US Supreme Court to weigh restrictions on abortion pill

Tuesday marks the resumption of the bitter legal struggle over abortion by the Supreme Court as it considers limitations on the medication that is most frequently used to end pregnancies in the country.

Oral arguments about access to mifepristone, the abortion pill, will be heard by the conservative-dominated court that reversed the constitutional right to an abortion almost two years ago.

Pro-life organisations are pushing for the drug’s outlawing on the grounds that, despite its extensive safety record, it is harmful.

Since the Food and Drug Administration authorised mefepristone in 2000, the FDA estimates that over 5.9 million Americans have used the medication to terminate pregnancies.

The case stems from a ruling last year by a conservative US District Court judge in Texas, an appointee of former Republican president Donald Trump, that would have prohibited mifepristone.

A conservative-dominated appeals court overturned the outright ban because the statute of limitations on challenging the FDA’s approval had expired. But the court nonetheless limited access to the drug.

Danco Laboratories, the mifepristone maker, and the administration of Democratic President Joe Biden appealed the lower court’s restrictions on mifepristone to the Supreme Court.

The nation’s highest court, where conservatives wield a 6-3 majority, froze the rulings by the lower court and the drug remains on the market for the time being.

The FDA approved mifepristone for use up to seven weeks of pregnancy in 2000 and further loosened the regulations in 2016, allowing it to be used up to 10 weeks.

It lifted in-person dispensing requirements in 2021, during the Covid pandemic, allowing for the drug to be distributed by mail and prescribed remotely through telemedicine.

The appeals court decision would roll back the legal limit for use of mifepristone to seven weeks, block it from being delivered by mail and require the pill to be prescribed and administered by a doctor.

‘Decrease abortion access’

Lewis Grossman, a lawyer at Covington & Burling who joined a group of food and drug law scholars in submitting a brief in the case to the Supreme Court, said he was reluctant to predict how the nine justices will rule.

But if the court upholds the appeals court ruling they “would be doing something that I think would be very unprecedented,” Grossman said.

“They would be imposing restrictions on the availability of a drug based on a disagreement with the scientific experts at FDA.”

The latest legal skirmish over reproductive rights comes as abortion pill use is on the rise in the United States.

Medication abortion accounted for 63 percent of the abortions in the country last year, up from 53 percent in 2020, according to the Guttmacher Institute.

The actual number is likely higher, the institute said, because the figures do not take into account self-managed medication abortions outside the health care system or pills mailed to women in states where abortion is banned entirely.

“Reinstating outdated and medically unnecessary restrictions on the provision of mifepristone would negatively impact people’s lives and decrease abortion access across the country,” said Amy Friedrich-Karnik, Guttmacher’s director of federal policy.

Some 20 states have banned or restricted abortion since the Supreme Court in June 2022 overturned the landmark Roe v. Wade ruling that enshrined the constitutional right to abortion for half a century.

Polls repeatedly show a clear majority of Americans support continued access to safe abortion, even as conservative groups push to limit the procedure – or ban it outright.

The Supreme Court is expected to issue a decision in the abortion pill case by the end of June – four months before the presidential election in which abortion is almost certain to be a major topic.