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

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

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.


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Justices ask if anyone has standing to sue FDA over mifepristone

Justice Clarence Thomas asked Solicitor General Elizabeth Prelogar if there is anyone who would have have a legal right to sue in this case -- which quickly emerged as the first major topic of the court's questioning of the federal government. The FDA has claimed the current plaintiffs do not have standing, with Prelogar suggesting at the hearing that their relationship to people who use mifepristone is too speculative and remote.

Prelogar said there may be an instance where a "competing drug manufacturer might sue and claim that FDA approval of a drug creates a competitive harm or injury or injury in that sense."

Chief Justice John Roberts asked if there is a number of adverse events or a number of patients who go to the emergency room in which the arguments would change. Facing such questions, Prelogar responded by reiterating her view that these possibilities appeared to be too theoretical and detached from specific decision-making and the history of patients who have used mifepristone.


Government defends FDA's expert judgments and warns of 'grave harm' for women

Pelogar, in her opening statement, contended the anti-abortion plaintiffs have no standing and defended the FDA's approval of the drug.

She warned that the relief sought by the Alliance for Hippocratic Medicine would both "severely disrupt the federal system for developing and approving drugs" and "inflict grave harm on women across the nation."


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.


Competing protests outside the court

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

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.


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.

The FDA authorized mifepristone for medication abortion in September 2000 for up to seven weeks' gestation, which was then in 2016.

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