On Friday, April 21, 2023, the US Supreme Court ruled that mifepristone (aka “the abortion pill”) would remain widely available across the United States without restrictions—at least for now. The order delayed the potential for a ban or limitations on this FDA-approved drug, which is used in more than half of abortions across the nation.  

We asked American University Professor of Sociology Tracy Weitz, one of the nation’s leading voices on abortion care and reproductive health, to explain the legal back-and-forth, what might happen next, and why it matters.

To the Point: Mifepristone (aka “the abortion pill”) Has Been in the News a Lot Lately—Why?

Medication abortions make up over half of all abortions in the United States using a two-drug medication abortion regime including the drug mifepristone, which has been in the news a lot recently. Mifepristone is safe and effective and has been used by more than five million women in the US. It is also available in more than 60 countries and is the mainstay of abortion care in countries as diverse as Sweden and Tunisia. 

The US Food and Drug Administration (FDA) approved mifepristone in 2000. Since then, it has twice approved changes to the official drug label, allowing more people to use the medication and making it easier to access. The last change allowed the drug to be mailed to patients following a telehealth visit with a clinician. Complications are incredibly rare, and if it weren’t for abortion politics, scientists say it should qualify for over-the-counter status given its safety profile. 

The popularity and simplicity of medication abortion have angered abortion rights opponents. To impede access to the drug, activists founded the Alliance for Hippocratic Medicine in Amarillo, Texas, to file a lawsuit against the FDA’s approval of mifepristone. Amarillo is a federal district with only one judge, Matthew Kacsmaryk, who is known for his hostility to abortion rights. And sure enough, on April 7, he issued a ruling ordering the FDA to reverse its approval of mifepristone. In anticipation of this decision, the Attorneys General of 17 states had already filed a separate lawsuit seeking increased access to the medication. It all led to a legal back and forth resulting in the US Justice Department seeking emergency relief, which was granted by the Supreme Court, which agreed to hear arguments immediately. On Friday, April 21, the Court halted the ruling until the case is heard in full by the court of appeals. So, for now, medication abortion remains legal and available in states where abortion remains legal. 

All of these legal machinations are really complicated, and the story is not over. The anti-abortion movement understands the potential of medication abortion to expand access to the health care service they have long restricted through unnecessary regulation and harassment of abortion providers. What is not complicated is the science behind medication abortion. The regime is safe, effective, and popular. In the United States, we often conflate the clinical safety of abortion with the social complexity of abortion. We shouldn’t.

About Professor Tracy Weitz

In 2022, Professor Tracy Weitz joined AU as a professor of sociology and director of the university’s Center on Health, Risk, and Society. She also works as a senior fellow at the Center for American Progress, a non-partisan policy institute in Washington DC. From 2014-2021, Weitz served as the US Programs Director for the Susan Thompson Buffett Foundation in Omaha, Nebraska. Prior to joining the foundation, from 2003-2013 as faculty in the Department of Obstetrics, Gynecology and Reproductive Sciences, she co-founded and directed the Advancing New Standards in Reproductive Health research program. She received the 2012 UCSF Academic Senate Distinction in Mentoring Award and the 2021 Charles S Schultz Lifetime Achievement from the American Public Health Association. In 2015, Weitz and her wife were awarded the Roger Baldwin Civil Libertarians of the Year Award from the ACLU-Nebraska for challenging the Nebraska ban on same-sex marriage.