A Texas federal judge on Friday suspended the marketing authorization for mifepristone, one of the two drugs used for medical abortions. The United States Medicines Agency and the Department of Justice have appealed.
The right to abortion is again restricted in the United States. A federal judge issued a decision on Friday, April 7, suspending the authorization to market an abortion pill approved for more than twenty years, and used each year by half a million American women. This decision, which could apply throughout the country, comes ten months after the historic judgment of the Supreme Court which now allows each American state to prohibit voluntary terminations of pregnancy (abortion) on its soil. How did the US government react? Is this decision irrevocable? Franceinfo takes stock.
>> Suspension of an abortion pill in the United States: “It’s a setback for women’s rights and abortion which is very important”, says a historian
1 How does the abortion pill work?
The abortion pill is used once a pregnancy is confirmed, for the purpose of aborting. This method, authorized since 2000 in the United States, actually uses two drugs. The first is mifepristone (or RU 486), which stops the development of pregnancy by acting on a hormone called progesterone. The second, misoprostol, is taken between one and two days later, and triggers contractions and bleeding to expel the fetus.
At the time of the abortion, women are at home or in a place of their choice, and not in a health facility. In the United States, this method is authorized up to 10 weeks after the last period. Abortions using mifepristone and misoprostol within the allowed time frame are very safe, and 95% effective, experts say.
More than half of abortions (53%) in the United States in 2020 were medical, according to the Guttmacher Institute (in English). This is less than in certain European countries, such as France, where this method represented 72% of abortions the same year, according to the Ministry of Health (in PDF).
2 What does this decision say?
Federal Judge Matthew Kacsmaryk on Friday suspended the marketing authorization for mifepristone throughout the United States. In practice, this decision therefore prevents the prescription of the drug. In his 67-page judgment, the magistrate validates most of the arguments in the complaint filed in November by a coalition of doctors and anti-abortion organizations against the United States Drug Administration (FDA).
Like them, he resumes studies on the risks attributed to the abortion pill although they are considered negligible by the majority of the scientific community. He also accuses the FDA of failing to follow its procedures in order to meet a political objective. “There is evidence indicating that the FDA faced intense political pressure to waive its safety precautions in order to promote the political goal of expanding access to abortion”he writes in particular.
Matthew Kacsmaryk is the only federal judge in Amarillo, Texas. By filing a complaint in this city, the opponents of abortion were therefore certain that the file would come back to him. But, at the same time, another Washington State judge ruled, in another case, that the marketing authorization for mifepristone could not be withdrawn in the 17 Democratic states that had seized it. In his decision, Judge Thomas Rice forbids the health agency from taking “any action to remove mifepristone from the market or reduce the availability of the drug”details the New York Times.
3 Who is the judge who made this decision?
Aged 45, Matthew Kacsmaryk is known for his ultra-conservative positions. Before being appointed as a federal judge by former Republican President Donald Trump in 2017, he served as a lawyer with the First Liberty Institute, an organization that defends the views of the religious right in court. For example, she has represented pastry chefs who, in the name of their Christian faith, did not want to make a wedding cake for a homosexual couple, or even a sports coach in a public school who was fired after praying with students.
In this post, Matthew Kacsmaryk, for example, denounced the historic decision of the Supreme Court to legalize same-sex marriage and opposed the use by transgender people of the toilets of the sex with which they identify..
Since taking office in Amarillo, the magistrate has mainly handled common law cases. But he proved the administration of President Joe Biden wrong in a migration case, and right a father who attacked a federal program funding the contraception of minors without the consent of their parents.
4 In what context does this decision take place?
The decision of judge Matthew Kacsmaryk is part of a global context of resurgence of the limitation of the right to abortion in recent months in the United States. It comes, in particular, ten months after a historic judgment of the Supreme Court, which allowed each American state to prohibit terminations of pregnancy on its soil. And only a few days after the decision of the State of Wyoming to ban the abortion pill.
Since the historic decision of the Supreme Court, fifteen American states have made abortion illegal and medical abortions are therefore also prohibited. Organizations have mobilized to provide abortion pills to women in these states, from abroad or from other American states. Where abortion is still legal, the FDA has eased restrictions on the use of mifepristone, allowing it to be mailed when prescribed, or sold directly in pharmacies like any other drug (and no longer delivered only in specialized establishments).
5 What are the reactions?
“This is unprecedented and deeply damaging”commented the powerful organization of American family planning, Planned Parenthood, which manages many clinics practicing abortions in the country. “We should all be outraged that a judge can unilaterally reject medical evidence” to contradict the FDA, added its president, Alexis McGill Johnson.
More than two decades ago, the FDA approved the abortion pill “based on a comprehensive review of the available scientific evidence and determined to be safe and effective for its indicated use – medical termination of early pregnancy”recalled the agency in a statement to the American media, adding that it had appealed the decision of Judge Kacsmaryk.
US President Joe Biden has also said he is determined to “combat” this decision, calling it an attempt “unprecedented to deprive women of fundamental freedoms”. “The Ministry of Justice strongly disagrees” with the decision, “he will appeal (…) and ask for a reprieve in the meantime”Minister Merrick Garland also said.
Conversely, the authors of the complaint before the Amarillo court did not hide their great satisfaction on Friday. The SBA Prolife America group hailed “a victory for the health and safety of women and girls”. Its director of political affairs, Katie Glenn, felt she had “Hopefully the dangerous disregard for women’s lives displayed by the FDA for two decades will soon be corrected”.
6 Is this decision immediately applicable?
Judge Matthew Kacsmaryk’s ruling won’t go into effect for another week regardless, as the magistrate opted to give the federal government and the FDA time to appeal. It will therefore be up to the New Orleans Court of Appeal, also known for its conservatism, to examine the case urgently. In the event of a decision similar to that rendered by Matthew Kacsmaryk, the Supreme Court will decide. However, thehe current composition of the court is clearly in favor of the conservatives, since six of the nine judges were appointed by Republican presidents.
Even if justice suspends ultimately clearance from the FDA, it would probably take several months before its decision would apply. According to health law experts interviewed by AFP, the drug regulator must follow a strict procedure before withdrawing a product from the market.
Women and doctors could in any case fall back on the second pill used during medical abortions, misoprostol, used alone in other countries. “We will not let this unfair decision prevent access to abortion pills”which via “alternative routes” will be able “always arrive in your mailboxes”also said Elisa Wells, founder of the Plan C network of information on abortion pills.