fact or law – and yet it has sowed chaos, confusion and panic for patients and providers across the country, including those in states with strong protections for abortion rights,” she added. “That crisis was not resolved today.”
Jennifer Dalven, director of the ACLU Reproductive Freedom Project, also welcomed the Supreme Court’s decision, adding that “it is frightening to think that Americans came within hours of losing access to a medication that is used in most abortions in this country and has been used for decades by millions of people to safely end a pregnancy or treat a miscarriage.”
“Patients shouldn’t have to monitor Twitter to see whether they can get the care they need,” she added.
Anti-abortion legal group leading mifepristone lawsuit vows to continue challenge
Saturday 22 April 2023 00:29 , Alex Woodward
The senior counsel for the Alliance Defending Freedom, the legal group leading the challenge to mifepristone on behalf of a group incorporated as the Alliance for Hippocratic Medicine, issued a statement acknowledging the Supreme Court’s decision.
“As is common practice, the Supreme Court has decided to maintain the status quo that existed prior to our lawsuit while our challenge to the FDA’s illegal approval of chemical abortion drugs and its removal of critical safeguards for those drugs moves forward,” Erik Baptist said.
The right-wing legal group also led the challenge at the Supreme Court that ultimately struck down Roe v Wade last year in the high court’s conservative supermajority decision in Dobbs v Jackson Women’s Health Organization, which revoked a constitutional right to abortion care.
“The FDA must answer for the damage it has caused to the health of countless women and girls and the rule of law by failing to study how dangerous the chemical abortion drug regimen is and unlawfully removing every meaningful safeguard, even allowing for mail-order abortions,” Mr Baptist addded. “We look forward to a final outcome in this case that will hold the FDA accountable.”
Full story: Supreme Court preserves abortion drug approval as legal case plays out
Saturday 22 April 2023 00:30 , Alex Woodward
The Supreme Court’s decision on Friday, hours before its self-imposed midnight deadline, means that the FDA’s 23-year-old approval of mifepristone will remain in place while a high-profile challenge mounted by an anti-abortion activist group continues in a lower court.
Everything we know so far:
Supreme Court preserves abortion drug approval as legal case plays out
New York attorney general says Supreme Court decision is a ‘major relief'
Saturday 22 April 2023 00:41 , Alex Woodward
New York Attorney General Letitia James led a coalition of 24 attorneys general urging the Supreme Court to block the federal court decision that would strike down mifepristone’s government approval.
Following the Supreme Court’s decision to keep the approval in place while the legal challenge continues, she said the ruling is a “major relief for millions of Americans.”
New York Governor Kathy Hochul was among several Democratic state leaders across the US stockpiling thousands of doses of abortion drugs in the event that they were no longer on the market without FDA approval.
“As the appeals process moves forward, I will use the full force of my office to help ensure that medication abortion options, including mifepristone, remain available and protected in New York. It’s your body, and it should always be your choice,” Ms James added.
Clarence Thomas and Samuel Alito dissent from Supreme Court decision to preserve abortion drug
Saturday 22 April 2023 00:59 , Alex Woodward
The two dissenting justices in the Supreme Court’s decision are Clarence Thoms and Samuel Alito, who wrote the opinion that struck down Roe v Wade.
It’s typical in such emergency motion decisions that the justices do not explain their vote or reveal them. Justice Alito, however, argued that the public would not have been harmed by keeping intact a ruling that strikes down recent FDA changes that expanded access to mifepristone.
“It would simply restore the circumstances that existed (and that the Government defended) from 2000 to 2016 under three Presidential administrations,” he wrote. Those rule changes expanded access to the drug for patients up to the 10th week of pregnancy and allowed prescriptions by mail and telehealth appointments, rather than repeat visits to abortion providers – in many states, they are hundreds of miles away or nonexistent.
He rejected the idea that “chaos” would follow as a result of two different federal court rulings from earlier this month – one from Texas that struck down the FDA’s approval and another in Washington state that preserved the status quo.
“That should not be given any weight,” he added.
Vice President Harris: ‘No one should stand between a woman and her doctor'
01:04 , Alex Woodward
Vice President Kamala Harris, who has led efforts at the White House on reproductive healthcare in aftermath of Roe, said in a statement that the administration will “continue to fight to protect a woman’s freedom to make decisions about her own body and access to reproductive health care, including medication abortion.”
“No one should stand between a woman and her doctor,” she added.
Our Administration will not waver in our commitment to preserving access to essential medication and defending the FDA’s ability to approve safe and effective drugs,” she said. “Americans need to look no further than their medicine cabinet to see how many FDA-approved medications are at risk if lower court decisions disregarding the FDA’s scientific judgment are allowed to stand.”
What happens next?
01:20 , Alex Woodward
It was unclear whether the justices on the conservative supermajority court would uphold the Texas ruling or pause the decision while the legal battle continues, but the Supreme Court has now blocked a federal court ruling against mifepristone from taking effect while the case returns to the appeals court.
The case of Alliance for Hippocratic Medicine v FDA returns to the Fifth Circuit Court of Appeals in Louisiana.
Both parties will have a chance to file briefs, and the case will be argued before a three-judge panel on 17 May.
In the meantime, mifepristone remains legal and accessible and its FDA approval is intact.
Justice Alito accuses Biden administration of potentially ignoring a ruling against mifepristone
02:00 , Alex Woodward
In his dissent in the Supreme Court’s decision to pause a federal court ruling that would strip the FDA’s approval of a widely used abortion drug, conservative Justice Samuel Alito took direct aim at the Biden administration with an extraordinary accusation that the president would disobey the court.
He suggested that the White House would ignore a ruling that would not be in its favour, but no administration officials has suggested that. Several members of Congress have argued that the administration should ignore a ruling that undermines the FDA’s authority, but the administration has said that the case must play out in the courts to affirm the government’s regulatory authority.
Mr Alito, who authored the ruling that struck down Roe v Wade last year, suggested that the administration would consider disobeying "an unfavorable order".
Democratic congresswoman Alexandria Ocasio-Cortez, among lawmakers who said the administration should ignore an order that strips the FDA’s authority, said the court “has devolved into a highly politicized entity that is rapidly delegitimizing.”
The court is a political entity currently engaged in overreach and abuse of power.
In our system of checks and balances, SCOTUS’s reckless behavior warrants a check from the leg + executive branches. This is not unprecedented, it’s how our system is designed to avert tyranny— Alexandria Ocasio-Cortez (@AOC) April 22, 2023
Samuel Alito’s dissent criticises his colleagues, a federal court judge and the president
03:00 , Alex Woodward
A decision on the Supreme Court’s so-called “shadow docket” doesn’t provide much detail about the court’s decision making behind the action.
That is also the case in the closely watched mifepristone case, which has profound effects on abortion access.
In the mifepristone case, the order simply pauses a lower court ruling while the case continues, potentially signalling that the nation’s high court isn’t likely to agree with them in the future, while the appeals process picks up next month.
But there were two dissenting justices – Clarence Thomas and Samuel Alito, who used his dissent to criticise his colleagues on the bench, including fellow conservative Amy Coney Barrett, for their previous warnings about abusing the shadow docket.
“I did not agree with these criticisms at the time, but if they were warranted in the cases in which they were made, they are emphatically true here,” he said.
He also said the Supreme Court didn’t need to step into the case because an appeals court already “narrowed” the Texas decision. The appeals court kept the FDA approval in place but rolled back significant changes that would upend abortion access.
Justice Alito also criticised another federal judge in Washington state who issued a competing decision in an unrelated case that argued the FDA to preserve the status quo when it comes to mifepristone.
Finally, he took aim at the Biden administration, saying that “the Government has not dispelled legitimate doubts that it would even obey an unfavorable order in these cases, much less that it would choose to take enforcement actions to which it has strong objections.”
The full story: Supreme Court preserves abortion drug approval as legal case plays out
04:00 , Alex Woodward
The US Supreme Court has preserved access to a widely used abortion drug while legal challenges against mifepristone’s government approval continue, marking the court’s first major decision on abortion rights in the year after a constitutional right to abortion care was revoked.
The decision from the nation’s high court on 21 April will maintain the US Food and Drug Administration’s approval of the drug, which is used in more than half of all abortions in the US, after a federal judge in Texas struck it down in a ruling that would have profound and potentially dangerous consequences for millions of Americans if allowed to go into effect.
The case now returns to the Fifth Circuit Court of Appeals in Louisiana, where both parties will have a chance to file briefs. The case will be argued before a three-judge panel on 17 May.
Supreme Court preserves abortion drug approval as legal case plays out
05:00 , Alex Woodward
The end of Roe v Wade triggered a wave of state-level anti-abortion laws and restrictions. More than a dozen states, mostly in the US South, have effectively banned abortion for most pregnancies with limited if any exceptions. Florida is the most recent state to implment a ban on abortion care at six weeks of pregnancy, when people are still learning if they are pregnant.
The new law means that abortion care is effectively outlaws across the entire South.
Florida’s latest anti-abortion law will nearly eliminate access across the South
What happens if mifepristone is not available?
07:00 , Alex Woodward
Abortion providers and civil rights groups have warned of grave consequences to the loss of widely used abortion drugs from the market.
Providers could turn to a misoprostol-only medication abortion regimen, though that would be considered an “off-label” pharmaceutical use for the drug in the US. Misoprostol is currently approved by the FDA for the prevention and treatment of gastric ulcers but also is administered for other obstetric or gynecologic care.
Several Democratic-led states are stocking up on mifepristone and proposing legal protections for pharmacists and providers who dispense the drug.
A ruling that undermines the FDA’s drug approval process could also open the door for other activist-driven legal battles over other drugs, potentially inviting other destabilising lawsuits to Covid-19 vaccines, contraception, HIV medication, gender-affirming care, and other life-saving drugs.
The Supreme Court’s ruling on 21 April ensures that the drug remains available, for now, while the legal battle continues in a federal appeals court.
Matthew Kacsmaryk, the Trump-appointed judge who wants to ban mifepristone
08:00 , Alex Woodward
Earlier this month, a Trump-appointed federal judge in Texas sided with an anti-abortion activist group in a lawsuit challenging the FDA’s approval of the commonly used abortion drug.
The Biden administration appealed, bringing the case to an appeals court in Louisiana and ultimately before the US Supreme Court, which has paused his ruling while the case continues to play out.
Meet the Texas judge and former anti-abortion activist attorney who set the case in motion.
Who is Trump-appointed judge Matthew Kacsmaryk trying to ban abortion drug?
Texas judge behind abortion drug ruling didn’t disclose radio interviews where he said being gay was ‘a lifestyle’
09:00 , Alex Woodward
The federal judge who suspended the US Food and Drug Administration’s approval of the abortion pill mifepristone failed to disclose two interviews where he discussed contraception and gay rights, CNN reported.
Matthew Kacsmaryk, a judge on the US District Court for the Northern District of Texas, made the remarks in two interviews with the Chosen Generation, a show that bills itself as having a “biblical constitutional worldview.”
The revelation follows other reports that he also failed to disclose writing a article in a legal journal criticising abortion and transgender healthcare – while he was being considered for the federal judiciary.
Texas abortion judge didn’t disclose interviews calling being gay ‘a lifestyle’
Joe Biden issues statement after Supreme Court decision
10:00 , Alex Woodward
President Joe Biden said the Supreme Court’s decision blocks a ruling that “would have undermined FDA’s medical judgment and put women’s health at risk.”
“As a result of the Supreme Court’s stay, mifepristone remains available and approved for safe and effective use while we continue this fight in the courts,” he added.
“I continue to stand by FDA’s evidence-based approval of mifepristone, and my administration will continue to defend FDA’s independent, expert authority to review, approve, and regulate a wide range of prescription drugs,” the president continued.
“The stakes could not be higher for women across America,” he said. “I will continue to fight politically-driven attacks on women’s health. But let’s be clear – the American people must continue to use their vote as their voice, and elect a Congress who will pass a law restoring the protections of Roe v Wade.”
Major US abortion rights groups welcome Supreme Court decision but warn ‘we’re not out of the woods yet’
11:00 , Alex Woodward
The Supreme Court’s decision to maintain mifepristone is “a huge relief, but we’re not out of the woods yet,” said Nancy Northup, president and CEO of the Center for Reproductive Rights.
“The lower court ruling out of Texas has zero basis in fact or law – and yet it has sowed chaos, confusion and panic for patients and providers across the country, including those in states with strong protections for abortion rights,” she added. “That crisis was not resolved today.”
Jennifer Dalven, director of the ACLU Reproductive Freedom Project, also welcomed the Supreme Court’s decision, adding that “it is frightening to think that Americans came within hours of losing access to a medication that is used in most abortions in this country and has been used for decades by millions of people to safely end a pregnancy or treat a miscarriage.”
“Patients shouldn’t have to monitor Twitter to see whether they can get the care they need,” she added.
What is mifepristone?
12:00 , Alex Woodward
A medication abortion procedure typically consists of a two-drug protocol of mifepristone and misoprostol. Mifepristone is used in more than half of all abortions in the US.
The drug was first approved for use by the US Food and Drug Administration in most cases up to 10 weeks of pregnancy in 2000. A vast majority of abortions occur within the first nine weeks of pregnancy. From 2019 through 2020, nearly 93 per cent of all abortions were performed before the 13th week, according to the US Centers for Disease Control and Prevention.
Mifepristone is also used to treat miscarriages. Roughly 10 per cent of clinically recognized pregnancies end in miscarriages, according to the American College of Obstetricians and Gynecologists.
The widely used drug in the abortion rights battle at the Supreme Court
How the Supreme Court ruled, and what happens next in the high-profile case over the future of a widely used abortion drug
13:00 , Alex Woodward
The US Supreme Court has preserved access to a widely used abortion drug while legal challenges against mifepristone’s government approval continue, marking the court’s first major decision on abortion rights in the year after a constitutional right to abortion care was revoked.
The decision from the nation’s high court on 21 April will maintain the US Food and Drug Administration’s approval of the drug, which is used in more than half of all abortions in the US, after a federal judge in Texas struck it down in a ruling that would have profound and potentially dangerous consequences for millions of Americans if allowed to go into effect.
The case now returns to the Fifth Circuit Court of Appeals in Louisiana, where both parties will have a chance to file briefs. The case will be argued before a three-judge panel on 17 May.
Supreme Court preserves abortion drug approval as legal case plays out
What is the Comstock Act and why is it involved in this case?
14:00 , Alex Woodward
A puritanical Civil War-era federal law that sought to ban the mailing of “lewd” or “obscene” material is referenced in an anti-abortion activist group’s legal challenge to mifepristone that came before the Supreme Court.
The law has been repeatedly undermined by other laws and in the courts, but it remains on the books, exploited by anti-abortion activists who are now using the law to argue why it is technically illegal to mail abortion drugs.
The US Department of Justice disputes that argument. Pharmacists or other providers who mail mifepristone have no idea whether it will be used illegally, and the medicine is also used in miscarriage care. Mifepristone was approved for use 23 years ago, and can be taken up to 10 weeks of pregancy, when the vast majority of abortions are performed. The drug is used similarly in dozens of countries.
But US District Judge Matthew Kacsmaryk argued that the Comstock Act forbids mailing abortion drugs. A three-judge panel at a federal appeals court also appeared to agree.
Mary Ziegler, a law professor at the University of California, Davis and an expert on reproductive health law, said anti-abortion activists have intentionally relied on the law as part of a broader strategy to criminalise abortion care,
“Because if you can prosecute anyone for putting anything in the mail related to abortion, there is no abortion in the United States that takes place without something put in the mail,” she told NPR. “There are no abortion providers making DIY drugs and medical devices.”
