This week a federal Texas judge could stop over half of the abortions happening in the country in what may be the most consequential abortion ruling since the reversal of Roe v. Wade.

U.S. Judge Matthew Kacsmaryk for the Northern District of Texas is set to issue a decision in the Alliance for Hippocratic Medicine’s (AHM) suit against the Federal Drug Administration that alleges the agency ignored its own research and testing standards when approving the abortion drug mifepristone. 

AHM and several other medical organizations and doctors are represented in this suit by the legal group Alliance Defending Freedom (ADF).

ADF senior counsel Erik Baptist told CNA that unborn babies are not the only ones harmed by chemical abortion. Baptist said that at least 1 in 6 women experience severe medical complications because of using chemical abortion drugs.

“The regimen that the FDA has currently approved is inherently dangerous because it allows a woman to self-administer and induce labor and delivery, in an abortion context, in her home, in her bathroom, in her dorm room, in a hotel room without any medical supervision,” Baptist told CNA. 

“It’s inherently going to create a situation where there’s going to be potential for life-threatening infections, severe hemorrhaging, and bleeding … Therefore, it’s an inherently dangerous drug,” he said.

“This case is focused on protecting the health, welfare, and safety of women and girls who take chemical abortions because the FDA failed to follow the science and follow the law when approving and taking away basic protections for women and girls who do take these drugs,” Baptist said.

If Kacsmaryk, a Trump appointee, rules against the FDA, the administration could be forced to rescind its approval of the drug, bringing its legal distribution to a halt across the country, even in states where abortion remains legal.

Mifepristone is the first of two drugs used in chemical abortions, which account for 53% of all abortions in the country, according to the Guttmacher Institute

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The drug works by cutting off nutrients necessary for a fetus to continue developing. A second drug, misoprostol, is then ingested 24 to 48 hours later and induces contractions that expel the dead unborn child.

Though first approved in 2000 and commonly used throughout the country today, ADF argues that the FDA’s authorization of mifepristone was given for political reasons, while ignoring the administration’s own research and testing standards. ADF further argues that the FDA never conducted thorough tests on mifepristone’s effect on minors, directly harming young girls across the nation who use the drug to this day. 

Dr. Ingrid Skop, an OB-GYN and director of Medical Affairs at the Charlotte Lozier Institute, told CNA that “chemical abortion pills are far more dangerous than surgical abortion. They are far more dangerous than the abortion industry has told the American public.”

“Most of the studies to get published about abortion are published by researchers associated with the abortion industry. And they ignore the known fact that we cannot do a reference linkage study to determine all the complications,” Skop explained. “So, when they report complications, they’re only reporting complications they know about. But the reality is women who have complications often do not return to the abortion provider because they’re surprised to have a complication because they’ve been told that there are hardly ever any complications.”

“Just a couple of weeks ago I cared for a woman that I needed to do surgery on who had a chemical abortion complication,” Skop said. “Women are being hurt physically, and they’re being hurt emotionally and mentally.”

Though a ruling against the FDA could block the legal distribution of mifepristone, that result might only be temporary. 

The Biden administration has already announced it plans to fight any ruling against the FDA’s approval of mifepristone. Any appeals will go to the U.S. 5th Circuit Court, which upheld the Texas Heartbeat Act in 2021 and other key pro-life laws, suggesting that this case may advance even further to the Supreme Court. 

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Vice President Kamala Harris decried ADF’s lawsuit last Friday, saying “this is not just an attack on women’s fundamental freedoms. It is an attack on the very foundation of our public health system.”

A representative for Biden’s Health and Human Services told the Washington Post over the weekend that “mifepristone went through a rigorous and evidence-based approval process,” adding that they “will continue to use every tool we have available to protect access to reproductive health care.”

This is a developing story.