Abortion pill mifepristone: An explainer and research roundup about its history, safety and future

Medication abortion is also known as abortion with pills or medical abortion. These procedures rely on a regimen of two drugs, rather than surgery, to end early-stage pregnancies. The Food and Drug Administration has approved medication abortion for up to 10 weeks of pregnancy and the World Health Organization authorizes its use for up to 12 weeks. It is endorsed by several organizations, including the American College of Obstetricians & Gynecologists and the American Medical Association.

Prevalence and Medical Research

Medication abortions have played a significant part in keeping abortion access available in the United States as restrictions on the procedure multiply. A recent Guttmacher Institute report found that medication abortions made up 63% of all abortions last year, when the total number of U.S. abortions surpassed 1 million. Previously, medication abortions accounted for 51% of all abortions. Below is a summary of the current research and guidelines:

• FDA Approved Limit: Up to 10 weeks of pregnancy.
• WHO Authorized Limit: Up to 12 weeks of pregnancy.
• Recent Market Share: 63% of all U.S. abortions (2023).
• Safety Profile: Medication that is used for the safe termination of early pregnancy.

Legal Challenges and Supreme Court Decisions

On June 13, the Supreme Court justices in a unanimous decision preserved access to mifepristone, writing that “federal courts are the wrong forum for addressing the plaintiffs’ concerns about FDA’s actions.” The legal future of mifepristone had hung in the balance for several months. Previously, in August 2023, the 5th U.S. Circuit Court of Appeals ruled that mifepristone should not be prescribed past the seventh week of pregnancy, prescribed via telemedicine, or shipped to patients through the mail.

The legal conflict intensified when a federal judge in Texas ruled to invalidate the FDA’s 23-year-old approval of the abortion pill mifepristone in an unprecedented move. No federal court has ever “second-guessed the science” behind the US Food and Drug Administration’s approval of a medication until now. Legal experts suggest this judge doesn’t have the expertise to second-guess the FDA in this way, creating a clear separation-of-powers problem.

Impact on Healthcare and the Pharmaceutical Industry

The ruling rattled many in the medical field. More than 400 executives from the pharmaceutical industry have signed on to a statement condemning the legal challenges, writing that it “creates uncertainty for the entire biopharma industry.” 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. Furthermore, the case could limit Missourians more, as they already must cross the state line to get a legal abortion.

The Role of Media and Journalistic Coverage

It’s important for journalists covering abortion to have a good understanding of medication abortion so that they can better inform their audiences. A recent analysis of more than 1,100 articles finds that while U.S. newspapers are treating the topic as a serious policy issue, they are under-covering medication abortion considering its prevalence as the leading abortion method in the U.S. According to the study, less than half of the articles included basic facts on medication abortion, and only one in five articles included a personal story of someone seeking abortion.