A protest against the abortion pill ban, in Texas in February.  image AP

A protest against the abortion pill ban, in Texas in February.image AP

What does the Texas court ruling mean for abortion rights?

Conservative Justice Matthew J. Kacsmaryk’s ruling could have major consequences, even for women in states where abortion is legal. In June 2022, the United States Supreme Court reversed the decision in the well-known case Roe v. Wade, which guaranteed the national right to abortion. Since then, a patchwork of different regulations has emerged: abortion is permitted in some states, prohibited in others, restricted in others.

Judge Kacsmaryk ruled Friday that the Food and Drug Administration (FDA) had improperly approved the abortion pill. The FDA allegedly ignored information about harmful side effects. Nor would I pay enough attention to the psychological consequences of a medical abortion. “Many women experience intense psychological trauma and post-traumatic stress from excessive bleeding and seeing the remains of their aborted child,” Kacsmaryk wrote in his verdict. According to abortion rights advocates, he used language that is common among anti-abortion activists.

Also, because Kacsmaryk voids the pill’s FDA approval, it cannot be used in states that allow termination of pregnancy. However, not much will change in the short term. The FDA will appeal, with the support of President Biden’s administration. In addition, Washington State Judge Thomas O. Rice ruled that the abortion pill must remain available in Washington itself and in 17 other states that had filed the case. Most likely, the issue will eventually end up in the Supreme Court, where conservative justices have a majority.

A mifepristone tablet.  Picture REUTERS

A mifepristone tablet.Picture REUTERS

How does the abortion pill work?

The abortion pill actually consists of two pills. The first, mifepristone, hinders the supply of the hormone progesterone, preventing the pregnancy from developing. The second, misoprostol, causes contractions in the uterus that expel the fetus. The Texas case revolved around mifepristone, but anti-abortion activists have announced they are preparing a case against misoprostol as well.

More than half of abortions in the United States are performed with pills, in the first ten weeks of pregnancy. US abortion clinics have said they can continue to prescribe misoprostol if mifepristone is banned. However, this increases the risk of complications and side effects. They can also perform more surgical abortions, but capacity is limited.

The abortion pill is a French invention that first came on the market in France in 1988. In the US, the drugs were initially banned under pressure from conservative politicians, but in 2000, the FDA approved the abortion pill. Mifepristone and misoprostol are also used in the Netherlands. Since the end of last year, GPs have also been able to provide these medicines.

Who is Judge Matthew J. Kacsmaryk?

Kacsmaryk is a conservative judge appointed by President Trump. Previously, he served as legal counsel for the First Liberty Institute, a conservative Christian organization in Texas. The case against the abortion pill was brought by a group of Christian activists. According to abortion rights advocates, they got involved in the search for judges: they deliberately went to the court in Amarillo because they knew Kacsmaryk would hear his case.

What are the political implications of this case?

They can also be big. This is the first time a judge has overturned the FDA’s evidence-based approval of a drug. According to Kacsmaryk, the FDA failed to take the necessary precautions to achieve the political objective of facilitating access to abortion.

That’s nonsense, abortion rights advocates say. The safety of mifepristone has been widely documented. The drug has been used around the world for more than twenty years without major problems. Kacsmaryk, in particular, is guilty of a political evaluation of a drug, his opponents say. By doing so, he reinforces distrust of authorities and science. That sets a dangerous precedent for future drug and vaccine testing, President Biden said in response: “If this ruling on appeal is upheld, there will be virtually no FDA-approved drug that is immune to such political attacks and ideological”.

About the Author
Peter Giesen is a foreign editor, specializing in the European Union and international cooperation. He previously was a correspondent in France. He is the author of several books.