Mifepristone Access in the US: Regulations and Legal Status
On June 13, 2024, in FDA v. Alliance for Hippocratic Medicine, the US Supreme Court unanimously reversed a lower court decision suspending the Food and Drug Administration’s approval of mifepristone.
Mifepristone is a medication used to end pregnancies in the first trimester and treat early miscarriages. The ruling allows healthcare providers to continue distributing the medication without added restrictions.
Understanding Mifepristone and Its Use
Mifepristone is typically used to induce a medical abortion during early pregnancy (70 days or less since the first day of a patient’s last menstrual period). All states that allow Mifepristone prescriptions must meet FDA requirements ensuring that the drug must be prescribed by a health care provider that meets certain qualifications and is certified under the Mifepristone Risk Evaluation and Mitigation Strategy (REMS) Program.
Medical Abortion Statistics
In the 46 states that reported abortion data to the Centers for Disease Control and Prevention (CDC) in 2021, 80.9% of reported abortions were early medical abortions—meaning the medical abortion occurred at a gestational age of nine weeks or earlier.
State-by-State Access to Mifepristone
As of June 2024, 14 states have near-total bans on mifepristone. The other 36 states and Washington, DC, provide some form of legal access to the abortion medication.
Variations in Access
- Mifepristone is widely available in 22 states and Washington, DC, where it can be prescribed by a non-physician health care provider like a medical assistant or nurse practitioner.
- Another 14 states allow it but regulate it more heavily, making it available only when prescribed by a doctor or after mandated counseling or ultrasounds, along with other state-mandated abortion restrictions.
| Access Level | Number of States/Territories |
|---|---|
| Near-total bans | 14 |
| Legal access (various forms) | 36 states + Washington, DC |
| Widely available (non-physician prescription) | 22 states + Washington, DC |
| Heavily regulated (physician prescription, counseling, etc.) | 14 |