In summary
In its first ruling on reproductive rights since overturning Roe v. Wade, the U.S. Supreme Court on Thursday rejected a lawsuit that questioned the FDA’s approval of the abortion pill mifepristone.
Medication abortion will remain widely available to Californians after the U.S. Supreme Court rejected a bid by anti-abortion groups and doctors to challenge the Food and Drug Administration’s approval of the drug.
In a unanimous vote, the high court today said plaintiffs did not have standing to claim the FDA had inappropriately expanded access to mifepristone, also known as the abortion pill. In doing so, justices upheld FDA regulations allowing clinicians to prescribe the pill via telehealth appointment and mail order delivery of the drug.
“Specifically, FDA’s regulations apply to doctors prescribing mifepristone and to pregnant women taking mifepristone. But the plaintiff doctors and medical associations do not prescribe or use mifepristone. And FDA has not required the plaintiffs to do anything or to refrain from doing anything,” Justice Brett Kavanaugh wrote.
The Alliance for Hippocratic Medicine, a group representing doctors and others opposed to abortion, had argued that relaxed mifepristone regulations could cause doctors with moral or religious objections to treat patients arriving at the emergency room with complications related to taking the pill. The ruling stated that federal law already provides comprehensive protections for clinicians who object to performing abortions.
Kavanaugh wrote, “plaintiffs have not shown — and cannot show — that FDA’s actions will cause them to suffer any conscience injury.”
The decision is the first abortion challenge to make it to the high court after justices overturned Roe v. Wade and eliminated federal abortion protections in 2022. Justices are still considering a nearly four-decade-old federal law ensuring patients who arrive at an emergency room will get treated and are expected to rule later this month.
Advocates for abortion and reproductive rights were quick to celebrate the decision across social media. They say the ruling helps preserve access for people who live in rural and low-income areas.
“This #SCOTUS decision is a victory for #ReproductiveRights and #WomensRights!” Democratic Sen. Toni Atkins of San Diego said on X, the platform formerly known as Twitter.
Since the Supreme Court decision overturning the right to an abortion, California has strengthened abortion rights and welcomed patients from states that have prohibited abortion. Most recently, Gov. Gavin Newsom signed a law allowing abortion providers from Arizona an expedited licensing pathway in California.
After today’s ruling, Attorney General Rob Bonta reaffirmed the Department of Justice’s commitment to creating a “safe haven” in California for people seeking abortion care, while acknowledging that legal challenges would continue.
“The fight for reproductive rights across the country is far from over, as anti-abortion extremists stand ready to continue their meritless attacks on mifepristone and access to reproductive healthcare. No matter how many lawsuits they file or challenges they bring, they cannot change the facts: mifepristone is safe and effective,” Bonta said in a statement.
Abortion pill access
Medication abortion is the most commonly used abortion method, accounting for nearly two-thirds of all U.S. abortions, according to the Guttmacher Institute, a national reproductive health policy center advocating for abortion rights.
Mifepristone, the pill at the heart of the Supreme Court decision, is part of a two-drug regimen for medication abortion. It halts pregnancy by blocking the hormone progesterone before the second drug, misoprostol, empties the uterus by causing it to contract.
The FDA approved mifepristone in 2000 and made it easier to access in 2021 when the COVID-19 pandemic made in-person dispensing requirements impossible. It is now used in nearly all medication abortions.
A container with boxes of Mifepristone, a drug used for medication abortions, at the Alamo Women’s Clinic in Carbondale, Illinois on April 20, 2023. Photo by Evelyn Hockstein, Reuters
Multiple studies have demonstrated its safety and efficacy over the past 20 years.
Recently researchers from UCSF’s Bixby Center for Global Reproductive Health conducted the largest study of telehealth abortions and found that medication abortions obtained via telehealth appointments are just as safe as in-person medical care, with 98% of patients completing the abortion without the need of additional medical care.
Last year, Newsom announced the state would stockpile the second drug in the medication abortion regimen, misoprostol, in case the Supreme Court decision resulted in a shortage. That stockpile has been depleted and it was not immediately clear whether the state would replenish it.
Misoprostol can be safely used alone for abortions but is more likely to have side effects when not paired with mifepristone, studies show. Both drugs are also commonly used to manage miscarriages.
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