Supreme Court to Hear Arguments on Mifepristone and Abortion Medication

Abortion again on the Supreme Court docket with arguments about widely used medication. The Supreme Court will again wade into the fractious issue of abortion this week when it hears arguments over a medication used in the most common way to end a pregnancy, a case with profound implications for millions of women no matter where they live in America and, perhaps, for the race for the White House.

Understanding the Medical Process

Mifepristone, made by New York-based Danco Laboratories, is one of two drugs, along with misoprostol, used in medication abortions. In the standard procedure, mifepristone is taken first to dilate the cervix and block the hormone progesterone, which is needed to sustain a pregnancy. Misoprostol is taken 24 to 48 hours later, causing the uterus to contract and expel pregnancy tissue.

Underscoring the importance of the case, health care providers have said that if mifepristone is no longer available or is too hard to obtain, they would switch to using only misoprostol, which is somewhat less effective in ending pregnancies. However, taking pills at home to end a pregnancy is less invasive than surgery, more convenient than having to travel to an abortion clinic and more private, allowing women to avoid anti-abortion protesters who picket clinics.

Legal Challenges and Proposed Restrictions

Two years after the Supreme Court overturned Roe v. Wade and cleared the way for bans or severe restrictions on abortion in many Republican-led states, abortion opponents on Tuesday will ask the high court to ratify a ruling from a conservative federal appeals court that would limit access to the medication mifepristone. By rolling back Food and Drug Administration changes to the use of mifepristone, the ruling would cut off access to the drug through the mail and impose other restrictions, even in states where abortion remains legal. The restrictions would shorten the time when mifepristone can be used in pregnancy, to seven weeks from 10 currently.

Public Perception and Usage Statistics

Medication abortions accounted for 63% of the more than 1 million abortions in the U.S. last year, according to an estimate by the Guttmacher Institute. More than 5 million people have used mifepristone since 2000. Regarding safety, most adults in the U.S., 55%, believe medication abortion pills are very or somewhat safe when taken as directed by a doctor, and 65% have “a lot” or “some” confidence in the FDA to ensure that medications sold in the U.S. are safe and effective.

Political and Future Legal Landscape

The court's decision to reverse Roe had immediate political consequences, and the abortion question still hangs over voters in the 2024 election. If the court were to uphold restrictions on medication abortions it could roil the election landscape in races for Congress and the presidency. Furthermore, next month, the justices will hear arguments over whether a federal law on emergency treatment at hospitals must include abortions, even in states that have otherwise banned them.