(CTN News) – In the United States, mifepristone is one of two medications used to terminate a pregnancy, and next year, the Supreme Court will hear a case involving this approach.
As a result of state bans or limits on abortions or efforts to curb them following the overturn of Roe v. Wade in June 2022, the demand for the abortion medications mifepristone and misoprostol has increased.
The only medicine now licensed for use in abortion is mifepristone, but conservative organizations have sued to get it de-approved or to undo measures that have made it more accessible.
A case that might restrict the use of the abortion pill mifepristone and prevent its mail-order availability is set to be heard by the Supreme Court in the spring.
Requiring in-person office visits to obtain a prescription and limiting the window of opportunity to use the medicine during pregnancy are two of the limits.
A more detailed analysis of the mechanisms of action and legal hurdles encountered by mifepristone and misoprostol is presented here.
HOW DO ABORTION DRUGS WORK?
The recommended intervals between taking the prescription drugs are several days.
First, the medication mifepristone is taken orally. The medicine widens the cervix and inhibits the action of progesterone, a hormone essential for maintaining a pregnancy.
After 24 to 48 hours, you should take misoprostol, a medication that is also used to treat stomach ulcers. When put between the teeth and gums or in the vagina, the pill is meant to disintegrate. Because of the cramping and contracting it induces in the uterus, bleeding and the expulsion of pregnancy tissue occur.
Although the effectiveness of the two-drug combination is marginally higher, misoprostol is occasionally administered alone. Countries that have outlawed mifepristone seem to have a higher prevalence of that practice.
HOW ARE ABORTION DRUGS ADMINISTERED?
Medications that cause abortion are legal up until the tenth week of a pregnancy.
Prior to taking the pills, patients may have pre-medication testing, such as an ultrasound or blood work, at their doctor’s office or clinic. The medications can also be ordered during telehealth appointments and sent by mail by some providers.
More than half of the abortions in the United States involve the tablets.
WHAT ARE THE SIDE EFFECTS?
The pills are safe and effective (up to 99% effective) when taken simultaneously, according to studies and real-use evidence.
Symptoms such as queasy stomach, loose stools, and vomiting are in no way guaranteed. While some bleeding is natural, severe bleeding seldom happens and needs medical intervention.
Major problems almost never arise. Since its approval over 20 years ago, about 5.9 million women have taken mifepristone, according to the U.S. Food and Drug Administration.
The drug has been associated with 32 female fatalities, 2 of which were ectopic pregnancies (pregnancies that develop outside of the uterus).
Because many of the women who died were already dealing with other health issues or were on other medications, it is impossible to say if mifepristone was the sole cause of death.
Patients suspected of having an ectopic pregnancy or those who have an implanted intrauterine device (IUD) are not candidates for these drugs.
It is not advisable to utilize pregnancy tests immediately to ascertain the efficacy of a pharmaceutical abortion, according to Dr. Stephanie Rand, an OB-GYN from New York who is also an abortion specialist with the advocacy group Physicians for Reproductive Health.
This is due to the fact that the hormone associated with pregnancy can remain in the body for a number of weeks. According to her, the symptoms of success include bleeding with blood clots that comprise lighter colored tissue.
HOW MUCH DOES MEDICATION ABORTION COST?
price might be more than $500, though price varies by place and is comparable to abortion treatments. Different health insurance policies also cover the medications differently; some pay for them at a reduced cost or even don’t cover them at all.
Brand names for mifepristone and misoprostol include Mifeprex and Cytotec, respectively. You may get both of these medications as generics.
WHAT’S THE LEGAL STATUS OF MIFEPRISTONE?
Regardless of the legal issues, mifepristone is still fully approved. Since the drug’s clearance in 2000, the FDA and the Biden administration have stressed that several studies have verified the drug’s efficacy and safety.
Where a patient resides has a significant impact on access. Abortions, including pharmaceutical abortions, are illegal in 14 states at the present time. In addition, fifteen states have enacted legislation that restricts the distribution and prescription of mifepristone, for example by mandating an in-person consultation with a doctor.
However, because to lax regulation, some women in places that outright ban them can still get their hands on the tablets over the mail.
The current issue before the Supreme Court started in 2022 with a legal challenge by Christian conservatives who wanted to reverse the FDA’s initial approval of mifepristone.
At first, they succeeded in getting the medicine pulled from shelves after a Texas judge ruled in their favor.
However, the drug’s approval remained unchanged after an appeals court issued a decision that would undo the FDA’s 2016 and 2021 decisions that loosened the drug’s access requirements.
Those alterations are on hold until the Supreme Court deliberates the matter.
HOW COULD THE SUPREME COURT’S RULING IMPACT ACCESS?
A possible end to the drug’s mail-order availability as of 2021 if the justices take the way of those who oppose abortion. It would also reduce the use window from 10 weeks to seven weeks, a reduction from the previously permitted 10 weeks in 2016.
Among other things, women would once again be required to see a doctor in person three times before they could acquire a prescription.
And it’s possible that women need a bigger dose of the medicine than what the FDA recommends. The reason behind this is that the FDA’s decision to allow a lesser dosage would likewise be nullified by a negative ruling.
By the end of June, the case should have reached a decision by the United States Supreme Court.