Latest Developments in the Abortion Pill Mifepristone Controversy

The Supreme Court has issued a full stay on the case of mifepristone on April 21, indicating that there will be no changes to the access or availability of the pill for the time being.


The issue of access to the abortion pill mifepristone is currently being contested in courts across the United States. On April 7, a Texas judge’s decision to block FDA approval of mifepristone caused confusion and controversy. Although the ruling was put on hold for a week to allow for appeals, a judge in Washington state ordered the FDA to take no action that would limit access to the pill. The conflicting rulings have created ambiguity over the status of abortion pill access.

What Is the Most Current Status of the Abortion Pill?

An appeals court recently ruled that mifepristone would remain available, but the drug could not be sent by mail. The court has ordered a rollback of the FDA’s 2016 expanded access measures, limiting the use of mifepristone to up to seven weeks of pregnancy instead of ten, and requiring the pill to be dispensed by a qualified physician. The three in-person office visits requirement will also be restored if the 2016 changes are reversed.

Where Is Medication Abortion Legal?

Medication Abortion Access by State
Source: Guttmacher Institute

Medication abortion is a two-step process that involves using mifepristone to block the hormone progesterone and misoprostol to empty the uterus. It is currently legal in most states, except for 12 states that have banned medication abortions, including Alabama, Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, South Dakota, Tennessee, Texas, and West Virginia.

Why Are the Courts Fighting About Mifepristone?

Anti-abortion groups have filed a lawsuit accusing the FDA of approving mifepristone without proper safety studies. However, the FDA reports that out of 5.6 million medication abortions, only 28 deaths have been reported, and none of these cases could definitively attribute the cause of death to mifepristone. Medication abortion with both mifepristone and misoprostol has been deemed safe in Canada since 2017.

The Supreme Court’s temporary stay order will expire on Wednesday, April 19. Justice Samuel A. Alito Jr. has ordered the anti-abortion groups challenging the FDA’s approvals of mifepristone to submit their brief by Tuesday, after which the Supreme Court will decide whether to leave the FDA approvals in place. The ongoing legal battle is likely to create further changes and updates in the coming weeks.


  1. Food and Drug Administration. Mifepristone U.S. Post-Marketing Adverse Events Summary through 06/30/2022.
  2. Medication Abortion | Guttmacher Institute
  3. Schummers L, Darling EK, Dunn S, et al. Abortion safety and use with normally prescribed mifepristone in CanadaN Engl J Med. 2022;386(1):57-67. doi:10.1056/NEJMsa2109779