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The U.S Supreme Court voted in favor of preserving access to the FDA-approved abortion pill mifepristone. Geoff Livingston/Getty Images
  • On June 13, the U.S. Supreme Court ruled in favor of the abortion pill mifepristone after weighing whether to restrict access.
  • Restricted access to this medication would have had a ripple effect across dozens of states where the right to a safe and legal abortion is controlled by legislators.
  • The Court’s decision followed a U.S. appeals court ruling to impose restrictions on the medication, challenging its FDA approval and safety.
  • A large body of evidence confirms that mifepristone is safe and effective.

The U.S. Supreme Court voted unanimously on June 13 that the commonly prescribed abortion medication mifepristone will remain available.

The FDA vs. Alliance for Hippocratic Medicine ruling found that the plaintiffs lacked legal standing to challenge how the FDA regulates mifepristone.

The highly-anticipated decision follows a 2023 ruling by the U.S. Court of Appeals for the 5th Circuit. The lower court challenged the Food and Drug Administration’s authority on the abortion pill, which has more than two decades of research determining its safety and effectiveness.

Now that Supreme Court justices have ruled in favor of the FDA, access to mifepristone remains available through telehealth prescriptions and shipments of the medication by mail.

Stella M. Dantas, MD, president of the American College of Obstetricians and Gynecologists, said in a statement the decision was a relief for organization.

“Today’s decision from the U.S. Supreme Court provides us with long-awaited relief,” Dantas said.

“We now know that patients and clinicians across the country will continue to have access to mifepristone for medication abortion and miscarriage management. Decades of clinical research have proven mifepristone to be safe and effective, and its strong track record of millions of patient uses confirms that data. As the unanimous decision from the court makes clear in no uncertain terms, the people who brought this case were driven solely by a desire to impose their views on others and make it harder for patients to access safe, effective abortion care when they need it.”

Demand for abortion pills prescribed via telehealth has skyrocketed since the Supreme Court’s June 2022 decision to overturn Roe v. Wade.

A comprehensive study published March 25 in JAMA shows that self-managed abortions rose sharply following the landmark ruling. The findings show nearly 28,000 additional doses of abortion pills were prescribed during the first six months after the Court ended the constitutional right to an abortion.

This increase underscores the necessity for continued access to this medication.

A tremendous body of evidence supports the safety and efficacy of abortion medication, as noted by the FDA.

A recent study, for instance, published May 13 in JAMA Internal Medicine, found that abortion pills dispensed by mail-order pharmacies are just as effective as abortions performed by a healthcare professional at a clinic or doctor’s office.

Of the 510 females studied, researchers say 91.2% were satisfied with abortion medication prescribed by mail, with less than 1% experiencing adverse events.

Other studies, of which there are many, have shown similar results.

“Mifepristone is safe, effective and essential,” said Destiny Lopez, acting co-CEO of the Guttmacher Institute, in a statement shared with Healthline.

“Guttmacher data show that medication abortion accounted for nearly two-thirds of abortions in the formal U.S. healthcare system in 2023. Mifepristone also plays a key role in helping many people safely self-manage their abortion.”

Sarah Prager, MD, a professor in the Department of Obstetrics and Gynecology at the University of Washington, told Healthline she was relieved by the Supreme Court’s decision.

“Mifepristone and misoprostol are incredibly safe medications and access to medication abortion is critical for the continued health and safety of pregnant people in our country,” she said.

“This decision means access to abortion will continue as it currently stands, which is already significantly restricted for many pregnant people in the U.S.”

Abortion has been banned or severely restricted in a number of states following Roe’s reversal. According to the Guttmacher Institute, 14 states have total abortion bans, and seven have bans on abortion prior to 18 weeks gestation.

Abortion clinics have shuttered in regions with the tightest bans and restrictions. In states where abortion remains legal, long wait times at clinics may stretch for weeks or have no availability at all.

Meanwhile in Louisiana, the state Senate approved a bill on May 23 that made it the first state in the U.S. to reclassify mifepristone and misoprostol, another drug used to induce abortion, as controlled substances with a potential for abuse or addiction.

Possession of these medications are now considered a crime punishable by up to five years in prison and a $5,000 fine. Pregnant people would be exempt from prosecution, however.

Experts note despite the Supreme Court’s decision to preserve access to mifepristone, barriers to abortion services remain in many regions in the country.

“Even with this baseless challenge defeated, we must remain vigilant,” Lopez said. “The anti-abortion movement is ruthlessly pursuing its end goal of banning abortion nationwide. This attempt to restrict mifepristone was just one prong of a larger strategy that has already done so much damage: Two years after Roe was overturned, abortion is banned in 14 states and severely restricted in many more.”

“In the face of relentless attacks, policymakers at all levels need to keep pushing forward expansive and protective policies that ensure everyone can access abortion care using the method that best suits their needs,” Lopez added.

Prager agreed, pointing out that mifepristone access could be challenged again in the future.

“Just because these plaintiffs were found to not have standing does not mean the fight is over. I expect another case to be brought and future plaintiffs may be found to have standing and to be able to challenge mifepristone. We must continue to be vigilant about protecting the right of all pregnant people to access abortion, which protects their right to health and life,” Prager said.

In a unanimous decision, the Supreme Court struck down the mifepristone case on June 13, which will allow continued access to this commonly prescribed abortion medication.

Restricted access to mifepristone would have created barriers in many states where safe and legal abortion is banned or severely limited.

More than two decades of research show that mifepristone is a safe and effective abortion method, but the fight for abortion rights is far from over.

“We are relieved by this outcome, but we are not celebrating,” Lopez said. “From the start, this case was rooted in bad faith and lacking any basis in facts or science. This case never should have reached our nation’s top court in the first place and the Supreme Court made the only reasonable decision by leaving access to medication abortion using mifepristone unchanged.”