Here's what Supreme Court's ruling on mifepristone means for Wisconsin

Mifepristone is safe, for now.

In a late-afternoon Friday ruling, the U.S. Supreme Court halted restrictions that would have limited access to mifepristone, known as the abortion pill, resolving a massive and fast-moving conflict over access to the drug while the underlying lawsuit is decided.

"I am sitting here watching CNN, and the news just broke," Kristin Lyerly, a Green-Bay based obstetrician and gynecologist said Friday. "I am relieved that we will still be able to continue to use this safe, effective, tested medication for women to have a medication abortion or who choose to use it for miscarriage management."

Mifepristone, along with misoprostol, works as a two-drug combination to end pregnancies in the first 10 weeks and to manage miscarriage care. Medication abortions account for more than half of all abortions in the U.S., according to research from the Guttmacher Institute.

Restrictions on access to mifepristone that were set to take effect at midnight Friday included a requirement that Americans sit for in-person visits with doctors and a prohibition on the drug being dispensed through the mail.

The legal battle over mifepristone, which has played out in a series of last-minute decisions and middle-of-the-night court filings, landed as the nation is still grappling with the Supreme Court's decision last year to end the constitutional right to abortion that Roe v. Wade established in 1973. With states like Wisconsin essentially banning abortions in response to that ruling, access to mifepristone has become even more significant for both sides of the debate.

"Fortunately the Supreme Court ruled in favor of science and evidence-based care," said Dr. Christopher Ford, who practices emergency medicine in Milwaukee. Both he and Lyerly are members of the Committee for Public Health's reproductive task force and are interveners in the legal suit challenging the state's 1849 abortion ban.

Both doctors emphasized the medication's safety record, saying "it is safer than penicillin or Tylenol."

"With this being such a high-profile case, it reassures people that mifepristone is available, it is safe, and it is effective," Lyerly said.

Though the Biden administration asked the Supreme Court to consider hearing arguments in the case, the fight over mifepristone now instead returns to lower courts. That means the issue could be back before the Supreme Court within a few months.

In the meantime, here's what the ruling specifically means for access to the medication in Wisconsin.

What are mifepristone and misoprostol used for when taken together?

The medication combination is used to end a pregnancy in the first 10 weeks of pregnancy, according to the FDA. People experiencing miscarriages, medically known as a spontaneous abortions, also are given the medication combination to empty the uterus.

Are medication abortions legal in Wisconsin?

No, not if a doctor is providing the medications. Patients can obtain the medications via mail and take them without a doctor's supervision. That could change, depending on the outcome of a legal challenge to the state's 1849 abortion law. Arguments in the case begin May 4 in Dane County Circuit Court.

Prior to the overturning of Roe v. Wade, people seeking a medication abortion were required to get an in-person physical examination, followed by a 24-hour waiting period, before receiving mifepristone.

Can I use telehealth to obtain mifepristone for an abortion if I live in Wisconsin?

No, not in Wisconsin. While people in other states could obtain mifepristone by obtaining a prescription through a telehealth appointment, that practice was banned by Wisconsin lawmakers in recent years.

How do mifepristone and misoprostol work?

Mifepristone blocks the hormone progesterone. Without progesterone, the lining of the uterus breaks down, preventing a pregnancy from continuing. Misoprostol causes the uterus to empty by softening and dilating the uterus, causing uterine contractions.

How could my doctor use the two medications to manage my miscarriage?

A woman experiencing a miscarriage is typically given mifepristone at their doctor's office. A day or two later, they are able to take misoprostol at home. Patients will experience cramping and bleeding within the next few hours and up to 48 hours after taking it.

What if mifepristone is no longer available to manage miscarriages?

Lyerly said women would experience more cramping and more bleeding.

"It is not ideal," she said. "It is not the science-based, standard of care."

More: Arguments in abortion lawsuit at the center of Wisconsin's Supreme Court race begin in May

Up to what point is the medication most effective?

When used for an abortion, the FDA says in the first 10 weeks or 70 days gestation.

Miscarriages are a little bit different because it depends on at what point fetal cardiac activity ceased and how much fetal material is in the uterus.

"Everyone’s body is different," Lyerly said. "There is no one size fits all for how medications works for people or how people choose to perform their medical decision making."

She added: "That’s why the courts can't be the ones who tell us what to do here. It needs to be up to the patient with the advice of their trusted provider, family, friends, faith leader, whoever it is she turns to for her personal decision-making."

More: For health workers, Wisconsin Supreme Court race wasn't about politics. It was about basic care.

When did the FDA approve mifepristone for medical termination of pregnancy?

The FDA first approved Mifeprex (mifepristone) in September 2000 for medical termination of pregnancy through seven weeks gestation. This was extended to 10 weeks gestation in 2016.

Mifepristone, the generic version of Mifeprex, was approved in April 2019.

Can someone who wishes to terminate a pregnancy still access mifepristone in Wisconsin?

State law prevents doctors from providing mifepristone and misoprostol for purposes of an abortion in Wisconsin. However, people in Wisconsin can obtain mifepristone online through sites such as Aidaccess.org.

Is mifepristone the same as Plan B?

No. Plan B is a high dose of birth control that prevents ovulation. The over-the-counter contraceptive does not require a prescription.

More: Abortion pills will soon be available in pharmacies. But not in Wisconsin.

USA Today contributed to this report.

Jessica Van Egeren is Milwaukee Journal Sentinel's enterprise health reporter. She can be reached at [email protected].

This article originally appeared on Milwaukee Journal Sentinel: What Supreme Court's mifepristone ruling means for Wisconsin abortions