abortion pill
A container holding boxes of Mifepristone, the first medication in a medical abortion, are prepared for patients at Alamo Women's Clinic in Carbondale, Illinois. Image Credit: REUTERS

Washington: Abortion rights supporters expressed relief on Friday after the US Supreme Court preserved access to a widely used abortion pill but warned of a long fight ahead as a legal challenge to the medication continues.

The move by the court to halt new restrictions on the drug set by lower courts was welcome news less than a year after its conservative majority upended US abortion access by overturning the landmark 1973 Roe v. Wade decision that had legalised abortion nationwide.

Abortion providers had been stockpiling the abortion pill mifepristone or planning to switch to a new regimen amid the battle over the legality of a drug used in more than half of US abortions.

Several providers said late on Friday they would pause plans to change their medication abortion protocol in light of the Supreme Court's order.

The stakes could not be higher for women across America. I continue to stand by FDA's evidence-based approval of mifepristone, and my administration will continue to defend FDA's independent, expert authority to review, approve, and regulate a wide range of prescription drugs.

- US President Joe Biden

"It's the right decision and a huge relief," said Joshua Sharfstein, a public health professor at Johns Hopkins University and a former FDA official. "The alternative would have not only undermined access to reproductive health care, it would have thrown into disarray drug regulation in the United States." Friday's order will allow mifepristone to remain available with no new restrictions while a court battle that could take months or longer plays out.

The Supreme Court did not rule on the merits of the case, however, meaning that mifepristone could still be restricted or banned at a later stage in the case.

Anti-abortion activists hold a prayer vigil
Anti-abortion activists hold a prayer vigil and news conference to call for the Supreme Court justices to "affirm the decision of Federal District Court Judge Matthew Kacsmaryk who suspended the Food and Drug Administration's approval of Mifepristone," in front of the US Supreme Court in Washington, on April 21, 2023. Image Credit: REUTERS
Biden vows to fight
US President Joe Biden pledged to continue fighting "politically-driven attacks on women's health" after the Supreme Court on Friday preserved access to a widely-used abortion drug until a lower court rules on the legal fight.

If the justices had upheld a restriction on mifepristone imposed by a lower court, it would have undermined the US Food and Drug Administration's medical judgment and put women's health at risk, Biden said.

"The stakes could not be higher for women across America," Biden said in a statement. "I continue to stand by FDA's evidence-based approval of mifepristone, and my administration will continue to defend FDA's independent, expert authority to review, approve, and regulate a wide range of prescription drugs."

Biden also pointed to the political stakes of the issue and vowed to continue pushing to preserve abortion access.

"Let's be clear, the American people must continue to use their vote as their voice, and elect a Congress who will pass a law restoring the protections of Roe v. Wade," he said.

Opponents confident

Abortion opponents said on Friday they were confident the court ultimately would rule in favour of the pill's challengers, who contend that the FDA illegally approved mifepristone and then removed critical safeguards on what they call a dangerous drug.

"What the courts will see is a drug that does not cure a disease or alleviate the symptoms of a disease," said Carol Tobias, president of National Right to Life. "It was developed to take the life of an unborn child and always has the potential to harm the mother." Several states where abortion remains legal, including California, Massachusetts and Washington, previously said they had begun stockpiling abortion drugs in advance of possible restrictions. Some Planned Parenthood clinics also said they had stockpiled at least a year's worth of mifepristone.

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California and other liberal states have promised to protect pharmacists who continue to dispense mifepristone if it is prescribed by doctors, even if FDA approval is withdrawn.

Mifepristone is taken with another drug called misoprostol to perform medication abortion in the US.

A person holds a sign in support of abortion rights
A person holds a sign in support of abortion rights at the US Supreme Court in Washington, DC, on April 21, 2023. Image Credit: AFP

Nicole Erwin, a spokesperson for Planned Parenthood Alliance Advocates and Planned Parenthood of the Great Northwest, Hawaii, Alaska, Indiana and Kentucky, said there was no longer an immediate reason to switch to a one-drug regimen using only misoprostol.

"The court ruled that access to mifepristone should remain unchanged while the case moves through lower courts, which means there is no need to move away from the current two-pill regimen," she said.

But reproductive rights supporters said they remained concerned about the future risks to access as the case returns to the lower courts that had sought to restrict it.

"We're still planning to stockpile both mifepristone and misoprostol just in case," said Josie Urbina, a physician specializing in complex pregnancy at the University of California, San Francisco, Center for Pregnancy Options.