Texas court to hear challenge to key drug used in medication abortions

Case could end up before US supreme court which last year overturned Roe v Wade ruling which provided federal constitutional right to abortion

Opponents of abortion walk past the US supreme court during the annual March for Life on the National Mall in Washington in January. A court in Texas will on Wednesday hear a challenge to access to a drug used in medical abortions in the US. Photograph: Shawn Thew/EPA
Opponents of abortion walk past the US supreme court during the annual March for Life on the National Mall in Washington in January. A court in Texas will on Wednesday hear a challenge to access to a drug used in medical abortions in the US. Photograph: Shawn Thew/EPA

A court in Texas is scheduled on Wednesday to hear a challenge by conservative groups to access to a key drug used in medication abortions in the United States.

The case could ultimately end up before the US supreme court. Last year the supreme court overturned the 50-year-old Roe v Wade ruling which provided a federal constitutional right for a woman to have a termination.

The case is being brought by a group known as the Alliance Defending Freedom on behalf of four anti-abortion medical organisations and four doctors.

It is seeking the court to order the regulator for drugs and medicines in the United States, the Food and Drug Administration (FDA), to withdraw approval it granted more than 20 years ago for the use of mifepristone.

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Mifepristone is the first of a two-drug regimen that is used to terminate a pregnancy of up to 10 weeks gestation.

In their case the medical associations and doctors contend the FDA made an error in determining the safety and effectiveness of the drug and claim it exceeded its regulatory authority in allowing its use.

The pro-choice Guttmacher Institute said last month that “banning mifepristone would cause large disruptions to abortion provision in the United States and patients’ ability to get the timely care they need and deserve”.

It said that while 98 per cent of medication abortions in the United States in 2020 used a regimen of mifepristone in combination with another medication called misoprostol, this second drug can be used on its own to end a pregnancy.

“If mifepristone becomes unavailable, it is unclear whether all current providers using the two-drug regimen would offer abortion care using only misoprostol and to what extent patients would take up this method. The fact remains that revoking approval of mifepristone would go against an overwhelming body of scientific evidence that the drug is safe and effective”, the Guttmacher Institute said.

The Alliance Defending Freedom group said when it filed the case last November that the FDA had chosen politics over science when it pushed for the legalisation of the chemical abortion drugs mifepristone and misoprostol in 2000.

It argued that the only way the FDA was able to approve the drugs was by characterising pregnancy as an “illness” and maintaining that such drugs provided a “meaningful therapeutic benefit”.

It contended that the FDA had failed to abide by its legal obligations to protect the health, safety, and welfare of girls and women.

The White House said in January that since the supreme court’s decision last year in the Dobbs v Jackson Women’s Health Organisation case which overturned the Roe v Wade ruling, president Joe Biden had “emphasised the need to protect access to mifepristone”.

The case in Amarillo, Texas is scheduled to be heard on Wednesday before judge Matthew Kacsmaryk who was appointed by former president Donald Trump.

A ruling could issue at any time after that. However, any decision may be appealed, initially before a US court of appeals and ultimately to the US supreme court in Washington.

Martin Wall

Martin Wall

Martin Wall is the Public Policy Correspondent of The Irish Times.