Trump-picked judge throws US abortion pill access into jeopardy 

Roe v wade abortion rights

A Trump-nominated federal judge in Texas has ruled to suspend the approval of mifepristone, the most widely-used abortion drug in the United States.

On Friday (7 April), Judge Matthew Kacsmaryk issued a preliminary injunction ordering the Food and Drug Administration (FDA) to pause the approval of mifepristone – the pill used in more than half of medical abortions. 

An hour later, an Obama-selected federal judge in Washington state discharged a competing ruling, ordering that access to the abortion drug be protected in 17 states. It is now expected that the future of mifepristone will be decided by the US Supreme Court. 

Judge Kacsmaryk’s ruling does not immediately go into effect, allowing seven days for the federal government to appeal. 

However, his decision represents a major threat to the ability of pregnant Americans to make choices about their own bodies and could limit access to safe and effective healthcare for millions of people. 

In the lawsuit, brought by anti-choice group the Alliance for Hippocratic Medicine against the FDA, the plaintiffs argued that the safety of mifepristone had not been properly studied, citing widely disputed claims about patient safety regarding in-person dispensing and invoking an archaic 19th century law about use of the postal service to send “obscene, lewd or lascivious” items. 

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Jenny Ma, senior counsel to the Center for Reproductive Rights, described the lawsuit as “based on junk science”, and warned that the far-reaching impact of this “seeks to undermine the entirety of FDA authority over drug approval”, The Guardian reported.

In a White House-issued statement, President Joe Biden vowed that his administration would “fight this ruling” and called it “the next big step” towards a “national ban on abortion”.

Abortion rights advocates gather in front of the J Marvin Jones Federal Building and Courthouse in Amarillo, Texas, on March 15, 2023. (MOISES AVILA/AFP via Getty Images)

He said: “If this ruling were to stand, then there will be virtually no prescription, approved by the FDA, that would be safe from these kinds of political, ideological attacks. 

“It is the next big step toward the national ban on abortion that Republican elected officials have vowed to make law in America. My administration will fight this ruling. The Department of Justice has already filed an appeal and will seek an immediate stay of the decision.  

“But let’s be clear,” President Biden continued, “the only way to stop those who are committed to taking away women’s rights and freedoms in every state is to elect a Congress who will pass a law restoring Roe v. Wade.”

The American Civil Liberties Union (ACLU) described Judge Kacsmaryk’s decision in Texas as “devastating”, with the potential to “compromise the ability of people to get abortion care in every state across the country”.

In a Twitter thread, the ACLU continued: “The case to block the FDA’s approval of mifepristone, Alliance for Hippocratic Medicine v. FDA, was brought by extreme anti-abortion groups to a hand-selected, radical judge, as part of a larger campaign to ban abortion entirely nationwide.”

What is mifepristone?

Mifepristone is the most used abortion drug in the US, and widely used all over the world. It was approved by the FDA in September 2000, and has been permitted for safe and effective usage in North America for over 20 years. 

It works by blocking the hormone that is needed for a pregnancy to continue – progesterone. Mifepristone, when used in combination with another drug, misoprostol, is used to end pregnancy. 

In 2000, mifepristone – also known as Mifeprex – was approved for the medical termination of pregnancy through seven weeks gestation, extended to 10 weeks (70 days) gestation in 2016.

According to the FDA’s website, Mifepristone is safe and was approved “based on a thorough and comprehensive review of the scientific evidence presented and determined that it was safe and effective for its indicated use”.

 woman sells abortion rights themed badges in front of the Supreme Court building during the annual National Women’s March in Washington DC. (Probal Rashid/LightRocket via Getty Images)

It continues: “The FDA’s periodic reviews of the postmarketing data for Mifeprex and its approved generic have not identified any new safety concerns with the use of mifepristone for medical termination of pregnancy through 70 days gestation.” 

On Friday night, the FDA issued a statement confirming that it has appealed Judge Kacsmaryk’s decision.

It reads: “The FDA has appealed this decision. FDA approved Mifeprex more than 20 years ago based on a comprehensive review of the scientific evidence available and determined that it was safe and effective for its indicated use – medical termination of early pregnancy.

“The approval was based on the best available science and done in accordance with the laws that govern our work.

“FDA stands behind its determination that mifepristone is safe and effective under its approved conditions of use for medical termination of early pregnancy, and believes patients should have access to FDA-approved medications that FDA has determined to be safe and effective for their intended uses.”

Who are the Alliance for Hippocratic Medicine?

The Alliance for Hippocratic Medicine describes itself as “uphold[ing] and promot[ing] the fundamental principles of Hippocratic medicine”, which involves “protecting the vulnerable at the beginning and end of life” and “seeking the ultimate good for the patient with compassion and moral integrity”.

In the Alliance for Hippocratic Medicine v. US Food and Drug Administration, the anti-choice group was represented by conservative Christian legal advocacy group Alliance Defending Freedom (ADF). 

The ADF is known for working to restrict LGBTQ+ rights and expand ‘Christian practices’ in public schools and government. It played a key role in the June 2022 overturning of Roe v Wade, which removed the US-wide constitutional right to abortion. 

Since the overturning of Roe v Wade, 12 US states have introduced a near-total ban on abortion. They are Alabama, Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, South Dakota, Tennessee, Texas and West Virginia. 

In two states, North Dakota and Wisconsin, abortion is currently unavailable. Four states have gestational bans on abortion which would have been unconstitutional under Roe – Arizona, Florida, Georgia and Utah.