Supreme Court abortion pill case ‘terrifying’ for Michigan women, Nessel says

• U.S. Supreme Court hears arguments over the abortion pill, which lawsuit claims poses health risks for women
• Major medical groups contend such arguments are based on ideology, not science
• Michigan Attorney General Dana Nessel framed the case as an attack on women’s reproductive rights

The U.S. Supreme Court heard arguments Tuesday in a case that could severely restrict abortion by pill in Michigan and across the nation. 

The high court’s pending decision — expected this summer — could limit access to abortion by medication, even in Michigan, where more than 2.4 million Michigan voters amended the state Constitution in 2022 to guarantee a right to abortion.

“It’s terrifying,” Democratic Attorney General Dana Nessel told Bridge Michigan Tuesday, referring to the pending federal court decision. “It should terrify women all over the country – even in states like ours, where we voted to ensure that we have reproductive freedom for all Michiganders.”

But others have argued that patient safety is at stake.

At issue is the abortion pill, mifepristone, the first drug first in a two-drug regimen to medically end a pregnancy. (The second medication is misoprostol.) 

Related:

• Dec. 13, 2023: U.S. Supreme Court to weigh limits on pill used in most Michigan abortions
• Nov. 8, 2023: Right to Life of Michigan lawsuit seeks to overturn abortion rights Proposal 3
• July 11, 2023: Michigan abortions for out-of-state patients jumped 66 percent last year
• April 23, 2023: Abortion access expands with online prescriptions in Michigan. Some fear risks
• Nov. 21, 2022: A Texas lawsuit could stifle Michigan access to the abortion pill

The U.S. Food and Drug Administration approved mifepristone for abortions for up to seven weeks of pregnancy in 2000. In recent years, the agency made it easier to obtain the abortion pills — allowing patients to purchase them online, for instance. It also extended the gestational age that the pills could be used for abortions — from seven to 10 weeks — while allowing medical professionals other than doctors to prescribe it. 

Conservative groups argue that the FDA erred in its original approval of mifepristone in 2000, calling into question the agency’s very regulatory authority. The state policy director for Susan B. Anthony Pro-Life America has accused the FDA of “working hand-in -glove with the abortion lobby.”

Genevieve Marnon, legislative director for Right to Life of Michigan, previously told Bridge that restricting the pill would be a win for patient safety. 

Anyone seeking an abortion should be required to see a doctor to rule out complications such as ectopic pregnancies, among other things, said Marnon.

On Tuesday, Marnon again noted the importance of the case.

The case is “not about access to abortion,” but rather “about ensuring safeguards for women taking the abortion pill – ensuring that when she takes it, she is under the care of a physician and can access medical treatment should there be any complications,” she wrote in an email to Bridge.

“Women in Michigan should be very concerned,”  Marnon added.

The FDA maintains that mifepristone is safe. 

As of Dec. 31, 2022, the agency had reports of 32 deaths since the pill was first approved in September of 2020. FDA officials say it’s unclear to what extent the drug played in those deaths because of other medical conditions, other drugs that were present in the person’s system, and a lack of information about the cases. Two cases involved ectopic pregnancy, and several involved sepsis, or wide-spread infection. 

Leading medical associations, including the American Medical Association as well as the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine, argue the abortion drugs are “safe and effective,” and concerns are “fundamentally ideological, not scientific.”

On Tuesday, the lawyer for Alliance for Hippocratic Medicine, which represents clinicians who oppose abortion and filed the original case, reportedly argued that doctors who oppose abortion are forced to choose between helping a woman with a life-threatening condition and violating their conscience in cases in which there are complications.

But the justices appeared reluctant to allow the case to upend long-standing authority by the FDA to deem what drugs are safe and effective.

In 2022, slightly more than half of abortions in Michigan were done by medication — 15,606 of 30,120, or nearly 52%, according to state data. The next most common abortion procedure was by suction curettage, in which the doctor extracts pregnancy tissue through the cervix using a tube and suction device. In 2022, 12,279 of the Michigan abortions were performed this way.

Nationally, the pill’s role has grown significantly in recent years, driven at least in part by the U.S. Supreme Court’s reversal of Roe v. Wade. That 2022 decision set off a scramble for new state laws. Some states like Michigan guaranteed abortion access and others enacted near or total bans, leaving a nation with a patchwork of wildly varied abortion laws.

That access to abortions is still being debated in court filings and at ballot boxes doesn’t surprise Paula Thornton Greear, president and CEO of Planned Parenthood of Michigan. 

The case in front of the nation’s justices is “a glaring example of how power and privilege can dictate who has control over their body and who does not,” she told Bridge. 

It also underscores the need for abortion rights supporters to vote in the upcoming presidential election, she said, adding that the case is part of a “wider effort to impose restrictions and ultimately try and ban abortion nationwide.”

That’s a sentiment Nessel echoed, telling Bridge she believed the court — containing three Republican judges picked personally by former President Donald Trump — would only stop abortion-related litigation when “abortion rights are eliminated nationwide.”

Trump has publicly toyed with the idea of implementing a 15-week federal abortion ban if reelected president. Even if he didn’t, those in his orbit have published plans which involve utilizing a century-old law to ban mailing “obscene” items — which includes abortion-inducing drugs.

On the heels of the 2022 vote in Michigan guaranteeing constitutional protections, Gov. Gretchen Whitmer signed the Reproductive Health Act, removing some long-standing restrictions on abortion access. On Tuesday, she called the case in front of the Supreme Court “politically motivated.”

Right to Life, Republican lawmakers and other abortion opponents filed suit to overturn the 2022 Michigan vote.

Meanwhile, more than 1 million abortions were reported throughout the nation in 2023 — far fewer than a peak of 1.6 million abortions in 1990, but an increase over previous years, according to Guttmacher Institute, a national reproductive rights research group.