US Supreme Court asked to restore abortion pill access

The pharmaceutical company that makes the abortion pill mifepristone has asked the Supreme Court to intervene after a lower court placed significant restrictions on access to the pill by mail.

In a decision issued on Friday, the Fifth Circuit Court of Appeals temporarily reinstated a requirement that abortion pills be obtained in person.

That will, for now, curb access to abortion pills - the most common method of terminating pregnancies in the US - in states where abortion is banned.

In 2023, the Food and Drug Administration (FDA) allowed doctors to send pills without seeing patients in person, giving women the ability to receive the pills by mail or at a pharmacy through telemedicine.

"Every abortion facilitated by FDA's action cancels Louisiana's ban on medical abortions and undermines its policy that 'every unborn child is human being from the moment of conception and is, therefore, a legal person,'" the appeals court wrote in the order.

The decision -which stems from a lawsuit brought by the state of Louisiana - will remain in effect as the case plays out.

On Saturday, Danco Laboratories, the pharmaceutical company that makes mifepristone, asked the Supreme Court to intervene and pause the ruling, temporarily restoring access to the pill.

"The resulting chaos for patients, providers, pharmacies, and the drug-regulatory system is a quintessential irreparable harm that underscores the need for emergency relief from this Court," lawyers for Danco wrote in the filing.

Mifepristone is the first of a two-pill regimen recommended by the FDA to end a pregnancy. It is widely available in states where abortion is legal.

The drugs' availability was expanded in April 2021, when the FDA said it would lift the in-person dispensing requirement for mifepristone for the duration of the Covid-19 pandemic. In 2023, the FDA permanently lifted that requirement, meaning the medication could be sent by mail.

In 2024, the US Supreme Court unanimously rejected an effort to restrict access to mifepristone.

But the decision, which came two years after the court rescinded the nationwide guarantee to an abortion, left the door open to other attempts to limit the availability of the drug.

Friday's appellate order overrides a lower court's ruling from earlier this month that paused the case while the Trump administration conducts an FDA review.

Louisiana Attorney General Liz Murrill celebrated the court's decision, saying the Biden-era rule "facilitated the deaths of thousands of Louisiana babies (and millions in other states)".

"I look forward to continuing to defend women and babies as this case continues," she added.

But Julia Kaye, an attorney with the American Civil Liberties Union (ACLU), said in a statement: "This decision defies clear science and settled law and advances an anti-abortion agenda that is deeply unpopular with the American people."

New York Attorney General Letitia James said on Friday that abortion access would continue to be legal in her state, despite the appellate court's ruling.

"In New York, our laws ensure that anyone who needs abortion care can seek it here. That has not changed, and we will continue to protect access to abortion, including medication abortion," she said in a statement.

But Marjorie Dannenfelser, head of Susan B Anthony Pro-Life America, said the ruling was "a huge victory for victims and survivors of Biden's reckless mail-order abortion drug regime".

Mifepristone works by blocking a hormone called progesterone, which is necessary for a pregnancy to continue. The second drug, misoprostol, empties the uterus.

The US first approved mifepristone for the medical termination of pregnancy through seven weeks of gestation in September 2000. In 2016, its approved use was extended to 10 weeks of pregnancy.

Misoprostol has been available by prescription for decades as a treatment for stomach ulcers and to manage postpartum haemorrhaging.

Its non-pregnancy related uses are probably why it has not attracted the same controversy as mifepristone.

Mifepristone is also used to treat women who have suffered miscarriages and Cushing syndrome, a hormone-related condition.

Over 3.7 million women used mifepristone in the US between 2000-18, according to the FDA.

The American College of Obstetrics and Gynaecologists (ACOG) and other mainstream medical organisations say both mifepristone and misoprostol are safe.

US studies say the two-step medication regime is about 95% effective in ending pregnancy and requires further medical follow-up less than 1% of the time.