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A Judge's Ruling Against the "Abortion Pill" Nearly Invalidated FDA Approval for Common Miscarriage Treatment, Putting Mothers at Risk

The U.S. Supreme Court blocked Texas Judge Matthew Kacsmaryk’s ruling against the “abortion pill”, which would have invalidated the Food and Drug Administration's approval of the most common miscarriage treatment mifepristone.


Mifepristone has been safely used for more than 20 years in the US to treat miscarriages, which happen in up to 30% of pregnancies. When a woman miscarries and her body does not fully pass the pregnancy, mifepristone is administered (especially early in term) to avoid the need for surgery and prevent life threatening infection.


Had the judge’s decision stood, it would have blocked access to mifepristone nationwide, leaving more than 1 million mothers suffering miscarriage each year without medical treatment. 

Typical Miscarriage Treatment with Mifepristone

An expectant mother goes in for a routine pregnancy check-up and ultrasound. Holding hands with her husband, she’s watching the nurse do the ultrasound with excitement. But when the nurse excuses herself and hurries out of the room to fetch the doctor, the mother’s heart drops. It’s not long before the doctor comes in to continue the ultrasound, before turning to the couple to explain that the baby has no heartbeat and that miscarriage is imminent. 

ultrasound miscarriage

Though the mother is devastated at the loss of her baby, she must decide how she wants to proceed. She can choose to either let the pregnancy pass naturally, which can be drawn out and dangerous, or she can choose medical treatment.

Usually, mifepristone is used to treat miscarriage in the first trimester after tests confirm the diagnosis of a miscarriage. By using mifepristone instead of waiting for the miscarriage to complete naturally, doctors can keep a better eye on the mother and help reduce the risk of sepsis.  

It also dramatically reduces the emotional trauma for the mother by allowing the miscarriage to complete and avoiding invasive surgery.


Less often, doctors prescribe misoprostol (sometimes alongside mifepristone) to induce an impending stillbirth or second-trimester miscarriage. This may happen after an ultrasound reveals a fetus with no heartbeat or otherwise definitive evidence that a pregnancy is not viable.


A two-step regimen uses both mifepristone and misoprostol because patients experience fewer side effects when the medications are combined. 


“We previously used a misoprostol-only regimen in order to medically manage miscarriage, and there is data to show that the combination regimen of mifepristone and misoprostol increases the safety and effectiveness of medication management for miscarriage,” said Jennifer Villavicencio, a leading researcher at the American College of Obstetricians and Gynecologists. 


While the media has focused on mifepristone’s use in abortions, it has ignored the pill’s incredibly important role in providing mothers suffering from miscarriage safe medical treatment. If mifepristone were to be outlawed, it would severely hamper doctors’ ability to help women experiencing one of the hardest losses imaginable. And it would limit women’s options to decide what’s best for them as they cope with the loss of their child. 

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