Texas judge, Matthew Kacsmaryk, has suspended the U.S. Food and Drug Administration's (FDA) approval of the abortion pill Mifepristone in a horror move for abortion access across the United States.

The decision will result in a nationwide ban on Mifepristone in seven days, with the FDA given one week to appeal the ruling. While the ban also affected access in states that have secured abortion post-Roe v Wade, a conflicting ruling from Judge Thomas O. Rice from a federal court in Washington state ordered the FDA to maintain access to Mifepristone in 17 democratic states and Colombia District – effectively putting access to the pill into limbo.

Mifepristone, which has been FDA-approved for more than 22 years and has a safety record of over 99%[i], is taken alongside the drug Misoprostol during medical abortion procedures. Since then, it has been used by over 5 million[ii] Americans and was used in more than half of abortions nationwide last year. While Misoprostol can be used alone in medical abortion, people should have access to the full spectrum of abortion care options.

Mifepristone is also used in the medical management of miscarriage and second and third-trimester pregnancies when the fetus has died before birth.

While the ruling does not prohibit the FDA from making a new authorization for Mifepristone, this will likely take many months. Severe disruption to abortion care services, healthcare services and supply chain issues are expected as healthcare providers and pharmacies grapple with legality, stock, retraining and reeducation.

Beth Schlachter, Director of Global Advocacy for the International Planned Parenthood Federation, said:

"For 22 years, Mifepristone has been safely used in medical abortion care across the U.S., allowing healthcare providers to deliver safe, practical and discreet care to people who have chosen to end their pregnancies, regardless of their economic status or ability to travel.

"In one fell swoop, anti-abortion extremists have once again stripped people of their rights in another blow to liberty. This horror ruling based on junk science, wilful distortion of fact and extreme political agendas will profoundly affect the lives of millions of people already struggling to access the care they need, especially in states where abortion is already banned."

Anti-abortion extremists deliberately filed the case against the approval of Mifepristone in the Amarillo division of the Northern District of Texas — a single-judge division where cases are automatically assigned to Judge Matthew Kacsmaryk, a conservative judge appointed by former President Trump.

The group claim that:

• "the statutory basis on which the FDA's approval of Mifepristone was issued 22 years ago is invalid" - an assertion both the Government Accountability Office and FDA have previously investigated and put to rest
• "an 1873 vice law that made it illegal to send "obscene, lewd or lascivious" material through the mail applies to abortion pills" - federal courts have consistently ruled it doesn't apply to lawful abortions
• "the drug's original approval wasn't supported by evidence of safety and efficacy" — a claim that medical and policy experts have continuously discredited

Beth Schlachter, added:

"The implementation of a national ban on Mifepristone via a state court debunks one of the principal anti-abortion arguments in the Roe v Wade case  - that the ruling curtailed state freedom and that abortion rights should be defined on a state-by-state basis.

"This weaponization of federal courts by anti-abortion extremists proves just how dangerous the overturning of Roe v Wade is for everyday Americans, whose access to healthcare now lies in the hands of fanatical religious extremists determined to disrupt, harass and deceive until they end access to abortion care and long-held sexual and reproductive rights for good."

The International Planned Parenthood Federation's local partner, the Planned Parenthood Federation of America, will continue to provide abortion care where safe and legal to do so. Those seeking medical abortion can also access care via AidAccess and WomenonWeb.

At least two abortion networks, Trust Women and Whole Womans Health, have also announced that they will not immediately stop prescribing Mifepristone and will await a directive from the FDA – a move known as a conscientious provision which refers to providers who continue to provide care despite the legal parameters.  

Alongside its partner and other reproductive health organizations, IPPF will keep fighting for access to abortion care, freedom from stigma and freedom from criminalization until everyone, everywhere, is free to make choices about their sexuality and well-being.

For media enquiries, please contact Karmen Ivey at [email protected] or [email protected]  

About the International Planned Parenthood Federation

The International Planned Parenthood Federation (IPPF) is a global service provider and advocate of sexual and reproductive health and rights for all. 

For 70 years, IPPF, through its 118 Member Associations and seven partners, has delivered high-quality sexual and reproductive healthcare and helped advance sexual rights, especially for people with intersectional and diverse needs that are currently unmet. Our Member Associations and partners are independent organizations that are locally owned, which means the support and care they provide is informed by local expertise and context.

We advocate for a world where people have the information they need to make informed decisions about their sexual health and bodies. We stand up and fight for sexual and reproductive rights and against those who seek to deny people their human right to bodily autonomy and freedom. We deliver care that is rooted in rights, respect, and dignity - no matter what.