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Update 4/13/23: On Wednesday, April 12, the 5^th U.S. Circuit Court of Appeals allowed the FDA’s 2000 approval of mifepristone to remain in effect. However, the appeals court panel did vote to put on hold changes the FDA made in 2016 and 2021 that have made the drug easier to obtain and that have limited reporting requirements around non-fatal adverse events resulting from chemical abortion. This ruling is expected to hold until the full case is heard. It is expected to eventually go to the Supreme Court. 

In two separate rulings this past Friday, federal judges in the states of Texas and Washington issued conflicting opinions regarding chemical abortion drugs. This could result in a legal showdown that ends at the U.S. Supreme Court.

In the first ruling, a U.S. District Court Judge in Texas, issued an opinion that could reverse the FDA’s approval of the abortion drug mifepristone, which is one of the two drugs used in the RU-486 chemical abortion protocol. Judge Matthew J. Kacsmaryk, however, delayed the effect of his opinion for seven days to allow the federal government time to respond and “seek emergency relief from the United States Court of Appeals for the Fifth Circuit.” An appeal was filed three days later.

This lawsuit seeks the withdrawal of FDA approval of the drug mifepristone (RU-486) for use in chemical abortions. The legal action was filed by Alliance Defending Freedom (ADF) in November 2022 on behalf of four doctors who care for pregnant and post-abortive women and four national medical associations representing over 30,000 medical professionals.

According to ADF, “As the medical groups and doctors filing suit explain, by approving chemical abortion drugs, the FDA failed to abide by its legal obligations to protect the health, safety, and welfare of girls and women. The lawsuit notes that the FDA never studied the safety of the drugs under the labeled conditions of use, ignored the potential impacts of the hormone-blocking regimen on the developing bodies of adolescent girls, and disregarded the substantial evidence that chemical abortion drugs cause more complications than surgical abortions.”

In the second ruling, U.S. District Judge Thomas O. Rice in Washington State granted a preliminary injunction to keep the federal government from “altering the status quo and rights as it relates to the availability of Mifepristone….” This legal action was brought by 17 states and the District of Columbia that are seeking to affirm the “FDA’s original conclusion that mifepristone is safe and effective.”

Clearly, the second opinion stands in direct contrast to the ruling in Texas. Because of the far-reaching effects of these conflicting decisions in two different federal district courts, this issue could well make its way up to the U.S. Supreme Court.