I wanted to send a shorter note today explaining a big case that is before the Supreme Court today (right now) related to the abortion medication Mifepristone, sometime referred to as “Miffy.” Mifepristone is part of a two-drug regimen (“Miffy” and Misoprostol) used to perform an abortion. According to the Guttmacher Institute 63% of abortions performed in 2023 used the abortion pill. While the Dobbs decision supposedly returned the regulation/legislation of abortion to the states, this case could further restrict abortion options in every single state.
Link to live feed of Supreme Court proceedings.
Two cases have been consolidated. One is the Food & Drug Administration’s (FDA) case against the Alliance for Hippocratic Medicine (AHM) and the other is DANCO (along with DoJ) case against AHM.
The AHM is a group of anti-abortion doctors, who have never prescribed Mifepristone, who took the case to the federal district court in Texas in November of 2022. They wanted to reverse the FDA’s 2000 approval of the drug based on some flawed studies and their supposed “standing” in relation to the drug. The judge blocked the FDA’s approval of mifepristone. After a series of appeals, the Supreme Court preserved access to Mifepristone until the Supreme Court could rule on it.
Meanwhile, the U.S. Court of Appeals for the 5th Circuit upheld the FDA’s original approval of Mifepristone in 2000, but said the FDA violated law with recent changes to allow Mifepristone use to be extended from up to 7 weeks to up to 10-11 weeks and by allowing it to be prescribed via telehealth. Those changes were still in effect until the Supreme Court rules on this today.
Right now, it is legal (in states that respect women’s rights to bodily autonomy) to take Mifepristone up to 10-11 weeks since your last menstrual period. It can also be prescribed via telehealth options. If the AHM wins, then you could only take the pill through 6-7 weeks since your last menstrual period (LMP). Women don’t even know their period is late until 4 weeks since their LMP and if their cycles are irregular or they experience light bleeding (which can happen), then they might not know they are pregnant until after 6-7 weeks. You can see my previous post about the significance of the weeks of pregnancy here.
They would also have to go see a health care provider in person for three visits to get the medication. This means it will be illegal to mail the pill to any state. This will make it even more difficult for women to get an abortion if they must travel out of state and will make it harder to schedule an abortion in states where it is legal because so many appointments need to be scheduled for every patient.
In terms of Mifepristone causing problems, the AHM’s case is based on flawed studies. Sage publishing recently retracted the studies from their journal. I’m not sure why they published the studies in the first place. The Boom! Lawyered! podcast covered the flaws in the study in their February 9, 2024 episode.
And, the AHM’s standing in the case is based on the off-chance that a woman suffering from complications after taking the abortion pill would come to them and they are too holy to have anything to do with abortion even if their duty as a doctor requires them to care for women in this condition. Here are some points about their “standing.”
Some of the members of the AHM are pediatricians and dentists. Yes, I said DENTISTS! Women suffering from what they feel might be excessive bleeding after an abortion (this is the main reason women go to the ER after using the abortion pill) aren’t going to go to a pediatrician or a dentist for this.
They also aren’t going to go to an OB/GYN that they know is opposed to abortion. They are going to go to the ER or urgent care.
There is a chance they will be cared for in the ER or at an urgent care facility by somebody who is opposed to abortion. That said, the person caring for them would not be performing an abortion unless the abortion was not complete. They would not be causing an abortion if they need to perform a Dilation & Curettage (D&C). They would literally be providing the same care that they would be if a woman came in with an incomplete spontaneous miscarriage.
Most women who go to the ER for complications after an abortion using Mifepristone do not need a D&C. They usually just need ibuprofen and a heating pad and some reassurance that the amount of bleeding they are experiencing is not serious.
Mifepristone has been approved and used since 2000. It has been proven safe.
If you need some reassurance about the likelihood of Miffy’s approval being overturned, listen to the recent Impromptu podcast.
Go to Abortion, Every Day to get way more detail on the case. I highly recommend this substack to stay on top of reproductive rights in this country right now.