Can you still get mifepristone and misoprostol for a medication abortion? It's a little complicated.
On Friday, the Supreme Court issued an order that would temporarily delay a lower court's decision to impose limits on mifepristone, coming just hours after President Biden asked the high court to intervene. This is just the latest in the developing situation, with the changes having the potential to affect access to medication abortion in the U.S. in the future.
The legal background
In Texas on Apr. 7, U.S. District Judge Matthew Kacsmaryk ordered a hold on federal approval of mifepristone, ruling in favor of a November 2022 lawsuit filed by the anti-abortion organization Alliance for Hippocratic Medicine against the Food and Drug Administration (FDA).
Around the same time, U.S. District Judge Thomas O. Rice had a nearly opposite ruling in Washington. Rice partially granted a request from 17 states and the District of Columbia to block the FDA from making any changes to mifepristone's access in the states that sued.
"The decision by the Texas judge was unprecedented — anti-abortion groups cherry-picked this extremist judge to overturn experts at the FDA and decades of evidence that mifepristone is safe and effective to try to get a de-facto nationwide abortion ban," Gretchen Borchelt, vice president for reproductive rights and health at the National Women's Law Center, tells Yahoo Life. The decision was stayed until Friday evening, giving the government time to appeal.
After the Justice Department asked the U.S. 5th Circuit Court of Appeals to put Kacsmaryk's ruling on hold, the federal appeals court decided on Wednesday not to suspend FDA approval of mifepristone. However, the court did impose tougher restrictions on the drug, preventing it from being sent to patients by mail.
Then, U.S. Supreme Court Justice Samuel Alito halted the ruling for five days, shortly before the 5th Circuit's ruling was set to take effect.
"The Supreme Court is likely going to be the one to settle the matter," Daphne Chen, co-founder and co-chief executive officer of TBD Health, tells Yahoo Life. Alito's interim order, an administrative stay, gives the Supreme Court until Wednesday to study the case and decide next steps.
Can you get abortion pills in all 50 states?
Things are changing by the day, which has raised a lot of questions about what is and isn't legal when it comes to using mifepristone in the U.S. right now.
Adding to the confusion are statements from groups like Mayday Health, which announced on Twitter that you can currently get "safe abortion pills" in all 50 states.
Not surprisingly, a poll conducted by the Kaiser Family Foundation that was published in February found that there is widespread confusion among Americans about whether medication abortion is legal in the U.S. — and that was before all of these court cases happened.
So, can you get abortion pills in all 50 states right now or not? For the record: It's a little complicated.
In a nutshell: Yes — but with a caveat. "Abortion is completely illegal in 13 states," Dr. Rachel Neal, an ob-gyn in Georgia and fellow with Physicians for Reproductive Health, tells Yahoo Life. "In those states, you cannot go to a clinic, doctor or health care provider and receive medications or a medication abortion."
However, she says, "people can safely manage their abortions with medications purchased online or in other countries, and there are places that will send them to every address in the U.S. — it's just not legal." These include sites such as AidAccess and Plan C that provide trusted information to help people access abortion medications.
A self-managed medical abortion (meaning, you take the medication without a doctor present) "is medically very safe, but it's legally precarious," Neal says. In states where abortion is illegal, "you are liable for prosecution if authorities find out that you have self-managed an abortion."
This didn't change with everything that's happening in the legal landscape, Neal says. It's how it's been for months.
As of right now, "mifepristone is currently still legal and available in states where abortion is legal," Danika Severino Wynn, vice president of abortion access at Planned Parenthood Federation of America, tells Yahoo Life. Meaning, if access to mifepristone was legal before the past seven days, it's still legal. "For now, approval of mifepristone remains protected," Wynn says.
What's unclear is whether that will last. "If the court’s ruling stands, mifepristone could become unavailable to people who need abortions across the country," Wynn says.
So what happens next?
It's not clear. "There's no denying that the ruling out of Texas is an attempt to impose effectively a national ban on the most common form of abortion care," Andrea Miller, president of the National Institute for Reproductive Health, tells Yahoo Life. "What happens next is unprecedented — we are in uncharted territory."
If mifepristone is banned, women seeking an abortion may need to use misoprostol, the other FDA-approved pill that is typically used in a medication abortion in the U.S., Neal says. "Misoprostol is one of the most common ways abortions are done worldwide," she explains. "It should not be considered dangerous, illegal or second-rate." Still, it's not the way medicated abortions have historically been done in the U.S. Typically a woman will take mifepristone, followed by misoprostol. And losing mifepristone gives women one less tool to access an abortion if they need it. The most common side effects of misoprostol include cramping, nausea, diarrhea, fever and chills.
"As this all plays out in the courts, it's important that individuals know that there are resources available to them," Borchelt says. "Individuals who need an abortion can call their local abortion fund. Individuals seeking information about their legal rights to abortion can contact the Repro Legal Helpline. And individuals who want information about their legal rights to help someone else obtain an abortion can contact the Abortion Defense Network.”
Again, mifepristone remains available in states where abortion is currently legal. Whether that will continue, though, is uncertain.
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