America's Top Court Must Not Curtail Access To Abortion Pills

A medical matter should not be determined by lawyers and judges

- LISA JARVIS

The US Supreme Court will decide in 2024 whether more restrictions should be placed on mifepristone, part of a two-drug regimen for abortion. Although mifepristone doesn’t seem to be at risk of being yanked from the market entirely, if the Court sides with the Fifth Circuit, it would hamper abortion access.

Mifepristone is used in more than half of all abortions in the US in conjunction with a second drug, misoprostol. If the Court agrees with the Fifth Circuit, it would turn back the regulatory clock on mifepristone to 2000, when the drug was approved. That would restore barriers to accessing the drug and discard more than 20 years of medical knowledge guiding the safe and effective use of the medication.

In accepting the case, the court seems to have narrowed the issue to the pill’s restrictions rather than its approval. That’s welcome news, but the stakes of the narrower case are still high. Expanded access to mifepristone has become essential for abortion care, says Ushma Upadhyay, a professor at the University of California, San Francisco. When mifepristone was first brought to market, the US Food and Drug Administration (FDA) laid out strict guidelines for how it could be used. Only physicians (not a pharmacy) could dispense it, and only when a patient visited their office in person. Over time, the FDA has slowly loosened those rules in recognition of the drug’s safety and efficacy.