Access to the abortion pill mifepristone must be restricted, a U.S. appeals court ruled on Wednesday, ordering a ban on telemedicine prescriptions and shipments of the drug by mail.
Here's what the ruling from the New Orleans-based 5th U.S. Circuit Court of Appeals means for doctors and patients:
CAN PATIENTS STILL GET THE ABORTION PILL?
Yes. Mifepristone's availability remains unchanged for now, following an emergency order from the U.S. Supreme Court in April preserving the status quo during the appeal. The latest decision will not take effect until the Supreme Court reviews it, which could happen in its upcoming term from October to June.
WHAT IS MEDICATION ABORTION?
Medication abortion is a two-drug regimen consisting of mifepristone followed by misoprostol used to terminate a pregnancy within the first 10 weeks. It accounts for more than half of U.S. abortions.
Two companies sell mifepristone for medication abortion in the United States: Danco Laboratories, which sells the brand-name version Mifeprex, and GenBioPro, which sells a generic version.
WHAT IF THE RULING IS UPHELD?
If the ruling is upheld, doctors could still prescribe the abortion pill, but with restrictions. Patients would no longer be able to obtain the medication through a telehealth visit, and it could not be sent by mail.
Instead, patients would need to visit a doctor in person to be administered mifepristone, again to be administered misoprostol and a third time for follow-up. The drug would also be approved only for use in the first seven weeks of pregnancy, rather than 10 weeks.
In effect, the drug's status would return to what it was before 2016, when the FDA began relaxing restrictions around it.
WHAT WILL HAPPEN NEXT?
The decision will almost certainly be appealed to the U.S. Supreme Court, which last year overturned its landmark Roe v. Wade ruling that had legalized abortion nationwide.
WHAT IS THE LEGAL DISPUTE ABOUT?
Anti-abortion medical associations led by the Texas-based Alliance for Hippocratic Medicine sued the U.S. Food and Drug Administration last year in federal court in Amarillo, Texas. They claimed the agency approved mifepristone for abortion in 2000 using an unlawful process and did not adequately consider the drug's safety, asking U.S. District Judge Matthew Kacsmaryk to revoke the approval.
The FDA, along with mainstream U.S. medical associations, strongly disputes the claims. Danco intervened in the case to defend its drug, and GenBioPro filed a friend-of-the-court brief.
