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Boxes of the drug mifepristone sit on a shelf at the West Alabama Women’s Center in Tuscaloosa, Ala., on March 16, 2022.(AP Photo/Allen G. Breed)

Since the U.S. Supreme Court overturned Roe v. Wade in June 2022, 21 states have banned or restricted abortion care. Medication abortions account for over 50% of all abortions. On Dec. 8, the high court is scheduled to decide whether to take up a case filed by anti-abortion groups challenging the approval in 2000 of the abortion medication mifepristone by the U.S. Food and Drug Administration. 

In August, the U.S. Court of Appeals for the 5th Circuit in New Orleans, Louisiana, issued a ruling on mifepristone, also known under its brand name, Mifeprex. The FDA approved mifepristone in 2000 as the first part of a two-step nonsurgical abortion regimen along with a second drug, misoprostol. 

The Alliance for Hippocratic Medicine, a group of physicians and Christian medical groups that oppose abortion, has argued that the FDA should never have approved mifepristone. 

In September, the 5th Circuit Court of Appeals ruled in favor of the group, ruling that the drug was improperly approved. The FDA appealed the ruling to the U.S. Supreme Court

No date has been set for the U.S. Supreme Court to hear oral arguments in U.S. Food and Drug Administration v. Alliance for Hippocratic Medicine

In November, the attorneys general of Kansas, Idaho, and Missouri asked the U.S. District Court for the Northern District of Texas Amarillo Division to allow them to join the case as plaintiffs.  

The Alliance for Hippocratic Medicine is represented by the Alliance Defending Freedom, a Christian legal group that has won 15 cases since 2011, most notably drafting and defending legislation that led to the overturning of Roe v. Wade in June 2022 with the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, which challenged a Mississippi law banning abortion after 15 weeks of pregnancy. 

President Joe Biden has called for the Supreme Court to overturn the 5th Circuit’s ruling and remove current restrictions, as has Danco Laboratories, which manufactures mifepristone. Hundreds of scientific studies have proven the safety of mifepristone and misoprostol. 

“Denying review of the Fifth Circuit’s opinion would eviscerate the sovereign authority of states that have chosen to expand and protect access to medication abortion in their jurisdictions,” the Danco legal team argued in September

Legal experts say the Supreme Court may not make a decision in the case until 2024, but with over 20 states banning or severely restricting mifepristone, withdrawal of approval of the medication could be devastating for abortion-seekers.

“The next step…[for anti-abortion groups is] to destroy reproductive freedom in an attempt to impose a nationwide ban on mifepristone. Mifepristone is also used in miscarriage management and to treat certain hormonal disorders and endometriosis,” Ellie Rushforth, a reproductive rights attorney for the American Civil Liberties Union of New Mexico, told the New Mexico Political Report in October.

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