Texas judge rules states can revive challenge to abortion pill

null / Credit: Brian A Jackson/Shutterstock

CNA Staff, Jan 17, 2025 / 17:35 pm (CNA).

A federal judge in Texas ruled that three other states can join a case challenging online prescriptions of the abortion pill mifepristone.

Trump-appointed Judge Matthew Kacsmaryk of Amarillo, Texas, ruled Thursday that Idaho, Kansas, and Missouri can pursue legal action to prohibit the Food and Drug Administration (FDA) from allowing online prescriptions.

In the order, Kacsmaryk cited concerns that the FDA regulations could “undermine state abortion laws and frustrate state law enforcement,” ruling that the states shouldn’t be prevented from suing in Texas just because they’re outside of the state.

The states want the FDA to prohibit telehealth prescriptions for mifepristone and require three in-person doctor visits — rather than none — to obtain a prescription. The states also want to limit the use of the pill from the current 10 weeks’ gestation to seven weeks.

A chemical abortion takes place via a two-pill regimen. The first pill, mifepristone, kills an unborn child by blocking the hormone progesterone, cutting off the child’s supply of oxygen and nutrients. The second pill, misoprostol, is taken between 24 to 48 hours after mifepristone to induce contractions and expel the child’s body.

Chemical abortions carry risks for women, with 15% of women experiencing hemorrhaging and 2% experiencing infection. A chemical abortion has a complication rate four times that of a surgical abortion, according to a study by the Charlotte Lozier Institute. 

A coalition of doctors in 2022 challenged the FDA’s regulation of the abortion pill due to safety concerns. The Alliance for Hippocratic Medicine, the American Association of Pro-Life Obstetricians and Gynecologists, the American College of Pediatricians, and the Christian Medical and Dental Associations claimed in the lawsuit that the FDA ignored safety regulations to approve the abortion pill regimen, but the U.S. Supreme Court ruled in favor of the FDA in 2024, saying that they lacked the legal right to sue.

Most abortions in the U.S. in recent years are chemical abortions via the abortion pill regimen. Doctors and pro-life advocates have voiced concerns about the safety of chemical abortion, especially when prescribed via telemedicine without a medical examination. 

In the U.S., abortion pills are illegal in 18 states and limited in 11. Louisiana last year classified the drugs as “controlled dangerous substances.” 

The ruling comes shortly before the inauguration of President-elect Donald Trump, who has committed to keeping abortion pills accessible during his second term, raising criticism from pro-life advocates who hope the new administration will increase safety regulations around chemical abortions.