What will happen if medication abortion challenge succeeds?
Medication abortions in the United States usually involve two different drugs.
In the latest effort to limit abortion access, opponents of the procedure are seeking to ban one of those medications. If they succeed, only one of the pills would be available, but women would still be able to get abortions.
Here’s a look at medications, efforts to curtail them and how clinics are responding.
The Food and Drug Administration regimen for medication abortions involves two drugs, mifepristone and misoprostol. The drugs can be taken at home and are used in just over half of U.S. abortions.
Mifepristone dilates the cervix and blocks the action of the hormone progesterone, which enables a pregnancy to continue. Misoprostol causes contractions that empty the uterus. Typically, mifepristone is taken by mouth first, followed by misoprostol a day or two later.
Studies show medication abortions are safe and effective, though with a slightly lower success rate than ones done by procedure in a clinic.
Mifepristone was developed in France in the 1980s as an abortion drug to be used with misoprostol. The FDA approved it in 2000. It’s indicated for use during the first trimester. It’s also approved in the U.S. to treat Cushing’s syndrome, a hormonal disorder.
Misoprostol, which is made by several companies, is approved for treating gastric ulcers. It’s sometimes used in miscarriages to help expel tissue, in addition to its use in abortions.
In countries where mifepristone is banned for abortions, misoprostol alone is often used instead. Some U.S. clinics and telehealth providers also offer misoprostolonly abortions.
In these instances, one four-tablet dose of misoprostol is typically recommended for very early abortions. Additional doses taken four hours apart are recommended for later abortions.
Medication abortions are generally less expensive than procedures. At Carafem, a reproductive health group with clinics in four states and telehealth services in 16 states, medication abortions with both drugs cost $249 or $175 with misoprostol alone when obtained through a virtual visit. Abortion procedures at Carafem clinics cost about $450, a representative said.
Since the U.S. Supreme Court overturned Roe v. Wade in June, several states have tightened restrictions on abortions. Some limits were imposed even before then. Abortions are banned or unavailable in 14 states and 14 others restrict access to medication abortion, according to the Guttmacher Institute, a research group that supports abortion rights.
In November, an antiabortion group filed a federal lawsuit in Texas seeking to ban mifepristone, claiming the FDA approved the drug 23 years ago without adequate evidence of safety. A federal judge appointed by former President Donald Trump could rule as early as Friday. If he sides with abortion opponents, access to mifepristone could be halted nationwide.
Clinics and telehealth providers already are preparing for a potential mifepristone ban by ordering more misoprostol supplies, so they can offer medication abortions with just that one drug. They’re also expecting a potential increase in demand for in-clinic procedures and are making sure they have enough staff members to handle the demand.