Supreme Court delays final decision on abortion pill for 2 more days

A common abortion pill, mifepristone, is still in grave danger of being pulled off the market after the Supreme Court gave itself until Friday, April 21, to weigh in on a case that could decide access to the medication.

On April 19, Supreme Court Justice Samuel Alito extended a stay that keeps mifepristone accessible under a lower court’s new restrictions to give the high court more time to hear arguments in the case and decide how to proceed. The Supreme Court is reviewing a decision from the 5th Circuit Court, which ruled that mifepristone could remain on the market with restrictions. Alito previously delivered a stay that was set to expire at 11:59 PM on April 19.

The 5th Circuit Court’s decision came after U.S. District Judge Matthew Kacsmaryk ruled that mifepristone was unsafe and ordered that U.S. Food and Drug Administration (FDA) approval of the drug be suspended. The ruling was the first time a judge has ever ordered an FDA-approved drug off the market, and the implication of the ruling, if it is not overturned, suggests judges can interfere in the drug approval process in the United States.

Mifepristone was approved by the FDA in 2000 and has been used in the United States by more than 5 million people since. It is commonly referred to as being “safer than Tylenol” and its access has been expanded in recent years due to the COVID-19 pandemic and its widely-regarded safety. It is the most common care method for the treatment of miscarriage, as well.

The 5th Circuit Court, in an appeal, did decide that Kacsmaryk’s ruling went too far, but still imposed changes to mifepristone access beyond the FDA’s approval and recommendations. Specifically, the court stripped extensions of mifepristone access that have been expanded since 2016, including letting patients access the medication longer into pregnancy––from 49 days to 70 days––and prescribing the drug via telehealth and accessing it through the mail.

Alito’s April 19 decision keeps those 5th Circuit Court restrictions in place as justices decide what to do next. How the Supreme Court will act next is unknown, and the litigation upheaval has created chaos for healthcare providers, patients and the pharmaceutical industry. To further confuse legal experts, another federal judge based in Washington allowed 17 states that sued to keep full access to mifepristone. How these different rulings will shake out is largely unknown and unprecedented, according to healthcare and legal experts with Planned Parenthood Federal of America (PPFA) who spoke to reporters on a press call April 18.