People march through downtown Amarillo to protest a lawsuit in federal court to ban the abortion drug mifepristone on Saturday, Feb. 11, 2023, in Amarillo, Texas. (AP Photo/Justin Rex)
WASHINGTON (AP) — The Biden administration is bracing for a worst-case scenario if a conservative federal judge rules in favor of a lawsuit that seeks to limit access to one of the two drugs typically used to induce a medical abortion.
Two drugs, mifepristone and misoprostol, can be taken by women at home and are used in just over half of American abortions. But that could be quickly changed by one lawsuit filed by an anti-abortion group in Texas, alleging that the Food and Drug Administration erroneously 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 close the sale of the substance, but women would still have access to medical abortions with a regimen of misoprostol.
Vice President Kamala Harris vowed 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 to respond to the looming threat to access to medical abortions .
“There are now partisan attacks and political attacks trying to question the legitimacy of a group of scientists and doctors who have studied the importance of this drug,” Harris said. “There is now an attempt by politicians to remove it from doctors’ ability to prescribe and people’s ability to receive.”
The lawsuit against mifepristone was brought by the Alliance for Defending Freedom, which was also involved in the Mississippi case that led to the overturning of Roe v. Wade. It’s the latest setback in the battle over reproductive care that the Democratic administration has had to contend with since the Supreme Court overturned the constitutional right to abortion last year.
Harris has not publicly stated how the administration plans to respond if a ruling halting sales of the drug nationwide comes down on Friday.
Health and Human Services Secretary Xavier Becerra, meanwhile, was in California on Friday to meet with Planned Parenthood leaders to talk about access to abortion drugs.
Dr. Kristyn Brandi said she told the vice president on Friday that the ruling could spark widespread confusion about the availability of medical abortion in the United States. women asking if medical abortion is legal in the state.
“That’s a really important thing to communicate to people: medication abortion is not going away,” Brandi said.
She added that Harris expressed support for immediately challenging the ruling if it shuts down access to mifepristone.
Clinics and telehealth providers have been bracing for a ruling that closes access to mifepristone, ordering multiple doses of misoprostol so they can offer medication abortions with just one drug. They will have to change the way they counsel patients and tell 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, CEO of Carafem abortion clinic, told The Associated Press.
Mifepristone dilates the cervix and blocks the action of the hormone progesterone, making it possible to continue a pregnancy. Misoprostol causes contractions that empty the uterus. Typically, mifepristone is taken by mouth first, followed by misoprostol a day or two later.
Studies show that medical abortions are safe and effective, although with a slightly lower success rate than those performed by procedure in a clinic.
With the Texas decision pending, a dozen Democratic-controlled states filed their own lawsuit in federal court against the FDA on Thursday in Washington. The lawsuit seeks to make it easier for the woman to access the drug, claiming that multiple FDA requirements for prescribing and dispensing it are “burdensome, harmful and unnecessary.”
When the FDA approved mifepristone in 2000, it placed several safety restrictions on its use, including limiting dispensing to specialty clinics and requiring women to pick up the drug in person. The Biden administration had sought to expand access to medical abortions in light of the Supreme Court ruling, with an FDA announcement this year expanding the pill’s access through retail and mail-order pharmacies.
But several restrictions remain, such as one that doctors must be specially certified to prescribe the drug.
Several medical groups have long opposed these requirements, pointing to the low frequency of side effects seen with mifepristone compared to other drugs that have no certification requirements.
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Health writer Matthew Perrone in Washington and national medical writer Lindsey Tanner in Chicago contributed to this report.
