Potential consequences of a successful challenge to medication abortion.

In recent years, medication abortions have become an increasingly popular option for women seeking to terminate a pregnancy in the United States. This method involves taking two different drugs, mifepristone and misoprostol, over the course of a few days, and can be done in the comfort of a patient's own home. However, opponents of abortion are now seeking to ban one of these medications, mifepristone, which could have a significant impact on access to abortions across the country. The Food and Drug Administration (FDA) regimen for medication abortions is a two-step process. First, mifepristone is taken to dilate the cervix and block the hormone progesterone, which is necessary for a pregnancy to continue. A day or two later, misoprostol is taken to cause contractions and empty the uterus. This process is used in just over half of all abortions performed in the United States and is generally considered safe and effective, although its success rate is slightly lower than that of in-clinic procedures. Mifepristone was developed in France in the 1980s as an abortion drug to be used in combination with misoprostol. The FDA approved it in 2000 for use during the first trimester of pregnancy. It is also approved in the U.S. to treat Cushing's syndrome, a hormonal disorder. Misoprostol, on the other hand, is made by several companies and is approved for treating gastric ulcers. It is sometimes used in miscarriages to help expel tissue, in addition to its use in abortions. If opponents of abortion are successful in their efforts to ban mifepristone, women seeking abortions would only have access to misoprostol. While this would still allow for abortions to be performed, the process would be slightly less effective and sometimes more painful. In countries where mifepristone is banned for abortions, misoprostol alone is often used instead. Some U.S. clinics and telehealth providers also offer misoprostol-only abortions, but additional doses taken four hours apart are recommended for later abortions. Medication abortions are generally less expensive than in-clinic procedures. At Carafem, a reproductive health group with clinics in four states and telehealth services in 16 states, medication abortions with both drugs cost $249 or $175 with misoprostol alone when obtained through a virtual visit. In comparison, abortion procedures at Carafem clinics cost about $450. In recent years, several states have passed laws to restrict access to abortions, and the U.S. Supreme Court overturned Roe v. Wade in June. As a result, some states have further tightened their restrictions on abortions. According to the Guttmacher Institute, a research group that supports abortion rights, abortions are banned or unavailable in 14 states, and 14 others restrict access to medication abortion. In November, an anti-abortion group filed a federal lawsuit in Texas seeking to ban mifepristone, claiming that the FDA approved the drug 23 years ago without adequate evidence of safety. A federal judge appointed by former President Donald Trump could rule as early as Friday. If the judge sides with abortion opponents, access to mifepristone could be halted nationwide. Clinics and telehealth providers are already preparing for a potential mifepristone ban by ordering more misoprostol supplies, so they can offer medication abortions with just that one drug. They are also expecting a potential increase in demand for in-clinic procedures and are making sure they have enough staff members to handle the demand.