Op-Ed: Errington: A supreme dilemma for women’s health

By State Rep. Sue Errington (D-Muncie)

Word count: 661

In June 2022, the Supreme Court struck down Roe v. Wade, ending 50 years of federally protected access to abortions. One by one, states began to enforce abortion bans across the nation, severely limiting access to safe abortion care. Indiana Republicans were swift to act, stripping Hoosiers of their access to abortion that August.

In states where abortion bans are in effect, like in Indiana, virtual clinics have arisen as a saving grace for many women, especially women on a low-income and those in vulnerable populations. Even in a state where the procedure is banned, women can have the drug ordered online through one of these virtual clinics and have it safely delivered to them. Given that women's options are being continually placed on the chopping block, this access to the abortion medication mifepristone has proven essential.

The most recent data from the Indiana Department of Health's Terminated Pregnancy Report shows that non-surgical medical procedures are the most common type of abortion in the state. Additionally, mifepristone in combination with its counterpart misoprostol were used for all medical procedures in 2022, accounting for 5,047 abortions.

And yet, just five short months after the fall of Roe, anti-choice groups filed a lawsuit which directly challenged the Food and Drug Administration's approval of mifepristone. The lawsuit questions the legality of the FDA's relaxed prescription requirements by allowing sale of mifepristone through online vendors and by making it available to women later during pregnancy. Notably, the plaintiffs deemed the drug “unsafe” and allege that the FDA was in violation of the law when it first approved sale of the medication in 2000.

In 2023, the FDA's approval of mifepristone sales was upheld by the federal 5th Circuit Court of Appeals; however it's still too early to take a victory lap. While the initial sales approval was upheld, the three-judge panel agreed that the FDA overstepped in broadening accessibility to mifepristone in 2016 and 2021. As a result, the Court of Appeals ruled to block any further sales of the drug. Following a subsequent legal frenzy, the Supreme Court called for a pause on this ban while legal proceedings are still taking place.

Once again, the future of women's healthcare is left up to the Supreme Court to decide, and depending on their ruling, thousands of women across the country could lose access to this critical healthcare option. Mifepristone is only the first step in a two-part regimen. It is meant to be taken with the drug misoprostol. If telehealth prescriptions of mifepristone are deemed unlawful,  providers can only stock misoprostol, which is less effective on its own.

But what about the safety of dispensing this drug to women? A recent study published by Nature Medicine shows us the alleged risks don't match the plaintiff's assertions that the drug is “unsafe.” In the study, researchers examined the electronic medical records of over 6,000 patients from three telehealth providers offering medication abortion. Additionally, an opt-in survey was conducted of 1,600 additional patients. What they found is that 99.8% of these patients had no complications after using the drug.

The scientific study central to the plaintiffs' case has since been retracted, with the article's initial publisher citing a lack of scientific rigor in the study which claimed to demonstrate the supposed dangers of mifepristone.

It remains to be seen how this will all shake out, but based on the Supreme Court hearing held on March 26, it appears that the judges are hesitant to undermine the FDA and eliminate access through telehealth providers.

This case begs the question: Should the Supreme Court have the authority to overrule the FDA?

Time and time again, we have seen the Supreme Court overrule medical professionals, as is clearly evidenced by the undoing of Roe v. Wade. If the Supreme Court rules that it does in fact have the authority to override the medical expertise and experience of the agency, I am certain the results for Hoosier women will be grim.