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What to know about the abortion drug Mifepristone | Health Information

The U.S. Supreme Court plans to issue a decision that could affect access to mifepristone, an abortion drug used in more than half of abortion procedures in the United States.

Mifepristone was approved in 2000 by the Food and Drug Administration (FDA), the government agency responsible for determining the safety of drugs and medicines. But earlier this month, a conservative judge in Texas issued a ruling banning the sale of mifepristone starting April 7.

The Biden administration quickly appealed the decision, which has now reached the Supreme Court, which is expected to rule by a self-imposed deadline of midnight Friday.

What is mifepristone, why is it being questioned, and what does restricting its use mean for Americans? Al Jazeera takes you through these issues.

What is mifepristone?

Mifepristone is a widely used abortion pill, usually given as the first of a two-part procedure that includes a second pill called misoprostol. Taken together, these tablets can be used to stop a pregnancy for up to 10 weeks.

Misoprostol can be taken as a single pill to terminate a pregnancy, but scientists say it is more effective when taken with mifepristone.

Mifepristone was approved by the FDA in September 2000 for use during the first seven weeks of pregnancy. In 2016, the FDA extended its availability by 10 weeks to simplify access.

In recent years, the pill has become the dominant method of abortion in the United States, accounting for more than half of all abortions in the country. In 2020, the Guttmacher Institute, a pro-abortion rights group, found that 53 percent of all legal abortions in the U.S. were performed with drugs, up from 39 percent in 2017.

Is it safe to use?

Yes. The scientific and medical communities agree that mifepristone is a safe method of terminating pregnancy, and it has been used by millions of people in the United States and around the world for decades.

Mifepristone can be taken alone at home or in a private place, but there are some side effects such as bleeding and brief abdominal pain. Serious complications can occur but are rare.

In January, the FDA approved the drug for sale in U.S. pharmacies and permanently allowed people to receive the drug by mail, expanding access to the drug, continuing a policy in place during the COVID-19 pandemic.

Why is the use of mifepristone questioned?

Last June, the U.S. Supreme Court ruled with a 6-3 conservative majority to overturn the 1973 Roe v. Wade case, which established the constitutional right to abortion.

Many Republican-led states across the country have enacted various restrictions aimed at reducing access to abortion. However, with the repeal of the Roe Act, states gained the ability to ban abortion altogether, and more than a dozen states have since enacted such bans.

Anti-abortion rights groups hold up anti-abortion signs in front of the Supreme Court
Anti-abortion demonstrators in front of the Supreme Court in June, when the court struck down abortion rights in a controversial ruling [File: Jacquelyn Martin/AP Photo]

Anti-abortion rights advocates see pills like mifepristone as an important battle in the ongoing battle for access to reproductive health services and are pushing for greater restrictions on their use.

In Texas, a coalition of anti-abortion medical providers called the Hippocratic Medical League filed a lawsuit challenging the FDA’s approval of mifepristone, saying the pill is unsafe and should never have been approved.

The case is being heard by District Judge Matthew Kacsmaryk, a Trump appointee known for his sympathy for conservative causes, who ruled on April 7 in support of the anti-abortion group’s call to ban mipha A request for ketone.

If allowed to remain, the decision would further limit access to abortion services in the United States, where millions of people have lost or experienced reduced access after overturning Roe’s decision.

What happened next?

The ban would suspend sales of mifepristone in the United States as litigation continues, but Kacsmaryk’s decision gives the Biden administration seven days to appeal the order before it can take effect.

The decision is considered the first instance of a judge questioning the FDA’s authority to make decisions about the health and safety of drugs, and health experts have warned that if allowed to stand, the ruling would weaken the agency’s authority.

Shortly after Kacsmaryk’s ruling, another judge in Washington state issued a decision blocking “any action to remove mifepristone from the market.”

Three days later, the Biden administration filed an emergency motion asking an appeals court to temporarily stay Kacsmaryk’s ban, saying it would weaken the FDA’s authority and reduce access to necessary health care.

White House press secretary Karine Jean-Pierre said at the time that the administration supported the FDA’s approval of mifepristone. She added that the government expected the case to go to the Supreme Court and was “very confident we would win”.

On April 13, a New Orleans appeals court struck down some of the restrictions in Kacsmaryk’s ruling, keeping the pills legal but maintaining important restrictions, revoking the ability to receive pills by mail and request an in-person doctor’s visit.

The Biden administration quickly appealed the ruling to the Supreme Court, which issued an order to temporarily suspend the restrictions a week ago and extended the stay by two days on Wednesday.

It plans to issue its ruling by a self-imposed deadline of 12 noon ET Friday (4:00 GMT Saturday).

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