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White House braces for ruling on abortion pill’s fate

A lawsuit filed by an anti-abortion group in Texas claims that the Food and Drug Administration wrongly approved mifepristone for abortion use more than 23 years ago

Amarillo, Texas
People gather in Amarillo, Textas, on Saturday, February 11, 2023, to protest a lawsuit to ban the abortion drug mifepristone.JUSTIN REX (AP)

The Biden administration is preparing for a worst-case scenario if a conservative federal judge rules in favor of a lawsuit seeking to restrict access to one of the two drugs typically used to induce a medicated abortion. Two drugs, mifepristone and misoprostol, can be taken by women at home and are used for just over half of U.S. abortions. But that could be quickly changed by a lawsuit filed by an anti-abortion group in Texas that claims the Food and Drug Administration wrongly approved mifepristone for use more than 23 years ago.

The case is before a federal judge appointed by former President Donald Trump. A ruling in favor of the abortion opponents could immediately shut down the sale of the drug. Vice President Kamala Harris promised on Friday that the White House would push back on efforts to ban the drug, as she gathered a group of nearly a dozen doctors and abortion rights advocates to discuss a plan for responding to the looming threat to access to medical abortions.

“There are now partisan and political attacks attempting to question the legitimacy of a group of scientists and doctors who have studied the significance of this drug,” Harris said. “There is now an attempt by politicians to remove it from the ability of doctors to prescribe and the ability of people to receive.”

It’s the latest round of fallout in the struggle over reproductive care that the Democratic administration must grapple with since the Supreme Court overturned the constitutional right to an abortion last year. The administration had sought to expand access to medicated abortions in light of the Supreme Court’s ruling, with an FDA announcement earlier this year that broadened the pill’s access through retail and mail-order pharmacies.

Harris did not publicly lay out how the administration plans to respond if a ruling that halts the sale of the drug nationwide comes down on Friday.

Health and Human Services Secretary Xavier Becerra, meanwhile, was in California on Friday to meet leaders from Planned Parenthood to talk about access to abortion drugs. Clinics and telehealth providers have been preparing for a ruling that shuts down access to mifepristone, ordering more doses of misoprostol, so they can offer medication abortions with just that one drug. They will have to change the way they counsel patients, telling them that misoprostol-only abortions are slightly less effective and sometimes more painful than abortions done with both drugs.

Abortions using both drugs “can be as effective as 98% or more,” while misoprostol-only abortions are up to about 95% effective, Melissa Grant, chief operating officer of the Carafem abortion clinic, told The Associated Press. Mifepristone dilates the cervix and blocks the action of the hormone progesterone, which enables a pregnancy to continue. Misoprostol causes contractions that empty the uterus. Typically, mifepristone is taken by mouth first, followed by misoprostol a day or two later.

Studies show medication abortions are safe and effective, though with a slightly lower success rate than ones done by procedure in a clinic. The lawsuit against mifepristone was filed by the Alliance for Defending Freedom, which was also involved in the Mississippi case that led to Roe v. Wade being overturned.

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