In a ruling that could have a significant impact on abortion access in the United States, a federal judge in Texas has suspended the approval of the abortion pill mifepristone while a legal challenge proceeds. The preliminary injunction, which is set to take effect in one week, was issued by US District Judge Matthew Kacsmaryk, who was appointed by Republican President Donald Trump. The case was brought by four anti-abortion groups and four anti-abortion doctors who sued the FDA in November. They argue that the agency used an improper process when it approved mifepristone in 2000 and did not adequately consider the drug’s safety when used by girls under age 18 to terminate a pregnancy.
Mifepristone is part of a two-drug regimen, administered in combination with misoprostol, for medication abortions in the first 10 weeks of pregnancy. Drugs account for more than half of all abortions in the country. Some abortion providers have said that if mifepristone is unavailable, they would switch to a misoprostol-only regimen for a medication abortion, which is not as effective. It is not yet clear how widely available it would be.
The ruling is likely to inflame the fraught US politics of abortion, which have divided the country since last year’s US Supreme Court ruling that overturned a women’s constitutional right to the procedure. Since the Supreme Court ruled, 12 of the 50 states now ban abortion outright while many others prohibit it after a certain length of pregnancy, according to the Guttmacher Institute, a research organization that supports abortion rights.
The Biden administration, responding to the lawsuit, had said the drug’s approval was well supported by science, and that the challenge comes much too late. The Justice Department had argued that a ruling in favor of the plaintiffs in Texas would undercut trust in the FDA, the agency that signs off on the safety of food products and drugs, and would increase the burden on surgical abortion clinics already overcrowded with women coming from states that now ban the procedure.
In a seemingly conflicting injunction, a federal judge in Washington state on Friday also issued an order blocking the FDA from making any changes to the current availability of mifepristone. His ruling applied to the 17 states that sued. This conflict could bring the case before the US Supreme Court more quickly.
The ruling in Texas is a blow to abortion rights in the United States and could have far-reaching consequences. The Biden administration has vowed to appeal the decision, and the case will now go to the New Orleans-based 5th U.S. Circuit Court of Appeals, which has a conservative reputation, with more than two-thirds of its judges appointed by Republican presidents.