Mifepristone Dilemma – Balancing Autonomy and Safety in Supreme Court’s Hands

Mifepristone Dilemma – Balancing Autonomy and Safety in Supreme Court’s Hands

In a pivotal development in August 2023, the Fifth Circuit Court upheld a previous ruling demanding the reinstatement of pre-2016 restrictions on the mifepristone pill.

These restrictions, currently on hold awaiting the Supreme Court’s decision, have implications for both the FDA’s regulations and the permissible timeframe for mifepristone use during pregnancy.

Historical Context and FDA Approval:

Originally approved by the FDA for abortion in 2000, mifepristone came with dispensation restrictions aimed at averting severe side effects.

Notably, one such restriction mandated in-person prescription and dispensation.

However, in 2021, the FDA, deeming the in-person requirement burdensome on the healthcare system, decided to lift this particular restriction.

Evolving Regulations Pre-2016:

Over the years, the FDA progressively eased restrictions on mifepristone.

In 2016, the gestational limit for its usage was extended to 70 days, up from the previous seven weeks.

Simultaneously, non-physicians were granted the authority to prescribe the pill.

Fifth Circuit Court’s Affirmation:

The Fifth Circuit Court’s affirmation of the pre-2016 restrictions sets the stage for potential legal shifts in mifepristone regulations.

The Supreme Court’s pending decision will ultimately determine the fate of these reinstated restrictions and may also delineate the permissible stage of pregnancy for mifepristone usage.

Criticism and Legal Perspective:

Following the submission of briefs to the Supreme Court, Erin Hawley, senior counsel at Alliance Defending Freedom, voiced criticism against the Biden administration.

The law firm had argued the case in the Fifth Circuit Court, with Hawley denouncing the administration as “reckless.”

She emphasized the importance of women receiving ongoing care from a doctor when dealing with high-risk drugs, particularly in the context of abortion drugs.


The looming Supreme Court decision holds significant implications for the regulatory landscape surrounding the mifepristone pill.

The historical evolution of FDA restrictions, the recent Fifth Circuit Court affirmation, and critiques from legal experts collectively shape the backdrop against which the future of mifepristone regulations will be determined.