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SCOTUS Ruling Results in Continuation of Lax Regulations on Chemical Abortion Pill

Woman taking a white pill with a glass of water

The United States Supreme Court (SCOTUS) ruled unanimously today that the plaintiffs in a case challenging the FDA’s relaxed restrictions on a chemical abortion drug lacked standing before the court.  As we reported in December of 2023, SCOTUS agreed to hear the case brought by Alliance Defending Freedom (ADF) on behalf of the Alliance for Hippocratic Medicine and several independent physicians. The plaintiffs argued that the FDA’s reversal of important restrictions on the chemical abortion pill mifepristone were unlawful, and placed women across the country at risk for serious complications from a chemical abortion.

What Was at Stake

Specifically, in 2016, the FDA loosened restrictions on the abortion pill, allowing:

  • Prescriptions of the chemical to be made via telehealth:
  • Non-physician providers, such as physician assistants and nurse practitioners, to place orders for the drug;
  • Prescriptions up to 10-weeks gestational age of the unborn child (up from 7-weeks);
  • Elimination of the reporting of non-fatal events.

In 2021 the FDA further allowed Mifepristone to be shipped to patients through the mail, and in 2023 it permanently removed the in-person dispensing requirement. These new rules allowed for abortion on demand over the internet, prescribed by any primary care provider and obtained via the mail. The extension of the time period to 10-weeks gestation allowed for significantly more, and higher risk, abortions, while the reporting of only fatalities (as opposed to non-fatal events) misrepresented the dangers of the chemical abortion regimen. ADF argued that the FDA acted unlawfully and that their lack of safeguards placed women in greater danger with less supervision.

The Ruling from the High Court

The U.S. Supreme Court has ruled that the plaintiffs do not have standing before the court and that the federal courts are not the correct venue to dispute the FDA’s actions. In the Opinion of the Court, Justice Kavanaugh said that the correct avenue for complaints regarding federal agency decisions are through the Legislative and Executive branches of government, leaving room for the plaintiffs to continue to pursue further action through a different branch of government.

How Does This Affect N.C.?

This ruling could have direct implications in North Carolina. In a recent decision from the U.S District Court regarding the 2023 pro-life bill that tightened safeguards for women seeking a chemical abortion in N.C., a federal judge recently ruled that state leaders could not challenge rules that had been implemented and ultimately reversed by the FDA.  In the ruling, Judge Catherine Eagles wrote, “The provisions of the North Carolina law that prohibit health care providers other than physicians from prescribing the drug, require in-person prescribing, dispensing, and administering, mandate the scheduling of an in-person follow-up appointment, and require non-fatal adverse event reporting to the FDA stand as obstacles to Congress’ purpose and are preempted.”

Our Continued Hope

It was our hope that SCOTUS would have found that the plaintiffs had standing and that the FDA had acted wrongly, ultimately reinstating the original safeguards the federal agency had placed on the chemical abortion drug. Such action could have made Judge Eagles’ ruling moot and allowed N.C.’s stricter statutes to remain in place. We are disappointed with the High Court’s opinion, but will continue our work to educate and change hearts and minds until the day comes when abortion is unthinkable in our state and nation.


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