Narrator: A federal judge just suspended the FDA’s approval of one of the most widely used medication abortion drugs. Not just in states where abortion is illegal — anywhere in the United States. The ruling will go into effect in seven days, giving the government a short window of time to appeal.
Nearly all medication abortions in the U.S. happen using a combination of two pills: mifepristone and misoprostol. The Food and Drug Administration approved mifepristone more than 20 years ago.
Amelia Thomson-DeVeaux: In November, a group of anti-abortion doctors filed a lawsuit in Texas arguing that the FDA broke the law when it approved the drug. The judge in the case, Matthew Kacsmaryk, worked for a Christian right[-wing] organization before he was appointed by former President Donald Trump.
Narrator: So it’s not a surprise that the judge ruled in favor of the anti-abortion advocates. If the conservative Fifth Circuit Court of Appeals or the U.S. Supreme Court doesn’t intervene in the next week, and the FDA complies with the Texas ruling, mifepristone will be pulled from the market. But to make things more complicated, another judge in Washington state just issued a contradictory ruling ordering the FDA not to stop dispensing the drug.
Amelia Thomson-DeVeaux: Unless one of those courts lifts the injunction, the ruling in Texas will dramatically alter abortion access in the U.S. for the foreseeable future.
Maggie Koerth: This case hinges on the claim that the FDA followed politics and ignored science and its own rules when it approved mifepristone back in 2000 and that that resulted in a dangerous drug coming into the market. But these claims are not new. They were investigated and refuted, in fact, 15 years ago in a study published by the Government Accountability Office. That’s the nonpartisan federal agency that investigates spending, effectiveness and illegal activity within the federal government. And studies before and after approval have demonstrated that mifepristone is safe.
Narrator: More and more women are using abortion pills to end their pregnancies. According to the Guttmacher Institute, 53 percent of abortions in 2020 happened using medication abortion, up from 39 percent just three years earlier.
Amelia Thomson-DeVeaux: Some of those increases were particularly large in states where abortion is still legal. For example, the number of medication abortions in Illinois rose by 79 percent between 2017 and 2020 as clinics began closing in surrounding states.
Narrator: According to Caitlin Myers, an economics professor at Middlebury College who studies abortion access, about 40 percent of the country’s abortion clinics only offer medication abortion. Those clinics could be especially affected by this decision.
Amelia Thomson-DeVeaux: This poses a big problem to abortion clinics across the country. They won’t necessarily have to close — they can switch to using only the second drug, misoprostol, for abortions. But not all clinics will necessarily make that switch, and that could put a strain on all the other clinics, which already have wait times of multiple days.
Maggie Koerth: Mifepristone makes an embryo detach from the uterus. Misoprostol just causes contractions. And while misoprostol-only abortions are safe, they’re less effective than abortions that use both drugs.
Narrator: In a randomized controlled trial of 400 women in Vietnam, 96.5 percent of those who took the combination of pills successfully completed their abortions that way compared to 76.2 percent of those taking misoprostol alone.
Maggie Koerth: The side effects of misoprostol also make it more physically uncomfortable to use. One doctor I spoke with described it as “the worst of both worlds.”
Narrator: This ruling isn’t the last you’ll hear about the case. But for now, a lot depends on what happens in the next week. It could have an impact on millions of women across the country — and make it harder to get an abortion everywhere.