Mifepristone Madness – Medication Abortions and the Likelihood the Supreme Court will Once Again leave it up to the States
There are two types of abortions – surgical and non-surgical. The non-surgical method is termed a medication abortion. A medication abortion is most commonly referred to as the “abortion pill”. The abortion pill is actually a two-drug combination: Mifepristone followed by Misoprostol. Mifepristone blocks the hormone progesterone which is necessary to maintain a healthy uterine lining. It is this lining that supports a fertilized egg, embryo and fetus. Without the hormone progesterone, the uterus will rid itself of the fertilized egg, embryo, or fetus depending on the stage of the pregnancy.
Misoprostol is a synthetic prostaglandin used to treat stomach ulcers. It is also used to induce labor. Once mifepristone has stopped the pregnancy misoprostol “induces labor” and flushes the “pregnancy” out of the woman’s body. It takes most women 2 to 24 hours to rid themselves of their pregnancy after taking both medications.
The “abortion pill” is advertised as a safe, medically approved abortion method if used during the first 10 weeks of pregnancy. With conservative states passing laws designed to restrict or prohibit most abortions, the abortion pill offers the pregnant woman with a level of privacy, and in states where abortion is for the most part illegal, secrecy, which clinics and hospitals cannot provide.
According to the Guttmacher Institute, a research and policy organization committed to advancing sexual and reproductive health and rights worldwide, medication abortions accounted for 63% of all U.S. abortions in 2023—an increase from 53% in 2020.[1] This research shows that pregnant women seeking an abortion prefer having an abortion as early as possible in a pregnancy. It also demonstrates the preference for privacy and the comfort of home. There were an estimated 1,026,700 abortions in the United States in 2023.
States that highly restrict or ban abortion do not differentiate between surgical and non-surgical abortions. If abortion is banned, so is taking mifepristone and misoprostol in combination to cause an abortion. In these conservative states, injecting, inhaling, or digesting any substances for the purpose of ending a pregnancy, will most likely result in criminal charges against the woman.
Medication abortion is legal in 36 states and Washington, D.C. In 15 of those states the “abortion pill” must be prescribed by a doctor. In the 15 states where abortion has been banned, or essentially banned, medication abortions are included in the prohibition. However, there are numerous sources found online where women living in states with abortion bans can still order the abortion pill and have the drugs mailed to their home.
For example, the National Women’s Health Network (NWHN) has a page on its website to help women find providers of the abortion pill.[2] Two clicks later and a link is provided on the PLAN C site to learn where women in South Carolina for example, a state where abortion is banned, have obtained the two-drug combination to rid themselves of their unwanted pregnancy. It states clearly on the webpage…
South Carolina restricts abortion pill access, but there are several ways people still get abortion pills by mail in South Carolina.
With a few more clicks the “abortion pill” is able to be added to the shopper’s online cart, ready for checkout. Safe Abortions Online is selling the Abortion Pill Pack for $235.[3] It even has 56 five-star reviews!
Mila wrote on March 21, 2024…
I am so relieved after ordering their Abortion Pill Pack online, it not only helped me with abortion and also decreased my stress level caused by the unwanted pregnancy.
Amanda offered these words on February 21, 2024…
Thank god I took an Abortion pill pack. It’s all in one pack. I got 3 additional pills for nausea, pain, and bleeding control. It was really helpful. I will definitely recommend it as it has all the pills.
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Emilia had this to say on February 13, 2024…
The private nature of the Abortion Pill Pack purchase was crucial for me. The website provided discrete packing and a secure transaction. Reliable service for sensitive needs.
In South Carolina, abortion after 6 weeks is illegal with some exceptions. Anyone who violates the ban is guilty of a felony and, upon conviction, must be fined $10,000, face prison time of up to two years or both. Fifteen other states have similar abortion laws. It should be expected that shipments of abortion pill kits purchased online into these 15 states have increased substantially after their 6-week abortion laws were enacted.
On March 26, 2024 the United States Supreme Court heard arguments in the case known as FDA v. Alliance for Hippocratic Medicine. In 2016 the Food and Drug Administration (FDA) took actions which made mifepristone easier to obtain. The Alliance for Hippocratic Medicine, a medical association opposed to abortion rights, wants the Court to rule in favor of restricting access to mifepristone. They argue the FDA acted unlawfully when it relaxed the rules governing the access and usage of mifepristone.
Based on some of the questions asked by the Supreme Court justices, pundits have suggested the Court may determine the Alliance for Hippocratic Medicine doesn’t have “standing”. In Lujan v. Defenders of Wildlife (90-1424), 504 U.S. 555 (1992), the Supreme Court created a three-part test to determine whether a party has standing to sue:
- The plaintiff must have suffered an “injury in fact,” meaning that the injury is of a legally protected interest which is (a) concrete and particularized and (b) actual or imminent
- There must be a causal connection between the injury and the conduct brought before the court
- It must be likely, rather than speculative, that a favorable decision by the court will redress the injury
It’s a legal stretch to see how the members of the Alliance for Hippocratic Medicine have or will be injured by the easier accessibility of mifepristone. However, up to this point the courts have been flexible enough to determine the doctors who are Alliance for Hippocratic Medicine members do in fact, have standing in this case. If the Supreme Court determines standing exists, as the 5th Circuit Court previously ruled, it will have to determine if the FDA acted unlawfully in 2016 when it made mifepristone easier to obtain.
The FDA has broad regulatory powers. It has the power to approve drugs, adjust dosages, and set rules regarding who can prescribe and dispense approved drugs. The FDA also collects data and monitors drugs for safety and effectiveness after they have been approved. Mifepristone was approved by the FDA in 2000. The safety of the drug is established. Millions of pregnant women have taken mifepristone. The sum of side effects the millions of women have experienced have been determined to be acceptable.
Will the Supreme Court dive into the prescribed purpose of mifepristone – to eradicate an embryo or fetus? That is unlikely. Will the court tighten how mifepristone is prescribed and dispensed? As much as the people who are adamantly opposed to abortions may hope and pray the court places restrictions on mifepristone at least back to the levels prior to the easing in 2016, I anticipate the court is going to rely on its 2022 Dobbs case and leave states with the ability to restrict the “abortion pill” access based on their current abortion laws.
Our national debt is $34.6 trillion. We must cut costs. Unpopular and difficult decisions must be made. (7 of 630 in this series)
~ E.F. Haas
[1] Guttmacher Institute, Medication Abortion Accounted for 63% of All US Abortions in 2023 – An Increase from 53% in 2020, Rachel K. Jones and Amy Friedrich-Karnik, March 19, 2024 [Accessed March 31, 2024]
[2] National Women’s Health Network, PLAN C Find Abortion Pills Through Licensed Providers, [Accessed March 31, 2024]
[3] Safe Abortions Online, Abortion Pill Pack, [Accessed 31, 2024]
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