Supreme Court puts off any decision on access to medical abortion pill mifepristone until Friday

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The U.S. Supreme Court on Wednesday extended the temporary pause placed on restrictions to abortion pill mifepristone until Friday, putting off a decision on its future for now.

Justice Samuel Alito, who previously halted lower court rulings seeking to limit access to the controversial drug, wrote that the pause would continue until Friday at 11:59 p.m. ET.

Mifepristone was approved by the Food and Drug Administration (FDA) in 2000, and its use has been deregulated in recent years. Under President Biden, the FDA made abortion pills more widely available at retail pharmacies, including delivery by mail. 

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The Biden administration and New York-based Danco Laboratories, the maker of the drug, had asked the nation’s highest court to reject limits on mifepristone’s use imposed by lower courts, at least as long as the legal case makes it way through the courts. They say women who want the drug and providers who dispense it will face chaos if limits on the drug take effect. 

Pro-life doctors and medical groups, represented by the Alliance Defending Freedom, are challenging the drug's safety. They argue the FDA chose "politics over science" in approving the drug and urged the court to halt approval of the drug. 

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This battle over medication abortions, called chemical abortions by pro-life activists, comes less than a year after the Supreme Court overturned Roe v. Wade, ending federal protections for abortions. More than a dozen states have since moved to outlaw or heavily restrict the procedure, while others have sought to become safe havens for women seeking abortions. 

A box containing a Mifepristone tablet is seen at Blue Mountain Clinic in Missoula, Montana, on Feb. 28, 2023. (REUTERS/Evleyn Hockstein)

The case rocketed to the Supreme Court after Trump-appointed U.S. District Judge Matthew J. Kacsmaryk issued a highly controversial injunction halting the FDA's approval of mifepristone earlier this month. The order was partially overturned by the 5th U.S. Circuit Court of Appeals, but the appeals court preserved restrictions that made the drug available only to be dispensed up to seven weeks, not 10, and not by mail.

Pharmaceutical companies, leading medical organizations, former FDA officials, 250 Democratic members of Congress, Democratic-led cities and states and liberal interest groups are backing the administration and Danco. Women who say they were injured by abortion, medical groups opposed to abortion, nearly 150 congressional Republicans and Republican-led states are supporting limits on mifepristone.

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Mifepristone is taken with misoprostol in a two-drug regimen that first blocks hormones needed to keep an unborn baby alive and then causes cramps and contractions to expel the dead fetus from the mother's womb.  

Supreme Court Justice Samuel Alito. (Erin Schaff/The New York Times via AP, Pool, File)

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More than 5 million women in the U.S. have used Mifiprex to abort their pregnancies since it was approved in 2000, according to Danco. The drug is 97% effective in terminating early pregnancy, though approximately 3% of women who take it will "require surgical intervention for ongoing pregnancy, heavy bleeding, incomplete expulsion, or other reasons such as patient request," according to the manufacturer.  

The Associated Press contributed to this report.