Texas ruling would block abortion pill access nationwide. Here’s what that means in NC.
A federal judge in Texas released a ruling Friday night that overturns the federal approval of a common abortion pill, mifepristone, which would ban the medicine from being prescribed in the United States.
Mifepristone will still be available in North Carolina in the near future, as the Texas judge gave the U.S. Food and Drug Administration seven days to appeal before the ruling takes effect.
“We are reviewing the decision and awaiting further guidance from the FDA,” said Jenny Black, CEO of Planned Parenthood South Atlantic in a statement. “Medication abortion is still safe, legal, and available in Virginia, North Carolina, and South Carolina.”
Hours after the ruling, the Justice Department appealed the decision and a Washington federal judge issued a contradictory ruling in a separate case that prevents the FDA from changing the availability of mifepristone.
If the Texas judge’s unprecedented ruling is upheld, mifepristone, which is currently used in nearly 60% of abortions in the state, could be taken off the shelves. The medication is also commonly used to help manage miscarriages.
Dr. Jenna Beckham, a Raleigh abortion provider, said doctors can still use other medications to safely and effectively carry out medication abortions.
Here’s everything you need to know about how this ruling affects abortion care in North Carolina:
Medication abortion is still legal and available in North Carolina
Currently, most health care providers rely on two medications for medication abortions: mifepristone and misoprostol.
Doctors will typically prescribe mifepristone first, which blocks a hormone to stop the pregnancy from progressing, then misoprostol about a day later, which empties the uterus.
This method is extremely effective at ending pregnancy with a very low risk of major complications, the FDA and mainstream medical groups agree.
But even if mifepristone is taken off the shelves, there are other effective strategies doctors have to end a pregnancy.
This regimen typically requires patients to take 12 misoprostol pills, spaced out over several hours. This is a safe and well-studied way to end a pregnancy.
But Beckham said it is less effective than current best practices and is more likely to cause side effects like diarrhea, fever and chills.
Since the U.S. Supreme Court ended the federal right to abortion, North Carolina abortion providers have seen an influx of patients from Southern states with strict restrictions on the procedure.
Beckham said she worries how moving to a less effective abortion regimen will affect women who are unable to easily seek another abortion if the first is not successful.
“They may feel sort of forced or pressured into choosing a surgical abortion,” she said. “I don’t think the choices will feel as close to equal as they currently do for patients.”
How will this ruling affect efforts to make abortion pills more accessible?
In North Carolina, mifepristone is tightly regulated.
Among other things, state law requires that the pill be administered in-person, by a physician and after a 72-hour waiting period.
A lawsuit filed by a Triangle abortion provider in January challenged those restrictions, claiming that they were more burdensome than the regulations set by the FDA.
It’s unclear how a lawsuit predicated on FDA regulations will continue now that a federal judge has overturned those regulations.
This decision also throws the FDA’s decision to allow retail pharmacies to sell mifepristone into limbo. The Texas judge ruled that this decision, and another recent move to allow the pill to be prescribed via telehealth, was unlawful.
Dr. Beverly Gray, a Duke Health OBGYN, said even if the Texas judge’s ruling is overturned on appeal, it has already done damage by confusing patients.
“I think confusion is part of the strategy,” she said. “To make it more complicated for patients to understand what they have access to.”
Teddy Rosenbluth covers science and health care for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. The N&O maintains full editorial control of the work.
This story was originally published April 8, 2023 at 8:39 AM.
