Fifth Circuit Issues Decision Upholding Onerous, Medically Unnecessary Restrictions on Mifepristone

There will be no change in access to mifepristone until the case is heard by the Supreme Court

BOSTON (August 16, 2023) — The Fifth Circuit Court of Appeals issued a decision today to uphold a Texas ruling to reinstate medically unnecessary, pre-2016 restrictions on mifepristone, one of two medications taken in a typical medication abortion regimen. The Court did not uphold the entirety of Judge Matthew Kacsmaryk’s April 7 decision to completely overturn the FDA’s decades-old approval of mifepristone. There will be no changes to mifepristone access until the Supreme Court rules in the case, which will likely take place next year.

Mifepristone was approved by the FDA more than twenty years ago and has been proven to be a safe and effective method of ending a pregnancy.

If upheld by the Supreme Court, the Fifth Circuit’s ruling today would significantly restrict access to mifepristone in all 50 states by:

  • Reinstating pre-2016 FDA approval for mifepristone that permits usage of the medication up to seven weeks gestation, instead of 10 weeks gestation 

  • Reverting to mandatory in-person dispensing for mifepristone

  • Requiring patients to make three unnecessary in-person office visits

  • Preventing advanced practice clinicians, such as nurse practitioners, from prescribing mifepristone

“We are extremely disappointed that the Fifth Court upheld medically-unnecessary, politically-driven restrictions on mifepristone, but we are certainly not surprised,” said Rebecca Hart Holder, President of Reproductive Equity Now. “A rigged, far-right federal judiciary continues to play politics with our bodily autonomy and reproductive freedom. Today’s decision is yet another sign that anti-abortion forces will use any means necessary to attack abortion access nationwide, even in states like Massachusetts. The Dobbs decision was not the end of their assault and we should be clear-eyed about the looming threat. The good news is that nothing about mifepristone access will change until the Supreme Court hears this case, though we expect a showdown at the highest court.”

If the Fifth Circuit’s decision is upheld, it would significantly limit nationwide access to medication abortion, including in Massachusetts. This would also result in additional trips to the clinic for patients, disproportionately restricting access to care for both rural and low-income communities, who may not be able to afford to take time off of work or find child care in order to travel to a clinic. 

Providers who have questions about the continued use of mifepristone in Massachusetts can call Reproductive Equity Now’s Abortion Legal Hotline at (833) 309-6301.

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