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

This piece aims to help inform the narrative on medication abortion with scientific evidence. Medication abortion is also known as abortion with pills or medical abortion. It’s important for journalists covering abortion to have a good understanding of medication abortion so that they can better inform their audiences.

The Supreme Court and Legal Challenges

On June 13, the Supreme Court justices in a unanimous decision preserved access to mifepristone, a medication that’s used for the safe termination of early pregnancy, 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. Before this decision, 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. In September, the Justice Department asked the Supreme Court to consider a challenge to that ruling. On Dec. 13, 2023, the Supreme Court justices announced that they would take up the case on the availability of mifepristone. Following this, the American College of Obstetricians and Gynecologists issued a statement on the same day urging the court to rule in favor of keeping the pill on the market and available to patients. The justices heard oral arguments on March 26, 2024 before issuing the June 13 ruling.

Medical Guidelines and Usage

Medication abortion is endorsed by several organizations, including the American College of Obstetricians & Gynecologists and the American Medical Association. According to the research, medication abortions accounted for 51% of all abortions in the U.S. Clinical guidelines for the procedure are established by major health authorities:

• The Food and Drug Administration: Has approved medication abortion for up to 10 weeks of pregnancy.
• World Health Organization: Authorizes its use for up to 12 weeks and also supports its use beyond 12 weeks of pregnancy.
• International Federation of Gynecology and Obstetrics: Also notes it can be used beyond 12 weeks of pregnancy.

Research Roundup and Media Coverage

A recent analysis of more than 1,100 articles, published between January 2022 and June 2023 in five major U.S. news outlets, finds that "while U.S. newspapers are treating the topic of abortion in general and medication abortion access in particular as serious policy issues, they are under-covering medication abortion considering its prevalence as the leading abortion method in the U.S., and its importance to abortion seekers." According to the study, published in Sexuality Research and Social Policy, politicians and lawyers were quoted more than healthcare providers; 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. Beyond termination of pregnancy, newer research is exploring other applications; for instance, in the Women&More study, researchers aim to demonstrate that mifepristone 50 mg is an effective and safe contraceptive option.