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U.S. Supreme Court delays decision on abortion pill for two more days.

Mifepristone on box
A string of court rulings has left the future of the abortion pill uncertain. (Shutterstock)
  • Dueling federal court decisions earlier this month plunged the future of mifepristone into uncertainty.
  • The drug is used in more than half of Michigan abortions.
  • Michigan state health department director: Michiganders continue to have access to medication abortion

With the clock ticking toward its own midnight deadline, the U.S. Supreme Court on Wednesday pushed back its decision — by two days — on whether to uphold restrictions on the so-called abortion pill, mifepristone.

By Friday at midnight, the nation’s highest court will add yet another decision in what is certain to be a long road yet toward a final decision on the drug approved 23 years ago.

Justice Samuel Alito, in a two-sentence order, offered no explanation Wednesday for the delay in the closely watched case.


Also on Wednesday, the drug maker that produces the generic version of the drug, GenBioPro, sued the U.S. Food and Drug Administration (FDA), asking a court to preemptively block any limit to the FDA’s earlier approval.

Mifepristone is also known as RU-486 and sold under the brand name Mifeprex. The drug is the first half of the two-pill regimen to effect an abortion up to 10 weeks or so into a pregnancy. It blocks progesterone, triggering the lining of the uterus to break down, according to Planned Parenthood. Taken up to 48 hours later, a second drug, misoprostol, starts contractions to expel the pregnancy tissue — much like a miscarriage.

But while the U.S. medical community has for the most part accepted it as both safe and effective, a federal judge in Texas appointed by President Donald Trump ruled that the FDA erred in approving the drug in 2000 by not adequately weighing all the evidence. That ruling essentially would have ordered the drug be removed from the market. 

Given that the decision would undoubtedly be appealed, that same U.S. Court Judge Matthew Kacsmaryk put a temporary stay on his own ruling, giving the Biden administration time to file an appeal. 

On the same day, however, a federal judge in Washington state reached the opposition conclusion in a separate case. In Spokane, U.S. District Court Judge Thomas Rice ordered U.S. authorities to maintain the pill’s access without interruption.

Late Wednesday, the three-judge Fifth Circuit Court of Appeals blocked that part of Kacsmaryk’s order that would have taken the pill off the market, but let stand the FDA’s approval prior to 2016, when the agency began expanding access to the pill. That essentially rolled back the approval of mifepristone from being used up to 10 weeks of pregnancy to seven weeks. The appeals court decision also meant the drug could no longer be shipped to patients’ homes.

Under the appeals court decision late Wednesday, the abortion pill would be banned by mail-order and approved FOR USE only through the first seven weeks of pregnancy.

Michigan providers — some whose clinics provide mifepristone up to 11 weeks of pregnancy, which has been deemed safe by the World Health Organization — told Bridge they will continue providing medication abortions nonetheless, noting they can do medication abortion without using mifepristone.

Still, they also acknowledged that they continue to consult with attorneys.

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