What to know about mifepristone, the abortion pill the Supreme Court just ruled to protect

A pack of mifepristone.
What to know about the abortion pill mifepristone. (Getty Images)

The Supreme Court ruled unanimously on Thursday to protect access to mifepristone, one of two drugs used in the majority of medication abortions. Access to mifepristone has been on shaky ground since the overturning in 2022 of Roe v. Wade, the Supreme Court ruling that protected access to abortion in the United States.

According to the Guttmacher Institute, medication abortion is the most common abortion method in the U.S., surpassing surgical abortions for the first time in 2020. Mifepristone is currently in the middle of a political tug-of-war, with some conservative states seeking to restrict or eliminate access to the abortion pill, while other states are trying to protect and expand access. Also, the Biden administration has recently allowed certified pharmacies to dispense medication abortion. Here’s what you need to know.

💊 What is mifepristone?

Mifepristone is a medication that effectively blocks the hormone progesterone and can be used, in combination with misoprostol, to end a pregnancy up to the first 10 weeks of gestation. “When someone first gets pregnant, there are a lot of changes in hormones, and one of the most important hormones at the beginning of a pregnancy is progesterone,” Dr. Jessica Shepherd, an ob-gyn, tells Yahoo Life. Shepherd explains that progesterone helps sustain a pregnancy, while mifepristone has “an anti-progesterone effect,” essentially blocking the hormone “from doing what it needs to do early in pregnancy, so it can’t sustain the pregnancy.”

Mifepristone is “exceptionally safe,” says Shepherd, noting that the drug has been approved by the Food and Drug Administration since 2000. “It’s been used for decades,” she notes. “It’s approved in nearly 100 countries.” Women’s health expert Dr. Jennifer Wider agrees, telling Yahoo Life, "Many, many studies have fully established the safety and efficacy of mifepristone.”

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🏥 What’s happening with CVS and Walgreens selling abortion pills?

On March 1, CVS and Walgreens — two of the largest pharmacy chains in the U.S. — announced that they would soon start selling mifepristone via a prescription in states where it’s legal to do so. Walgreens is now dispensing the medication at select certified locations in more than 20 states. CVS Health locations in select states, including Rhode Island and Massachusetts, are also currently dispensing mifepristone.

The Biden administration called the move “an important milestone in ensuring access to mifepristone.” Many experts applaud the decision. “I think it’s good news and helps ensure women’s reproductive rights,” says Wider. Shepherd says that the move clearly shows that Walgreens and CVS are “making a stance toward, how can we get women the care they need? It’s so imperative and so overdue. I look forward to seeing where it’s going and am hopeful it will expand to other states as well.”

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⚖️ What’s happening with the Supreme Court and mifepristone?

After a federal judge in Texas ruled to suspend the FDA’s approval of mifepristone in April 2023, which would have pulled the drug off the market, there’s been an ongoing legal battle over access to the medication. In August 2023, an appeals court in New Orleans upheld some restrictions to the abortion pill — essentially banning telemedicine prescriptions and mail delivery of mifepristone. However, that ruling was put on hold until the Supreme Court could weigh in, allowing in the meantime access to the drug in states where abortion is legal.

On Dec. 13, 2023, the Supreme Court agreed to hear appeals from the Biden administration and mifepristone manufacturer Danco Labs, both of which sought to reverse those restrictions. The court started hearing arguments on March 26, marking the first time Supreme Court justices weighed in on abortion since overturning Roe nearly two years ago. On June 13, justices ruled unanimously to protect access to mifepristone. The justices ruled that the groups who brought the case against mifepristone had no legal standing to sue over the FDA's approval of mifepristone, the Associated Press reported.

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🛎️ Why it matters

Experts say that patients should have access to mifepristone, with Shepherd calling it a “reproductive justice issue.” She notes that “obstacles have been put in the way” of abortion access in states with restrictions and that access to the medication provides “ways for people to make decisions for themselves.”

Wider agrees, saying: “Access to mifepristone is very important because its use accounts for more than half of medical terminations across the country, and it’s safe and effective.” She adds: “It allows women to make these choices without putting themselves at risk.”

This article was originally published on March 1, 2024, and has been updated.