The divisions in the United States regarding women’s reproductive rights are evident more than ever before.
Two federal judges – one in Texas and the other in Washington – pronounced contrasting rulings on a widely used abortion pill on Friday (7 April), putting its availability in limbo.
What were the rulings and how will they impact access to the most common abortion drug in the US? Let’s take a closer look.
Two judges. Two contrasting orders
Matthew Kacsmaryk, a Donald Trump-appointed federal judge in Texas, suspended the US Food and Drug Administration’s (FDA) approval of mifepristone, one of the two drugs used to terminate a pregnancy, in a preliminary injunction on Friday.
He ruled that the FDA’s 23-year-old approval of the abortion pill was improper and the government agency had not adequately reviewed its safety.
“The Court does not second-guess FDA’s decision-making lightly.” Kacsmaryk said, as per Associated Press (AP).
“But here, FDA acquiesced on its legitimate safety concerns — in violation of its statutory duty — based on plainly unsound reasoning and studies that did not support its conclusions.”
The access to abortion drug mifepristone is in jeopardy in the US. AP
This comes after anti-abortion groups led by Alliance for Hippocratic Medicine filed a lawsuit against the FDA last year, claiming the abortion drug’s safety was not properly considered in 2000 and it was approved using an unlawful process.
The FDA has rejected the charge that it had expedited the approval of the drug, which came only after four years of reviewing.
The judge also ruled that the FDA had failed to consider the “psychological effects” of mifepristone.
The FDA’s “failure [to account for this] should not be overlooked or understated”, Judge Kacsmaryk was quoted as saying by BBC.
The federal judge also gave a seven-day stay on his order to allow the government time to appeal.
Within hours of the Texas verdict, a Barack Obama-picked judge in Washington said in a separate case that the FDA must keep mifepristone available in more than a dozen states.
The lawsuit filed by a coalition of Democratic attorneys general in 17 states and the District of Columbia sought to stop the FDA from removing the abortion pill from the market, reported NPR.
In his order, US District Judge Thomas O Rice blocked the FDA from “altering the status quo and rights as it relates to the availability of Mifepristone.”
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What was the reaction?
US president Joe Biden said the ruling in Texas could have large-scale consequences.
“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,” he said in a statement.
“It is the next big step toward the national ban on abortion that Republican elected officials have vowed to make law in America,” Biden added.
Massachusetts Democratic Senator, Elizabeth Warren, condemned the Texas ruling in a tweet and said: “We can’t let one right-wing extremist overrule women, their doctors, and the scientists.”
Planned Parenthood, one of the largest pro-abortion groups in the US, called Kacsmaryk’s order an “assault” on science, according to AFP.
Jack Resneck, the president of the American Medical Association, said that judges interfering in “extensive, evidence-based, scientific review of … well-established FDA processes is reckless and dangerous,” reported AFP.
On the other hand, anti-abortion groups welcomed the Texas ruling.
“Today’s decision out of Texas is a win for the health and safety of women and girls,” Katie Glenn of Susan B Anthony Pro-Life America, was quoted as saying by AFP.
“The ruling reaffirms that pregnancy is not an illness and abortion is not health care. Finally the FDA is being held accountable for its egregious violation of its own rules.”
“The court’s decision today is a major step forward for women and girls whose health and safety have been jeopardised for decades by the FDA’s rushed, flawed and politicised approval of these dangerous drugs,” March for Life President Jeanne Mancini said, as per AP.
What do the conflicting rulings mean?
More legal battles and confusion.
The US Justice Department has already appealed to the US Court of Appeals for the 5th Circuit to seek an immediate stay of the Texas ruling. However, the 5th Circuit is known for its conservative reputation.
In case the injunction is suspended, mifepristone will continue to have FDA approval to be legally sold in the markets.
More than half women in the US depend on medication abortion. Reuters (Representational Image)
But, if the agency is ordered to revoke its approval, the abortion drug will become illegal in the US, noted Reuters.
The two duelling rulings mean the matter will likely escalate to the US Supreme Court, which last year overturned Roe v Wade which had guaranteed abortion rights across the country.
As the Texas judge’s ruling will come into effect after seven days, there is no immediate threat to mifepristone’s availability.
The Guardian reported citing legal experts that even after the seven-day stay period, the FDA is not required to implement the Texas ruling.
Amanda Allen, senior counsel and director for the The Lawyering Project, which supports abortion rights, told NPR that the two courts “could come out with two very conflicting orders, and they could impose very different obligations on the FDA that would be very untenable for the FDA to try to reconcile.”
In the US states where abortion is already banned, there will be hardly any change. While the states where abortion is legal could face issues related to access to mifepristone.
However, some abortion providers have already said they are ready to provide only misoprostol for medication abortion if mifepristone goes off the market.
The FDA had approved mifepristone in combination with misoprostol to end pregnancies until the 10th week of conception.
While misoprostol can be used alone for abortion, studies show it is less effective than the two-step regimen.
There are concerns that if mifepristone is taken off the shelves, it would enhance demand on clinics providing surgical abortion.
“The decision likely will mean uncertainty and confusion for doctors and patients”, Farah Diaz-Tello, senior counsel with the reproductive rights legal advocacy group If/When/How, told NPR.
“People who are seeking an abortion with pills … are going to find it much more difficult to do so, especially in the time period as providers figure out what they’re going to be able to do,” she added.
Diaz-Tello also said fears more people may try to induce their own abortions sans medical guidance if the widely used pill becomes unavailable.
Whatever the fate of mifepristone would be after all the legal hullabaloo ends, it would affect more than half of women in the US who terminate pregnancies through medication abortion.
With inputs from agencies
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