The temple of American law, dominated by conservatives, is thus once again seized of a file on abortion, the outcome of which could not be more uncertain.

The ongoing legal battle, the latest twist in the assault on abortion rights in the United States, is about access to mifepristone throughout the United States.

In combination with another drug, this pill is used for more than half of abortions in the United States, and more than five million American women have already taken it since it was approved by the U.S. Food and Drug Administration (FDA) more than 20 years ago.

If it goes into effect, a federal appeals court ruling Wednesday would have "immense consequences for the pharmaceutical industry, women needing access to the drug, and the FDA's ability to enforce its regulatory authority," the government said.

The legal saga began last week: a federal judge in Texas, seized by anti-abortion activists, had withdrawn the marketing authorization of mifepristone. Despite scientific consensus, he considered that it posed risks to women's health.

He had set a one-week delay before his decision would apply.

Seized by the federal government, the appeals court partially overturned the judge's decision, allowing the abortion pill to remain authorized for the time being -- but he reversed the access facilities granted by the FDA over the years.

His judgment thus amounts in particular to prohibiting the mailing of mifepristone, and to return to a use limited to seven weeks of pregnancy, instead of ten.

"Chaos"

In its application, the government asks for a "stay" of the judgment of the Court of Appeal "to preserve the status quo", pending an examination of the case on the merits.

Otherwise, the restrictions, which will apply at 01:00 am on Saturday (05:00 GMT), will create "regulatory chaos".

Indeed, the boxes of pills in circulation would have different indications than those ordered by the Court of Appeal, points out the government. And changing them is a process that would take "months".

In addition, another federal judge ruled otherwise, prohibiting the FDA from changing the conditions of distribution of the abortion pill in the 17 states that initiated the appeal and the capital Washington, placing the agency in an "untenable situation", argues the government.

One of the two companies that market mifepristone in the United States, Danco Laboratory, has also asked the Supreme Court to intervene.

The fear of pharmaceutical officials, and many experts, is that this ruling could pave the way for courts to challenge other drugs -- or even vaccines.

This is the first time that a court has struck down the conditions of authorization of a drug based on an assessment of its safety, the government said in its petition, accusing the judges of going against the "scientific judgment" of the FDA.

Restricted in Florida

On Thursday, the legislature of Florida, one of the most populous US states, also passed a law banning abortions beyond six weeks of pregnancy, before most women know they are pregnant.

States have been free to legislate on the subject since the Supreme Court overturned, in a landmark decision in June 2022, federal protection of abortion, burying the landmark "Roe v. Wade" of 1973.

In fifteen states, abortion is now prohibited -- including by medical means.

However, there are roundabout channels for women in these states: organizations are mobilized to provide abortion pills from abroad or other states, and commercial sites also sell them online.

For states where abortion remains legal, if access to the abortion pill is restricted, women would still have the option of aspiration abortion -- a more cumbersome procedure requiring a clinic.

Some doctors plan to continue offering medical abortions using only the second pill, misoprostol. But this method has a slightly lower rate of effectiveness and more side effects (strong cramps ...) than the one combining misoprostol and mifepristone.

© 2023 AFP