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Supreme Court temporarily allows Biden admin. to halt abortion pill safeguards

A welcome sign sits at the base of the steps to the U.S. Supreme Court on December 16, 2019, in Washington, D.C.
A welcome sign sits at the base of the steps to the U.S. Supreme Court on December 16, 2019, in Washington, D.C. | Samuel Corum/Getty Images

The U.S. Supreme Court on Friday temporarily lifted tighter restrictions on the abortion pill, allowing itself more time to review lower court decisions temporarily blocking the distribution of the drug by mail in response to the Biden administration removing longstanding safety protections.

Justice Samuel Alito granted the government's request for an emergency stay until Wednesday, when the full court, which has a 6-3 conservative majority, is expected to make a decision.

The temporary pause is not indicative of the court's final decision on the case, as the nation's high court issued a landmark ruling last year that abortion is not a constitutional right. 

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The FDA-approved chemical abortion regimen consists of a two-drug combination of mifepristone and misoprostol. After the FDA eased longstanding restrictions in recent years, women can use the drugs for chemical abortion up to 10 weeks' gestation, which was previously limited to seven weeks. The pills can now be prescribed following a telemedicine consultation without requiring an in-person appointment with a healthcare provider, which critics warn could put the health of women with ectopic pregnancies at risk. 

Mifepristone is the first drug in the chemical abortion regimen, which destroys the environment in the uterus and starves an unborn baby to death. Also known as chemical abortion or the abortion pill, mifepristone has emerged as a source of safety concerns for the pro-life movement. 

The Alliance for Hippocratic Medicine, the American Association of Pro-Life Obstetricians & Gynecologists, the Christian Medical & Dental Associations and four individual doctors filed a lawsuit seeking an overturning of the FDA's 2000 approval of mifepristone and the Biden administration's more recent lifting of restrictions, such as allowing the drug to be distributed by mail.

Last week, a federal judge in Texas approved the group's requests

On Wednesday, a three-judge panel on the 5th U.S. Circuit Court of Appeals had partially granted the request of the Biden administration to stay the decision by the Trump-appointed judge that suspended the FDA's 2000 approval of mifepristone. The appellate court upheld parts of the ruling striking down the relaxation of the requirements for distributing mifepristone that began in 2016 under the Obama administration and continued under the Biden administration. 

Erin Hawley, senior counsel with the legal group Alliance Defending Freedom, representing the pro-life groups that brought the legal action against the FDA, said Alito's administrative stay is "standard operating procedure whenever the Supreme Court is asked to consider an emergency request like this one."

"It gives the court sufficient time to consider the parties' arguments before ruling," Hawley said in a statement. "We look forward to explaining why the FDA has not met its heavy burden to pause the parts of the district court's decision that restore the critical safeguards for women and girls that were unlawfully removed by the FDA."

While proponents of easing restrictions on the abortion pill argue that data shows the drug is relatively safe compared to other approved drugs, the 5th Circuit panel ruled that the FDA "failed to 'examine the relevant data' when it made the 2016 major [Risk Evaluation and Mitigation Strategies] changes." 

"That's because FDA eliminated REMS safeguards based on studies that included those very safeguards," the 5th Circuit ruling states. "Imagine that an agency compiles studies about how cars perform when they have passive restraint systems, like automatic seatbelts. For nearly a decade, the agency collects those studies and continues studying how cars perform with passive safety measures. Then one day the agency changes its mind and eliminates passive safety measures based only on existing data of how cars perform with passive safety measures."

Wednesday's ruling included a picture of a "Black Box" warning on mifepristone that informs users that it can cause "serious and sometimes fatal infections or bleeding," including the possibility of "prolonged heavy bleeding." Additional potential side effects listed on the "Black Box" warning include "sustained fever, severe abdominal pain" as well as "abdominal pain or discomfort, or general malaise (including weakness, nausea, vomiting or diarrhea)."

NARAL Pro-Choice America President Mini Timmaraju, one of the nation's leading pro-abortion advocacy organizations, claims the "case should never have been heard in the first place."

"Nothing about the rulings from the lower courts' Trump-appointed judges had any basis in medical science — both are steeped in reckless disinformation and total disregard for the law," Timmaraju contends. "As this case continues, safe and effective medication abortion in all 50 states is at severe risk."

Many states with strict abortion bans also limit the availability of mifepristone, either through restrictions on who can prescribe and dispense the pill or outright bans of the pill. Abortion is banned outright in over a dozen states, and according to the Guttmacher Institute, which tracks state restrictions, 15 states require that abortion pills be provided by a physician.

Six states require the patient to have an in-person visit with a physician, while Indiana mandates that mifepristone be taken in the presence of a physician.

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