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Federal court ruling threatens availability of abortion medication

OHSU Center for Women’s Health reiterates safety, efficacy of mifepristone, a drug FDA-approved to end early pregnancy for more than 20 years
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More than half of the abortions performed in the U.S. are medication abortions. The OHSU Center for Women’s Health is reassuring the public that abortion is still legal in Oregon. (OHSU/Christine Torres Hicks)
More than half of the abortions performed in the U.S. are medication abortions. The OHSU Center for Women’s Health is reassuring the public that abortion is still legal in Oregon. (OHSU/Christine Torres Hicks)

Health care leaders at Oregon Health & Science University warn of potentially catastrophic effects on reproductive health care, following today’s decision by a federal judge in Texas that suspends Food and Drug Administration approval of mifepristone, which could temporarily block access to the most common method of abortion care nationwide.

An anti-abortion group filed the lawsuit in November, seeking to overturn FDA approval for the drug mifepristone, which is used to end an early pregnancy, but also has other critically important uses in the treatment of pregnancy complications.

Maria Rodriguez, M.D., M.P.H. (OHSU)
Maria Rodriguez, M.D., M.P.H. (OHSU)

“This case is not based in science. It goes against long-established and proven research and clinical knowledge that mifepristone is safe and effective,” said Maria Rodriguez, M.D., M.P.H., professor of obstetrics and gynecology in the OHSU School of Medicine and director of the OHSU Center for Reproductive Health Equity. “This is another extreme effort to limit reproductive rights, and it will have very real consequences on the health of women in this country. Whatever the outcome, OHSU remains committed to providing the full continuum of sexual and reproductive health care to all who seek it.”

OHSU has been steadfast in its position that, as an academic health center guided by a mission firmly rooted in health, science and a commitment to the well-being of all people, it will provide reproductive health care — including abortion — to all patients who seek it, and will educate the next generation of clinicians and advance groundbreaking research.

Amid uncertainty around the impacts of today’s ruling, clinicians at the OHSU Center for Women’s Health are reassuring the public that abortion is still legal in Oregon; care teams are prepared to continue to provide services; and anyone with an appointment should keep it. The team also provided answers to other common questions:

Questions and Answers

What is mifepristone?

Mifepristone is a medication typically used to bring about a medical abortion during pregnancy, as well as manage early miscarriage and other obstetrical complications. Mifepristone is currently FDA approved for use during the first 10 weeks of pregnancy. A medical provider must prescribe the drug to patients and provide counsel for safe and effective use.

How does it work?

Mifepristone is given orally during early pregnancy to induce abortion. It works by blocking a hormone called progesterone, which is needed for a pregnancy to continue. The drug is followed by a dose of misoprostol, a separate drug which causes contractions to empty the uterus.

It is safe and effective?

Mifepristone was approved by the FDA in 2000, following a thorough and comprehensive review of the scientific evidence. Since then, additional research has consistently shown abortion medications are safe and effective, with a success rate between 95% to 99% when used as indicated and directed. Additionally, it’s safer than full-term pregnancy itself, which presents many additional health risks. In fact, the United States has one of the highest rates of death and illness related to pregnancy and childbirth among developed nations, and these disparities are the greatest among people of color and those living in poverty. 

Why might someone seek a medication abortion?

How and when to have an abortion is a highly personal decision that can be dependent on an individual’s personal preferences and circumstances. Individuals may opt for a medication abortion using mifepristone because it can be done in the privacy of their own home, allowing for a safe and comfortable environment. Additionally, since the medication can be prescribed by mail, like many other prescription medications, access to mifepristone may be more feasible for those who face barriers to receiving in-person care, such as those who live in rural locations or have transportation challenges.  

What would it mean if the drug weren’t available?

More than half of the abortions performed in the U.S. are medication abortions. A ban of mifepristone removes the recommended, safest and most effective option for medication abortion, as well as for management of miscarriage and other pregnancy complications.

Alternative options exist, and providers are well-versed and ready to use these options; however, patients can be negatively impacted when care options suddenly become unavailable. The switch to alternative methods may result in different side effects; an increase in patients requiring additional in-person care; or longer hospital stays for individuals with more serious pregnancy complications. There are also clinical implications that may burden an already overburdened health care system, since the demand for in-person procedures could rise significantly and affect staffing, appointment availability and wait times for care.

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