Following conflicting rulings, officials say abortion pill remains ‘safe and legal’ in Michigan ⋆

The abortion pill is still accessible and legal in Michigan, officials and lawyers say, despite competing legal rulings in Texas and Washington on Friday.

On Friday, a Texas judge’s decision in Alliance for Hippocratic Medicine v. FDA revoked the U.S. Food and Drug Administration’s (FDA) two-decade-old approval of a key abortion drug, mifepristone.

Minutes later, a judge in Washington ruled that the FDA cannot change the way it regulates the drug in the 17 states — including Michigan — that had signed onto Washington v. FDA, including Michigan.

“Mife,” as the pill is colloquially referred to, blocks the effects of progesterone and is typically used as the first drug in a two-step medication abortion procedure. When the patient takes a prostaglandin drug called misoprostol (or “Miso”) 24 to 48 hours after, an abortion is induced within two to 24 hours.

U.S. Department of Justice asks appeals court to pause abortion pill ruling

Mifepristone is also approved to treat Cushing’s syndrome.

Trump-appointed U.S. District Judge Matthew Kacsmaryk gave the federal government seven days from Friday to appeal, a process which the U.S. Department of Justice (DOJ) began that same day — leaving national access to the pill in the short run unchanged in the meantime, even without the Washington ruling.

But unless a higher court stays Kacsmaryk’s ruling further, it will take effect Friday night. Michigan and 16 other Democratic-led states — Washington, Oregon, Arizona, Colorado, Connecticut, Delaware, Illinois, Nevada, New Mexico, Rhode Island, Vermont, Hawaii, Maine, Maryland, Minnesota and Pennsylvania — and the District of Columbia will not be affected.

In February, Attorney General Dana Nessel and her counterparts in the other states signed onto a brief in the Washington court case to argue that mifepristone should be kept on the market.

“Abortion remains safe & legal in Michigan. As a party to the Washington lawsuit, the court has ordered that mifepristone remain available to our state,” Attorney General Dana Nessel tweeted Friday.

Gov. Gretchen Whitmer also released a statement reassuring Michiganders that medication abortions are still available in the state, while slamming the “extreme” Texas judge for being “out-of-step with the majority of Michiganders and Americans.”

States not signed onto the Washington case will be impacted by Kacsmaryk’s ruling by Friday evening if a higher court does not take it up before then. 

The DOJ’s first step is to ask the respective circuit courts in Washington and Texas to take up the cases. The department requested on Tuesday for the higher court to stay Kacsmaryk’s ruling. The DOJ will next likely request that the Supreme Court of the United States (SCOTUS) take up both.

What happens then would depend on SCOTUS to sort out the conflicting rulings and ultimately decide what the FDA should do.

“There’s a lot going on in several federal courts right now. Everything possible is being done to appeal the decision out of Texas last week,” said attorney Mark Brewer, who represents Planned Parenthood of Michigan.

” … I suspect there will be appeals from the Washington case as well and they will all end up at some point, I think, in the United States Supreme Court.”

Of important note is that vacating the FDA’s mifepristone approval does not translate to an outright ban on the drug. The FDA only has authority to regulate a drug’s interstate commerce, meaning that it can only say whether a drug can be sold, marketed and distributed across state lines.

Neither the FDA nor any federal court have mifepristone over what states, let alone individual doctors and patients, do with mifepristone.

Mifepristone and misoprostol are typically both administered to most effectively procure a medication abortion.

The FDA approved mifepristone under the brand-name Mifeprex in 2000, and an abortion-drug regimen that has seen few deaths and a low rate of adverse events in more than two decades of use.  | Peter Dazeley/GettyImages

But misoprostol may also be used alone to procure an abortion, with a slightly lower rate of 66 to 90% effectiveness. This can be used as a backup plan for many providers if mifepristone were to be rendered completely unavailable.

Misoprostol would also be much harder to restrict via court rulings, should anti-abortion groups try to restrict it next.

Misoprostol is not subject to special protocols like mifepristone, and is also used to treat a variety of conditions outside of procuring an abortion. The drug can be used to treat ulcers, induce labor and treat postpartum bleeding.

Surgical abortions, which make up about half of abortion procedures in Michigan and nationwide, are also untouched by the current court proceedings.

“There is evidence across the country that there is widespread support for abortion. So we need to be paying attention to that and ensuring that we do everything that we can to prevent the courts from being used as a weapon against us in this moment, as they are now being used,” said Nicole Wells Stallworth, executive director for Planned Parenthood Advocates of Michigan during a virtual event Monday.

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authored by Laina G. Stebbins
First published at https%3A%2F%2Fmichiganadvance.com%2F2023%2F04%2F11%2Ffollowing-conflicting-rulings-officials-say-abortion-pill-remains-safe-and-legal-in-michigan%2F