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Washington, USA: Abortion supporters before the Supreme Court

Photo: Amanda Andrade-Rhoades/dpa

Nearly two years after the end of nationwide abortion rights in the United States, access to a widely used abortion pill is under scrutiny. In a hearing, the judges of the Supreme Court expressed doubts about the arguments of abortion opponents who want to impose severe restrictions on access to the pill mifepristone. The court will not announce its final decision for a few weeks. If the Supreme Court restricts access to the drug, this would apply nationwide - including in states where abortion is legal.

Access would be massively restricted

Mifepristone is used in more than 60 percent of abortions performed in the United States. The drug was approved in the USA in 2000 and is considered reliable by the US Food and Drug Administration (FDA). Mifepristone is usually used together with the drug misoprostol for abortion, but can also be used alone. According to the World Health Organization (WHO), the combination of both drugs is slightly more effective. In recent years, the FDA has issued several access waivers for mifepristone. These include, among other things, taking it up to the tenth week of pregnancy and sending it by post within the USA.

If the Supreme Court of the United States were to withdraw these reliefs, those affected would no longer be able to have mifepristone prescribed via telemedicine, for example, and would only be able to take it up to the seventh week of pregnancy. The pill can only be prescribed by doctors and no longer by other medical professionals. This would massively restrict access, particularly for many women who live in states where abortions are largely banned. You would sometimes have to travel long distances to get a prescription for mifepristone in person. In the USA, many people neither have the time nor the money to do this.

Number of abortions increased nationwide – despite restrictions

The Supreme Court has an ultra-conservative majority and has moved far to the right under former President Donald Trump. Only three of the nine judges are considered liberal. The court triggered a political earthquake almost two years ago when it overturned the nationwide right to abortion that had existed for around 50 years. As a result, state parliaments can regulate by law whether and under what conditions abortions are permitted. Since then, a number of Republican-governed states have largely banned abortions - a legal patchwork has emerged.

However, in the year following the Supreme Court's historic decision, the number of abortions increased nationwide. The number rose particularly in states bordering states with strict bans. One can only speculate about the reasons for this increase. One possible explanation is that clinics increased capacity to provide legal abortions in response to the ruling and the issue received widespread attention. In states with strict restrictions, the number has decreased as expected.

The religious right has been trying to restrict abortion rights in the United States for decades. The Supreme Court's ruling in 2022 was their greatest success - but is not the end of their efforts to restrict access to abortion. This is shown by the current case in which abortion opponents sued against the approval of mifepristone. Opponents of the drug argued, among other things, that doctors could be forced to prescribe the drug in certain cases - and that it was also too dangerous.

During the hearing, a majority of the justices made it clear that they were not convinced that the plaintiffs had even adequately demonstrated their standing to bring the case. They emphasized that the FDA has the authority to approve medications. However, the arch-conservative Justice Samuel Alito brought up the so-called “Comstock Act”. It once prohibited the sending of pornographic content by post and until 1971 also applied to contraceptives, but is no longer enforced. In this context, Alito spoke of a “significant” legal regulation.

There is currently a lot of focus on the Supreme Court. After it overturned nationwide abortion rights, critics questioned its legitimacy. US President Joe Biden's Democrats were recently able to score points with voters on the issue of women's physical self-determination. A majority of people in the United States support abortion rights, polls show.

The hearing was accompanied by protests outside the court. "People must have the opportunity to decide for themselves what is best for them at a given time," said 60-year-old demonstrator Jennifer in front of the court. She hopes that the Supreme Court will conclude that the FDA is a capable body of experts and makes decisions based on science. The 25-year-old abortion opponent Savannah Rose Deterich, however, said: "I believe that the right to life is the most important of all human rights and that it is the most valuable gift we have been given."

lph/dpa