U.S. Supreme ensures broad access to abortion pill in Michigan for now

The U.S. Supreme Court issued an order Friday evening preserving, at least for now, broad access to the abortion pill mifepristone. 

In its first abortion decision since overturning Roe v. Wade last summer, the high court’s short but eagerly awaited order provided continued availability to so-called abortion pills, which are used in more than half of abortions performed in the United States. 

The one-paragraph order puts a halt to a federal judge’s decision in Texas this month rescinding the Food and Drug Administration’s approval of mifepristone more than two decades ago. It also puts on hold recent lower-court restrictions imposed on distribution of the drug, which has been widely available online, allowing patients to receive and take the pills in the privacy of their homes.

Related: 

• Abortion pill chaos after flurry of rulings. Michigan providers say they won’t stop
• Whitmer: Abortion pill remains ‘legal in Michigan,’ despite judge’s ruling
• Abortion access expands with online prescriptions in Michigan. Some fear risks
• Gov. Whitmer signs repeal of Michigan’s 1931 abortion ban

The Supreme Court’s ruling is not the final word on the matter, however. The order merely preserves the status quo for people seeking medical abortions (in states where abortion remains legal) while an underlying suit moves forward over the medication’s safety.  

Conservative justices Samuel Alito and Clarence Thomas dissented from the Friday order approving the stay of the lower court ruling.  

Michigan Gov. Gretchen Whitmer took to Twitter to praise the ruling and condemn the anti-abortion groups that launched the legal challenge. 

“We need to be clear about why this case came before the court in the first place: a fringe, extreme minority that refuses to follow science or respect Americans’ freedoms is judge shopping to impose their agenda on women,” Whitmer wrote.

Mifepristone, also known as RU-486 and sold under the brand name Mifeprex, is the first half of a two-pill regimen intended to end a pregnancy. Meant to be taken within the first 10 or so weeks of a pregnancy, it blocks progesterone, triggering the lining of the uterus to break down. A second drug, misoprostol, taken up to 48 hours later, stimulates contractions to expel the pregnancy tissue — much like a miscarriage.

Mifepristone and misoprostol were first approved by the FDA in 2000, there is broad consensus within the U.S. medical community about their safety and effectiveness.

The pills have taken on more importance following the U.S. Supreme Court’s ruling last June in Dobbs v. Jackson Women’s Health Organization, which struck down Roe v. Wade’s finding of a federal constitutional right to abortion. Many conservative states then moved to ban or severely restrict the procedure.  

But mifepristone’s availability was thrown into question earlier this month when a federal judge in Texas with a history of fierce opposition to abortion suspended the FDA’s approval of the drug and restricted online access to it.  

Last week, a three-judge panel from the Fifth Circuit Court of Appeals blocked that part of the Texas judge’s order that would have taken the pill off the market, but imposed its own restrictions, including banning the drug online and limiting its use to just the first seven weeks of pregnancy. 

The Biden administration appealed to the U.S. Supreme Court. The high court had given itself until midnight Friday to decide whether the drug should remain widely available while the underlying suit proceeds over the medication’s safety. Friday's order did just that.

Michigan abortion providers — including some that provide mifepristone up to 11 weeks of pregnancy, which has been deemed safe by the World Health Organization — had told Bridge Michigan they would continue providing medication abortions, even if they can no longer access mifepristone, saying medical abortions can still be safely performed with just misoprostol, the second pill in the regimen. 

Shortly after the order was announced Friday, the Michigan Department of Health and Human Services issued a statement saying it “will continue to do all we can to protect and expand access to reproductive freedom.” 

MDHHS noted that the order “protects access to mifepristone, a safe and effective medication used in millions of medication abortions annually. This ruling maintains the ‘status quo’ of abortion access while the legal challenges continue to work their way through the court system.”