The Supreme Court extended a pause on a Texas court ruling that sought to limit access to the abortion pill on Wednesday, pushing the decision to 11:59pm on Friday, April 21, per the The New York Times.
A federal district court in Texas recently invalidated the Food and Drug Administration’s approval of the pill, per The New York Times. In response, the Biden administration appealed that ruling at another federal district court, and a panel there said the drug, mifepristone, could remain legal as the lawsuit goes through the courts. Conflicting district court orders and the appeal panel’s decision mean the case now sits at the Supreme Court.
The legal battle comes after the overturning of Roe v. Wade in June 2022. In January, the FDA actually finalized a first-of-its-kind ruling that allowed retail pharmacies to offer abortion pills in the United States, which had the potential to expand abortion access.
Retail pharmacies could complete a certification process to start providing the pills, and major chains like Walgreens and CVS said they planned on applying for and starting the certification process in states where abortion is legal, per The New York Times.
However, since last summer, lawmakers in conservative states have targeted abortion pills, and at least 24 states have already made abortion illegal or are likely to do so, per the Guttmacher Institute.
A new Supreme Court ruling on abortion pill limits may have you wondering what the abortion pill is, how it works, and if you can find it at your local pharmacy. Read on for everything there is to know about medication abortions.
Meet the experts: Kate O’Connell White, MD, is a practicing ob-gyn and an associate professor of obstetrics and gynecology at the Boston University School of Medicine. Ushma Upadhyay, PhD, is a professor for the Department of Obstetrics, Gynecology and Reproductive science at UC San Francisco. Erin Flynn is a family nurse practitioner and doctor of nursing practice at Favor.
What is the abortion pill?
The first thing to know about the abortion pill is that it’s not just one pill—it’s generally five pills consisting of two different medications.
The first medication is called mifepristone, says WH advisor Kate O’Connell White, MD, an ob-gyn and associate professor at Boston University School of Medicine. “The second set of pills are the misoprostol, where you usually take four of them roughly 24 to 72 hours after the mifepristone,” she adds.
Mifepristone can also be used to manage an early miscarriage, according to Planned Parenthood.
Misoprostol is currently widely available in pharmacies, since it has other uses such as softening the cervix for IUD insertion and preventing gastric ulcers for those who take inflammatory medication.
How does it work?
Mifepristone blocks a hormone called progesterone that is needed for a pregnancy to continue, according to the FDA. The agency has authorized the medication’s use in the first 10 weeks of pregnancy.
Misoprostol helps the uterus contract and dilates the cervix to expel the pregnancy tissue from the body, per Planned Parenthood.
What are the side effects?
Since medication abortion requires two kinds of medication, users can expect two waves of side effects.
“The most common side effects are the ones you want to happen,” explains Dr. White. After taking mifepristone, patients will start vaginal bleeding and having contractions, which will cause uterine cramping. She notes that these cramps can get severe and can be accompanied by diarrhea, low-grade fever, and chills.
“It can be scary for someone who doesn’t know what to expect,” adds Ushma Upadhyay, a professor for the Department of Obstetrics, Gynecology and Reproductive Science at UC San Francisco. “Some people also experience nausea and vomiting. Lighter bleeding can continue for two weeks or more.”
If you don’t experience side effects, reach out to your medical provider to see if you need a second dose.
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How much does the abortion pill cost?
The price will mostly depend on where you live.
In a survey of almost 800 clinics across the nation, the average cost of a medication abortion is $568, according to a report from the Abortion Facility Database Project, Advancing New Standards In Reproductive Health (ANSIRH), and the University of California San Francisco.
The same study found that clinics in the South charged around $520 while clinics in the West charged $650.
“Depending on one’s state of residence and specific policy, abortion may be covered by insurance or Medicaid,” explains Upadhyay. “Virtual clinics, also called Telehealth services, such as Hey Jane, Choix, Abortion on Demand, and Just The Pill are able to offer medication abortion at much lower prices, but they generally don’t accept insurance.”
Can I now get abortion pills at my local pharmacy?
Thanks to the March FDA ruling, any retail pharmacy can become certified to dispense mifepristone, says Erin Flynn, a family nurse practitioner and doctor of nursing practice at Favor. The ruling mostly affects mifepristone, previously only distributed by specially certified doctors, clinics, or select mail-order pharmacies.
But pharmacies likely haven’t met the new FDA regulations to have abortion pills available for distribution yet. Depending on the retailer, this process can take months to years.
“In the long term, this has the possibility of increasing access to abortion for people who don’t have an abortion provider in the neighborhood, county, city, etc., or who feel more comfortable managing the abortion on their own,” says Dr. White.
Additional reporting by Emily Shiffer.
Sabrina is an editorial assistant for Women’s Health. When she’s not writing, you can find her running, training in mixed martial arts, or reading.
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Olivia Evans (she/her) is an editorial assistant at Women’s Health. Her work has previously appeared in The Cut and Teen Vogue. She loves covering topics where culture and wellness intersect. In her free time, she enjoys cooking, running, and watching rom-coms.