The use of the abortion pill in the US, a battle between two opposing court orders

New threat to the right to abortion in the United States. Access to the abortion pill mifepristone is adrift in the country due to opposing court rulings, while the Government prepares an appeal.

This panorama is presented after on Friday, April 7, Judge Matthew Kacsmaryk, of Amarillo, Texas, ordered the revocation of the approval of more than two decades of the Food and Drug Administration (FDA) to use the drug.

This is a preliminary injunction, which would essentially ban sales of the pill while court arguments continue.

According to the initial 67-page ruling, mifepristone would not be safe and the FDA would have ignored the risks in approving it.

“The Court does not lightly challenge the FDA’s decision-making (…) But here, the FDA acceded to its legitimate safety concerns, in violation of its legal duty, based on clearly flawed reasoning and studies that did not support their conclusions,” Kacsmaryk said.

The magistrate added that the agency had faced “significant political pressure” to “increase access to chemical abortion.”

However, in the background there is a political and ideological crusade between magistrates, citizens, Republicans and Democrats with different views on the right to voluntary termination of pregnancy.

Kacsmaryk was nominated by controversial former Republican President Donald Trump and has long held anti-abortion views.

With its decision, it supports the case brought by four anti-abortion groups led by the recently formed Alliance for Hippocratic Medicine and four anti-abortion doctors, who last November sued the FDA. A pulse of the most conservative movements in the United States for further hindering that right.

The pill, endorsed since 2000, is the most commonly used abortion method in the US and in the event that the Biden government’s appeal is unsuccessful, it would be confirmed as an unprecedented ruling, since it would suspend for the first time a drug approved by the Food and Drug Administration.

Washington judge orders access to abortion pills protected

A statement contrary to that of Judge Matthew Kacsmaryk was made almost immediately by District Judge Thomas Rice, in Washington state, who was nominated for the post by former Democratic President Barack Obama.

Rice ruled that mifepristone is safe and effective. Therefore, he ordered to protect their access and preserve the “status quo” in 17 states and Washington DC, places that are behind a second lawsuit that seeks to maintain the drugs that lead to abortion.

Within hours of the Texas ruling, the Justice Department and drug maker Danco Laboratories filed their notice of appeal.

Attorney General Merrick Garland said the government would ask the US Court of Appeals for the Fifth Circuit to allow the FDA to keep the pill’s approval pending the outcome of the case.

President Joe Biden expressed his strong rejection of the Kacsmaryk court ruling, considering it an attempt to intervene in evaluations that are only the responsibility of drug experts.

“If this ruling were upheld, then there would be virtually no prescription, approved by the FDA, that would be safe from this type of political and ideological attack,” the president said.

For her part, Vice President Kamala Harris also rejected the ban on the drug. She said that it was a dangerous precedent, she recalled that it is important for the Government that women have control of decisions about their reproductive health and mentioned that the drug has been used safely for 20 years.

For now, the drug seems to be available as a result of the two contrary rulings by federal judges in Texas and Washington, underlines the US news agency AP.

Is mifepristone safe?

The pill approved more than 20 years ago is part of a two-drug regimen, administered in combination, in the first 10 weeks of a pregnancy. So far, the FDA and the American College of Obstetrics and Gynecology have ensured that it is safe to use.

Mifepristone has the function of block progesterone, a hormone that the woman’s body produces naturally during pregnancy and that is necessary for that state to continue.

After the woman takes the first pill, doctors prescribe another abortion pill called misoprostol, responsible for emptying the uterus and producing bleeding.

According to information from the FDA it is their serious adverse case reports In patients taking mifepristone, as of June 30, 2022, there have been 28 reported mifepristone-related deaths since the product was approved in September 2000; although there is no certainty about the relationship of adverse effects with mifepristone due to simultaneous factors such as the use of other medications, coexisting diseases and clinical treatment.

Although the FDA has a guide public response with all the information related to the drug and frequently asked questions. Anti-abortion campaigns claim that it is a risky and inefficient method, information that is not supported by leading medical organizations such as the World Health Organization and the American Medical Association.

Amid debates in courtrooms, some abortion providers have said that if mifepristone were not available, they would switch to a misoprostol-only regimen. However, they also warn that it would not be as effective.

How does the United States arrive at the possible revocation of the abortion pill?

It is a commitment to further restrict the possibility of abortion, after a door was opened in this matter for the most conservative last year.

On June 24, 2022, the US Supreme Court struck down the landmark ruling byand Roe vs. Wade, in force since 1973which allowed the interruption of pregnancy to be considered a constitutional right throughout the country.

The measure was settled with a majority of 6 judges in favor of canceling the historic ruling and 3 against. Those who voted to suppress the consideration of abortion as a right affirmed that it does not correspond to American “history or tradition”.

That decision was reached after the country’s highest court was made up of a majority of conservative-leaning judges, following nominations made during the Donald Trump Administration.

That move meant a victory for the interests of Republicans and religious conservatives in states where it is intended to limit or prohibit the voluntary interruption of pregnancy.

However, the measure also allows states to implement their own regulations.

Abortion clinics contacted by ‘The Washington Post’ emphasized that the Texas ruling would not affect their care for the next seven days.

And they even pointed out that if Kacsmaryk’s decision goes into effect, they would not stop prescribing mifepristone until the FDA indicates so.

With Reuters, AP and local media