What the U.S. Supreme Court hearing on abortion medication is about
CBC
Nearly two years after a momentous ruling from the U.S. Supreme Court that led to half of all states banning or restricting abortion access, the top court will hear arguments on Tuesday in a case that could have significant consequences for the availability of the abortion medication mifepristone.
Mifepristone, along with misoprostol, is one of two pills used in the most common type of abortion in the nation.
The arguments, and the resulting opinion, will be watched closely after a 2022 decision in Dobbs v. Jackson Women's Health Organization, which enabled 14 states to completely ban medical abortions.
The development made the U.S. an outlier among Western and advanced nations. For countries that have changed abortion laws so far this century, about 90 per cent made amendments that improved access rather than restricting it further, according to a 2019 Council of Foreign Relations report.
A ruling for the plaintiffs could restrict recent Food and Drug Administration (FDA) changes that have loosened requirements on receiving one of two pills used in this type of abortion. It could also potentially undercut federal regulatory authority over drug safety beyond just this medication.
There were approximately 642,700 medication abortions in the U.S. in 2023, according to a report last week from Guttmacher Institute, an abortion rights advocacy group. That represented about 63 per cent of all estimated abortions, and was up from 53 per cent in 2020 and 39 per cent in 2017.
Mifepristone results in a completed abortion 97.4 per cent of the time, according to the latest FDA data. In 2.6 per cent of cases, a surgical intervention is needed, while in 0.7 of cases, the pregnancy continues.
WATCH | U.S. government taking abortion pill case to Supreme Court:
The reduced incidence of surgical abortions has likely been enabled by a couple of FDA changes. In 2016, mifespristone was permitted for use from 10 weeks of gestation, up from previous guidance of seven weeks. In 2021, the FDA relaxed in-person requirements, allowing the pills to be sent through the mail, including by health-care providers who are not physicians.
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.
Last year, 85,000 women worked with order-by-mail abortion provider Aid Access to obtain the medication, Dr. Rebecca Gomperts, the group's founder, told the Associated Press. Of those, about 50,000 live in states with abortion restrictions, she said.
The Supreme Court ruling could also impact the major players in retail pharmacy services. In some states, drug stores CVS and Walgreens have announced pilot programs that would allow pharmacists to dispense pills without the need for a physician's referral.
The FDA and Danco, the manufacturer of Mifeprex, the brand name of mifepristone, are the defendants.
The plaintiffs in the Supreme Court case are the Alliance for Hippocratic Medicine, a group of medical associations and four doctors who oppose abortion on religious and moral grounds. They are alleging the FDA overlooked serious safety problems when it made mifepristone easier to obtain. But some legal experts say they will have to show a real risk to women has occurred, not just a hypothetical one.
