In abortion pill hearing, SCOTUS sounds skeptical of challenge to mifepristone access

It's the first major abortion rights case since Roe was overruled.

Last Updated: March 26, 2024, 9:02 AM EDT

A high-stakes hearing played out before the U.S. Supreme Court on Tuesday in a case that could reshape abortion access nationwide.

The justices considered a challenge to the Food and Drug Administration’s regulation of mifepristone, the first pill taken in a two-drug regimen for a medication abortion, which is the most common method of abortion in the country.

It is the first major reproductive rights case before the high court since Roe v. Wade was overturned in 2022. A decision is expected by the end of June.

Mar 26, 2024, 10:06 AM EDT

Arguments are underway

Oral arguments have begun over the abortion pill mifepristone and whether the FDA lawfully relaxed restrictions on the drug to make it easier to access to end a pregnancy.

Solicitor General Elizabeth Prelogar will be the first to give an opening statement.

Mar 26, 2024, 10:05 AM EDT

Competing protests outside the court

With arguments set to begin shortly, there are large competing demonstrations outside the building.

Abortion-rights activists rally outside of the Supreme Court, March 26, 2024, in Washington.
Jose Luis Magana/AP

Small groups of pro-abortion rights demonstrators were staging sit-ins on sidewalks and roadways.

There is a heavy police presence and Capitol Police are conducting some arrests.

Abortion-rights activists rally outside of the Supreme Court, March 26, 2024, in Washington.
Drew Angerer/AFP via Getty Images

Anti-abortion rights activist rally in front of the US Supreme Court on March 26, 2024, in Washington, DC.
Drew Angerer/AFP via Getty Images

Mar 26, 2024, 9:54 AM EDT

What anti-abortion groups claim about mifepristone

The lead plaintiff, the Alliance for Hippocratic Medicine, had initially challenged the FDA’s approval of mifepristone.

But the matter before the high court now is more narrow -- whether the FDA's subsequent regulatory decisions about the drug, in 2016 and 2021, were sound.

In court filings, the Alliance Defending Freedom, a Christian conservative legal advocacy representing the plaintiffs, has claimed mifepristone is not safe and that the FDA didn't study it closely enough before it was approved.

The group also argued that the FDA’s decisions in 2016, lowering the recommended dosage and extending the use from seven weeks through 10 weeks of pregnancy, and in 2021, which permanently lifted the restriction on requiring abortion pills to be dispensed in-person, were unsound.

In January 2022, the FDA went further by allowing retail pharmacies to provide the drug too, either by mail or in person, so long as they meet certain requirements, which the plaintiffs claim violate federal laws that prohibit the distribution of chemical abortion drugs by mail.

The FDA rejects the claims, arguing that mifepristone is safe when used as indicated and directed, and that the pill went through a thorough and comprehensive review before being approved.

Mar 26, 2024, 9:23 AM EDT

What is mifepristone at center of Supreme Court battle?

Mifepristone is a drug typically used in combination with another drug, misoprostol, to induce an abortion or to help manage an early miscarriage.

The medication works by blocking progesterone, a hormone that the body needs to continue a pregnancy.

This causes the uterine lining to stop thickening and to break down, detaching the embryo. The second drug, misoprostol, taken 24 to 48 hours later, causes the uterus to contract and dilates the cervix, which will expel the embryo.

In this photo illustration, packages of Mifepristone tablets are displayed at a family planning clinic on April 13, 2023 in Rockville, Md.
Anna Moneymaker/Getty Images, FILE

However, the World Health Organization says the two drug-regiment can be taken up until the 12-week mark of pregnancy.