On Friday, Federal Judge Matthew Kacsmaryk issued a ruling further restricting access to abortion nationwide by suspending the Food and Drug Administration’s approval of mifepristone, the most common and safest pill used. for medical abortion. Another ruling, from a federal judge in Washington state, ordered the FDA to make no changes affecting the availability of the drug. This causes a clash in the courts. The Texas judge suspended his order for seven days to allow the FDA to appeal.
The same anti-abortion hardliners who worked to reverse Roe against Wade are behind this lawsuit in Texas, Alliance for Hippocratic Medicine v. US Food and Drug Administration. With the appeals, it will now go to the United States Court of Appeals for the 5th Circuit in New Orleans and then to the Supreme Court. If the decision is not overturned, it will lead to a harmful restriction on access to abortion, even for people living in “blue” or “safe haven” states. Mifepristone, taken with misoprostol, is now used in more than half of all abortions in the United States
From the Dobbs vs. Jackson Women’s Health Organization decision in June, 13 states have banned most abortion procedures and 26 clinics have closed, including the four in Texas operated by Whole Woman’s Health. With the latest ruling in Texas, abortion care could be more disrupted than it already has been.
Whole Woman’s Health clinics pioneered the mifepristone-misoprostol regimen for medical abortion. It is a safe and effective drug for our patients, and after its FDA approval in 2000, it quickly became the most popular option for abortion care nationwide. Over two decades we have provided these abortion pills to thousands of patients and have seen the benefits and effectiveness of the combined regimen.
As this mifepristone case continues in the higher courts, there remains an option for people to use misoprostol alone. Misoprostol can be used safely alone to terminate a pregnancy with an effectiveness rate of 85% to 90% (the mifepristone-misoprostol regimen has an effectiveness rate of 99.6%). Miso-alone protocols have been used effectively around the world for decades. but are most often used in countries where abortion is restricted or banned, and where people do not have access to mifepristone. Whole Woman’s Health will continue to provide mifepristone abortions unless otherwise specified by the FDA.
The risk of losing the most effective method, the mifepristone-misoprostol regimen, is unacceptable for patients who deserve access to safe abortions without having to resort to workarounds. Unfortunately, when it comes to abortion, science is often sidelined as the political agenda of a small minority of Americans is weaponized, harming those who are or will become pregnant by limiting their options.
This Texas ruling also forces expert medical professionals to come up with a less effective method of medical abortion that might not be as comfortable for their patients. Providing compassionate abortion care is what we do, and navigating the ever-changing landscape of abortion care has become part of our daily lives. But without mifepristone, the experience of abortion with the pill will not be the same for our patients. Abortion care with misoprostol alone involves more side effects, including increased bleeding, cramping, nausea, and potential vomiting and diarrhea. The diet also involves more pills over a longer period of time.
Following another decision to eradicate access to abortion care, I no longer recognize the abortion landscape I started in over 30 years ago. This attempt to ban medical abortion shows what many of us in the fields of reproductive health, rights and justice have been saying for years: that anti-abortion extremists will not stop their war on abortion. bodily autonomy simply because Roe was knocked down. And they’re not going to stop now.
But abortion providers and our allies are not backing down. We know that banning abortion does not reduce the need for abortion care in our communities. We may be more limited in what we can prescribe when it comes to medical abortion, but we will continue to provide the best legally authorized care, with compassion, wherever we can and for as long as we can.
We continue our work to build a world beyond Roe, beyond Dobbs and beyond Friday’s decision in Texas. Abortion seekers deserve to have all health care options, and we remain true to our commitment to provide them with care.
Amy Hagstrom Miller is President and CEO of Whole Woman’s Health Alliance.