Mifepristone Under Fire

An anti-abortion group is suing the FDA to revoke approval of Mifepristone, a key component of medical abortion.

Why it matters: Legal analysts are concerned that the extremist judge hearing the case will ban Mifepristone across the entire country as early as tomorrow (2/24/23).

• Mifepristone, combined with another medicine misoprostol, forms the safest and most effective regimen for medical abortion and the treatment of miscarriage.

What they’re saying: The plaintiffs are claiming several ideological points that don’t make legal or medical sense.

• They claim that the FDA should never have approved mifepristone, because pregnancy is not a “disease” or “illness” and therefore mifepristone has no therapeutic benefit.
• They claim that the medicine is unsafe and puts “women and girls” at a higher risk for adverse effects, including an increased risk of medical illness.

Reality check: Mifepristone has been used in the US for over 20 years, and has a better safety record than colonoscopy, wisdom tooth extraction, and Viagra.

• Serious side effects occur in <1% of cases.
• Major adverse events–serious infection, significant blood loss, or hospitalization–occur in <0.3% of cases.

Zoom In Legally: Judge Matthew Kacsmaryk is a Christian extremist who used to work for a law firm trying to end the separation of church and state.

• The plaintiffs chose his jurisdiction out of the entire country because they wanted this judge to hear the case.
• If Kacsmaryk’s decision is appealed, the extremely conservative Fifth Circuit Court of Appeals will hear the case. A second appeal would take it to the Supreme Court if they choose to hear it.

The Big Picture: Anti-abortion groups are bolder after Dobbs. They’re legally attacking abortion everywhere, because there are enough extreme judges and politicians that they think they can win.

The Bottom Line: If Mifepristone is removed from the market, people will still be able to get medical abortions, but they’ll have to use misoprostol-only regimens–which are less successful, have more side effects, and more complications.

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