How one medication became a point of political divide 

You probably heard the term ‘abortion pill’ before you heard the word ‘mifepristone,’ a multi-purpose medication that now finds itself in the midst of a heated political debate regarding abortion access in the US.

Since the overturning of Roe v. Wade in 2022, states across the country have been introducing legislation to either expand or further constrict the rights of its citizens to access abortions. 

Even as procedural abortions were banned, as reported by Mara Gordon for NPR, those living in states with abortion restrictions could still receive medicated abortions by entering addresses in states where the procedure was legal.

One of the pills involved in medicinal abortion is mifepristone, which when taken with misoprostol can terminate pregnancy. Mifepristone blocks the hormone progesterone (necessary for pregnancy development), and misoprostol causes uterine contractions that lead to the passing of the pregnancy. 

In an effort to outlaw the use of mifepristone, a lawsuit against the FDA was filed in November of 2022 in Texas. The suit, started by religious and anti-abortion organization Alliance Defending Freedom (ADF), cites the FDA’s extension of safe mifepristone use, along with regulatory overreach as their reasons for the drug’s approval should be revoked.

Filing in Texas allowed the group to have their case heard by a known conservative and pro-life believer, federal Judge Matthew Kacsmaryk, who on April 11, 2023, ruled that mifepristone should be banned nationally because the FDA had not properly investigated the medication. 

However, on the same day, a separate suit filed in Washington saw Judge Thomas Rice rule in favor of mifepristone, telling the US government to continue its legality in 17 states and DC. 

The conflicting opinions have led to the mifepristone lawsuit being taken to the Supreme Court where Justice Samuel Alito postponed the hearing and restriction until April 19. This will give the court more time to review the case, and for proponents on both sides to submit more information. 

In the event mifepristone is banned, medication abortions will still be possible. Misoprostol alone can induce abortions, but with greater side effects like nausea, vomiting, and lengthened bleeding and cramping time, according to Gordon’s NPR article. 

Misoprostol is still safe when taken alone, but mifepristone is even safer and is considered one of the best medications for abortions– both induced and spontaneous.

The role of mifepristone in spontaneous-abortions (miscarriages) is often overlooked. When taken to help pregnant people pass miscarriages, mifepristone works the same way it does when used in medical-abortions, and lowers the risk of infection.

Despite the safety of mifepristone, lawsuits and challenges to its legality not only reduce pregnant people’s ability to utilize safe healthcare, but it could also lead to stigma, according to the Reg Review’s 2022 article, “Criminalizing Miscarriage.”  In this same article, the Review shares that pregnant people may avoid taking mifepristone because of its association with abortion. This can lead to preventable medical concerns and risks.

Mifepristone’s future is uncertain, and as an increasing amount of pro-choice and pro-life organizations begin to lobby, mifepristone’s identity will forever be one of controversy.