3 States Renew Push to Limit Access to Abortion Drug Mifepristone

States Seek Stricter Rules on Dispensing Abortion Pills

Kansas, Idaho, and Missouri are renewing their efforts to tighten access to the abortion medication mifepristone. The three states filed a legal request on Friday to reinstate stricter guidelines that would require in-person doctor visits and limit the use of the drug to the first seven weeks of pregnancy, down from 10 weeks. The filing also seeks to reverse federal changes that allowed mifepristone to be dispensed via mail without the need for a doctor’s visit.

New Filing Follows Supreme Court Ruling

The states are pursuing this case through a federal court in Texas, where the lawsuit was returned after the U.S. Supreme Court unanimously agreed in June to maintain federal rules that expanded access to mifepristone. The high court ruled that anti-abortion doctors and their organizations lacked the standing to challenge the FDA’s approval of the drug but left the door open for states to pursue their own legal challenges.

Kansas, Idaho, and Missouri argue that access to mifepristone undermines their state laws restricting abortion and complicates law enforcement efforts. Their filing calls for a return to pre-2016 FDA regulations, which limited mifepristone’s use and required three in-person doctor visits.

Expanding Medication Access

Mifepristone, typically used in combination with misoprostol, has become the most common method of abortion in the U.S., particularly after the 2022 Supreme Court ruling that overturned Roe v. Wade and allowed states to implement abortion bans. The drug accounted for nearly half of all U.S. abortions before the ruling and is now involved in nearly two-thirds of abortions nationwide. This expanded access, particularly via telehealth services, has led to a slight increase in the number of monthly abortions since Roe was overturned.

Providers in states with more lenient abortion laws continue to prescribe mifepristone to patients in states with stricter bans, using legal loopholes to protect themselves from prosecution. Groups like Aid Access, which help women access the medication, have criticized the states’ renewed efforts. Dr. Rebecca Gomperts, founder of Aid Access, called the legal filing “full of lies” and noted that telemedical abortions for pregnancies up to 13 weeks are as safe as in-clinic procedures.

FDA Affirms Safety of Mifepristone

Over the years, the FDA has eased restrictions on mifepristone, citing numerous studies that reaffirm its safety and efficacy. In 2021, the FDA allowed the drug to be sent through the mail and eliminated the requirement for in-person doctor visits. Anti-abortion advocates argue that loosening these restrictions has led to an increase in “emergency complications,” though medical professionals dispute these claims.

According to OB-GYNs, serious adverse events related to mifepristone are rare, occurring in approximately one out of every 300 patients. A legal brief filed by medical organizations, including the American College of Obstetricians and Gynecologists, stated that most emergency room visits following a medication abortion result in observation or minor care, not major medical intervention.