Supreme Court Rules Against Trump Judge on Abortion Pill

• The Supreme Court ruled on Friday that the abortion pill mifepristone will remain legal in the United States, at least temporarily.
• The ruling comes after a federal judge in Texas ruled in favor of a lawsuit arguing that the Food and Drug Administration didn't have the authority to approve the drug.
• Misoprostol, another drug used in abortions, also remains legal.

The Supreme Court has paused a Texas judge's attempt to revoke federal approval of mifepristone, at least temporarily preserving nationwide access to a drug used to manage abortions and miscarriages.

In a short order issued on Friday night, the court granted the Biden administration's request for a stay to the ruling from U.S. District Judge Matthew Kacsmaryk, an appointee of former President Donald Trump, while an appeal is being considered by the 5th U.S. Circuit Court of Appeals. Conservative Justices Samuel Alito and Clarence Thomas said that they would have denied the request.

The 5th Circuit previously blocked part of Kacsmaryk's ruling after a Department of Justice appeal. Some of the ruling was kept in place, tightening rules for accessing mifepristone. Friday's decision puts all of the Texas judge's ruling on hold, pending the 5th Circuit's decision on the merits of the case.

President Joe Biden celebrated the Supreme Court's pause in a statement on Friday, saying that denying the stay "would have undermined" the "medical judgement" of the Food and Drug Administration (FDA) and " put women's health at risk."

"As a result of the Supreme Court's stay, mifepristone remains available and approved for safe and effective use while we continue this fight in the courts," Biden said. "I continue to stand by the 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."

On April 7, Kacsmaryk ruled in favor of a November lawsuit filed by the anti-abortion organization Alliance for Hippocratic Medicine against the FDA. The lawsuit argued that the FDA never had the authority to approve mifepristone and that the approval should be rescinded.

In a separate ruling on the same day, U.S. District Judge Thomas Rice in Washington state, appointed by former President Barack Obama, issued a rival ruling, ordering the FDA to keep the abortion pill available in 17 states and the District of Columbia.

A final ruling in the case before the 5th Circuit, which consists largely of judges appointed by Republican presidents, could be followed by another appeal to the Supreme Court. The decision on Friday does not indicate how the nation's high court might rule on an additional appeal.

The conservative-dominated court reversed Roe v. Wade in June, granting states the power to decide on the legality of abortion. That reversal, which ended the constitutional right to the procedure, led to trigger laws automatically taking effect in some states, immediately limiting abortion access for many women nationwide.

But the abortion issue remained hotly debated across the country, specifically in the political realm. As the Supreme Court debated the Texas judge's ruling on mifepristone—and delayed its own ruling in the case by two days on Wednesday—abortion rights and women's rights groups expressed concern that a mifepristone ban would likely lead to women resorting to more dangerous ways of getting the procedure.

Rachel O'Leary Carmona, executive director of the group Women's March, called Friday's Supreme Court decision "the bare minimum" in a statement emailed to Newsweek. Carmona argued that the court "acted out of self preservation, and out of a desire to not seem as nakedly political as Matthew Kacsmaryk."

"The Supreme Court's decision to stay a ban on mifepristone was not a decision made on the merits of the case," Carmona said. "This is a moment of relief. A moment. But make no mistake, they are coming for our rights. And we will defend them."

If mifepristone is ultimately banned, it would not outlaw all drugs for abortions, but could result in more negative side effects. Mifepristone is often used as part of a two-drug regimen for medical abortions. A patient will take mifepristone, which blocks the body's production of progesterone, halting the pregnancy. Then the patient follows the dose with misoprostol, which causes the uterus to expel pregnancy tissue.

Misoprostol is not facing the prospect of a national ban. Mifepristone has been FDA-approved since 2000. Most medical experts say that the drug poses few serious safety concerns.

Doctors often use both drugs because pairing mifepristone with misoprostol lowers the risk of a patient experiencing side effects. Misoprostol can still be used by itself to complete an abortion or to manage miscarriages. It is also be used to treat stomach ulcers.

Although research shows that misoprostol-only abortions are as safe as those that also use mifepristone, the former increase a patient's likelihood of experiencing side effects such as nausea, vomiting, diarrhea and longer episodes of cramping and bleeding.

However, misoprostol-only abortions are quicker than those done with mifepristone. In the latter, patients are required to take misoprostol 24 hours after their dose of mifepristone.

Mifepristone was approved by the FDA for use in pregnancies up to 10 weeks. Misoprostol can be used for longer periods, up to 12 weeks. In states where abortions are legal past that point, doctors tend to recommend a procedural abortion to prevent excessive bleeding and cramping from using misoprostol in the second trimester. But some evidence suggests misoprostol is successful up to 22 weeks.