The abortion pill, or medication abortion, is a non-surgical way of ending a pregnancy in the early stages, up to ten weeks after the last menstrual period. Mifepristone, along with misoprostol, is the drug most commonly used to carry out this procedure. It has been in use in the United States for over 20 years and makes up more than half of all abortions. However, recent legal battles have caused confusion and uncertainty regarding the availability of the medication in certain states.
What is Mifepristone?
Mifepristone, also known as Mifeprex or RU-486, is a medication used to terminate early pregnancies, up to 10 weeks gestation. It was first approved for use in the United States in 2000.
Mifepristone is a progesterone receptor antagonist, which means that it blocks the hormone progesterone. Progesterone is essential for maintaining a pregnancy, as it helps thicken the lining of the uterus to support the developing embryo. By blocking progesterone, mifepristone causes the lining of the uterus to break down and the pregnancy to detach from the uterine wall.
Mifepristone is usually taken in combination with another medication called misoprostol, which causes the uterus to contract and expel the pregnancy. Misoprostol is usually taken 24-48 hours after mifepristone. This two-step process is known as medication abortion, and is a safe and effective alternative to surgical abortion for many women.
Why is Mifepristone under fire?
Despite its effectiveness, anti-abortion activists and lawmakers have tried to heavily regulate or even ban the use of the abortion pill, arguing that it poses health risks such as excessive bleeding and infection, and should only be administered by a licensed healthcare provider.
Texas Abortion Law
The Texas abortion law, SB8, has particularly targeted the use of Mifepristone. It requires healthcare providers to follow outdated FDA guidelines for prescribing it, which include a higher dosage and more frequent visits to the provider. This has made it more difficult and expensive for individuals to access the abortion pill, and puts them at risk of legal action if they are caught using it without following the strict guidelines. In November 2020, four anti-abortion groups and doctors sued the FDA alleging that it used an improper process when it approved Mifepristone and did not adequately consider the drug’s safety when used by girls under age 18 to terminate a pregnancy.
Legal Battles and Conflicting Rulings
Recently, two US district judges delivered conflicting rulings over the legality of Mifepristone. Judge Matthew Kacsmaryk, appointed by Trump in Texas, ordered a hold on federal approval of Mifepristone, while Judge Thomas O’ Rice, an Obama appointee in Washington, directed authorities not to make any changes that would restrict access to the drug in at least 17 states where Democrats sued to protect its availability. The Biden administration responded to the lawsuit, stating that the drug’s approval was well-supported by science, and that the challenge came too late.
What Happens Next?
The impact of the conflicting rulings is unclear, but they have brought the accessibility of Mifepristone into question, particularly in Texas. Medical professionals who recommend the combination of Mifepristone and Misoprostol have stated that they will switch to only prescribing Misoprostol if Mifepristone becomes unavailable. The single-drug approach has a slightly lower rate of effectiveness in ending pregnancies.
Overall conclusion is that Mifepristone has been an effective and safe way of ending a pregnancy for over 20 years, making up more than half of all abortions in the United States. However, recent legal battles and conflicting rulings have created uncertainty and confusion about the drug’s availability, particularly in Texas. While the Biden administration has stated that the drug’s approval is supported by science, it remains to be seen how these legal battles will play out and how they will affect individuals seeking abortions.
