The plaintiffs, known as the Alliance for Hippocratic Medicine, argued that the U.S. Food and Drug Administration should withdraw its approval of the drug.
But during arguments in the case last March, several of the court's seven justices expressed skepticism that any of the plaintiffs were harmed by the availability of mifepristone, which is necessary for them to have legal standing to file the lawsuit.
“Plaintiffs have serious legal, moral, and ideological objections to elective abortion and the FDA’s relaxed regulations, but have failed to demonstrate actual harm,” Justice Brett Kavanaugh wrote for the court.
“Plaintiffs’ desire to make their drugs less available to others does not establish standing to bring suit,” he also wrote.
The Supreme Court overturned Roe v Wade in June 2022, effectively abolishing the federal right to abortion. Since then, 21 states have decided to restrict abortion earlier in pregnancy than the standard they set. Of those, 17 had contraindicated the procedure before 6 weeks.
Thursday's ruling has nothing to do with these laws. In states that ban abortion, medication abortion is still illegal. But abortion pills served as an effective workaround to this ban, with thousands of pills entering restricted states through the mail.
Pro-abortion activists welcomed continued access to abortion pills but warned that the Supreme Court's decision was a clear victory.
At least three states, including Missouri, Kansas, and Idaho, also opposed the FDA's approval of the drug. The Supreme Court's decision Thursday does not rule out such future issues.
“This ruling is not a ‘victory’ for abortion, but merely maintains the status quo,” Nancy Northup, director of the Center for Reproductive Rights, said in a statement.
“The attacks on the abortion pill will not end here. The anti-abortion movement is seeing how important the abortion pill will be in a post-Roe world.”
Anti-abortion groups criticized this decision. But these groups also signaled that the fight would continue.
“It’s a sad day for everyone who values women’s health and the life of the unborn,” said Katie Daniel, state policy director for Susan B Anthony Pro-Life America. “But the fight to stop dangerous mail-order abortion medications is not over.”
The two-drug regimen was approved by the Food and Drug Administration (FDA) in 2000 for use up to 10 weeks of pregnancy. The patient is first administered mifepristone to induce an abortion and then misoprostol to empty the uterus.
Since 2016, the FDA has eased access to the drug and allowed doctors to make virtual appointments with patients and mail them prescriptions. In this case, recent approval was at issue.
According to the Guttmacher Institute, nearly two-thirds of all abortions currently performed in the United States are medical abortions.
For 20 years, the FDA, the American College of Obstetricians and Gynecologists (ACOG), and other mainstream medical organizations have maintained that both mifepristone and misoprostol are safe for use.
American studies have shown that medication abortions are about 95% effective in terminating a pregnancy, with less than 1% requiring further medical follow-up.
