The fate of mifepristone, the main drug used for 23 years in the United States for medical abortion, has been in an area of uncertainty, since federal judges in Washington and Texas handed down opposing rulings regarding the legality of its use .
Texas Judge Matthew Kacsmaryk invalidated the Food and Drug Administration’s FDA approval of mifepristone and, for good measure, “found” that abortion drugs cannot be sent by mail or other home delivery services according to the terms of an 1873 law.
Less than an hour after Kacsmaryk’s ruling, a federal judge in Washington state ordered the FDA to “maintain the status quo” and continue to allow access to mifepristone in states that want to protect and expand access.
For now, mifepristone is still available, but that could change dramatically if the Texas ruling does indeed go into effect on Friday, as set. If confirmed, the Texas ruling would lead to the withdrawal of the drug and would question the future of the abortion pill at the federal level.
But now there are two opposing rulings on mifepristone, and amid the uncertainty and confusion, several states and the federal government are taking steps to try to maintain access to the abortion pill for more than 40 million women.
The Biden administration has asked a federal appeals court to stay the Texas ruling to give the case more time, and to complete the appeals process. Biden was also joined by one of the manufacturers of mifepristone which made a similar request.
If the appellate court denies this additional time, then the Justice Department could ask the Supreme Court to intervene. The Biden administration has also asked the federal judge in Washington to give more information on the most effective response by the federal government to respond, in the event that the Texas ruling, which goes the other way, should be confirmed.
Many Democrats and a single Republican lawmaker said the federal government should ignore the Texas decision, while most other Republicans remained silent and carefully avoided commenting on the matter.
At the local level, even the governors of states fighting for abortion rights are taking action.
California Democratic Gov. Gavin Newsom said he was buying up to 2 million pills of misoprostol, Massachusetts announced it already bought 15,000, or more than a year’s worth of doses, and Washington state announced it bought enough mifepristone to have for about three years.
Meanwhile, many clinics have said they will continue to prescribe mifepristone anyway, until the FDA says otherwise.
Pharmaceutical companies have also taken sides in this battle.
About 300 Big Pharma executives, including Pfizer and Merck, have signed an open letter to take a stand against the Texas ruling, saying the decision “undermined the bipartisan authority granted by Congress” to the FDA and “ignores decades of evidence scientific and legal precedents”.
In the United States, women’s health and the right to manage their bodies continue to be a political battleground, and as states, depending on the leanings of their governors, try to figure out how to defend or bury the right to abortion, for US women, the right to self-determination appears destined to have varying protections, depending on their place of residence.