ATLANTA — Amid efforts hinder abortion access to millions of women in the U.S., the Supreme Court issued an order April 21 that {span}allows access to an abortion pill while efforts to ban the pill play out.{/span}

Its decision stems from an April 7 ruling by a federal judge in Texas to suspend the Federal Drug Administration’s approval of the abortion drug mifepristone. That same day, a federal judge in Washington issued an opposing ruling, ordering that the FDA make no change to the drug’s availability.

Subsequently, the federal government filed an appeal to the New Orleans-based 5th Circuit Court of Appeals in New Orleans asking to put the Texas decision on hold while the appeal is being heard.

The U.S. Department of Justice has also asked the Supreme Court to intervene, requesting the Court to remove restrictions of the pill by the Texas court while the lower appeals court continues to review the case.

“I do think that we’re seeing that these attempts to eradicate abortion care has not stopped a lot of people from continuing to take their reproductive health care into their own hands,” said Kwajelyn Jackson, executive director of Feminist Women’s Health Center, an abortion clinic in Atlanta.

Since the Supreme Court voted in its June 2024 Dobbs v. Jackson Women’s Health Organization decision to pivot abortion protections to the states, Jackson said the clinic reported less patients than normal, but more women coming in earlier in their pregnancy than normal amid Georgia’s ban on most abortions past six weeks.

“At the moment they get a positive pregnancy test they’re calling because they’re aware of how short of a time period they have to take action if they want to terminate their pregnancy safely,” she said.

Majority of out-of-state patients continue to come to the Georgia clinic from Alabama and Tennessee — where outright abortion bans are in place, with exceptions for medical emergencies — and other states in the Southeast.

“Traveling for abortion care, unfortunately has been somewhat of the norm for a really long time,” Jackson said. “But it is exacerbated by those states that have total bans and no exceptions that force people to leave the communities where they live in order to get health care that they need.”

Two pill combinations, mifepristone and misoprostol, are the most commonly used forms of medication for abortions for up to 10 weeks of pregnancy; however, mifepristone is being challenged in the Texas lawsuit as an unsafe drug.

Misoprostol can be used alone for pregnancy termination, and is less often used, though there are studies and evidence supporting its efficacy, Jackson said.

“So we know that even if mifepristone is not readily available or accessible, that it will not prevent medication abortion from continuing in the United States,” Jackson said. “We are a clinic that provides both medication and procedural care. We will continue to make sure that our patients have all the information and support that they need to make a decision about what kind of abortion is going to be best for them and to be able to feel like they are empowered to make their own decision.”

Republican-led states have restricted or banned abortions and have since continued efforts to restrict access to abortion pills to women in their states.

Those challenging the drug’s approval in the Texas case said a decision in favor of the federal government would “perpetuate FDA’s unlawful mail order abortion regime and result in further harms from a dangerous drug the district court found should never have been approved,” according to CNBC.

Attorneys general from more than 20 states— including in Alabama, Georgia, Mississippi, Texas, and Tennessee — have signed on to an amicus brief April 18 {span data-preserver-spaces=”true”}urging the U.S. Supreme Court to reject the FDA’s attempt to push a national mail-order abortion, a protocol the FDA has authorized since 2021 due to the COVID-19 pandemic.

At that time, FDA modified requirements for getting the pill from in-person and removed the requirement that the pill could only be dispensed in certain health care facilities. The update subsequently allowed for the pill to be dispensed by certified medical facilities via mail after a telemedicine appointment.

“The Dobbs decision, which overturned the flawed Roe v. Wade decision, rightfully gave authority back to states to protect the life of the unborn,” Alabama Attorney General Steve Marshall said. “… This attempt to create a mail-order abortion regime endangers women, violates federal law and undermines states’ authority to protect their citizens. Federal courts were right to put a hold on the FDA’s actions and this brief urges the Supreme Court to let the lower court order stand.”

After Dobbs, President Joe Biden directed his administration to ensure that abortion drugs were widely accessible; however, the attorneys general argue that the administration does not have the authority to do so.

”The Administration claims that it has the power to make abortion drugs broadly accessible despite contrary determinations by States and despite laws that States have enacted to protect life, health, and safety in the use of those drugs. … That claim is wrong,” the brief states.

The FDA suggests the abortion pills are a safe and effective way of terminating a pregnancy, reporting low numbers of hospitalizations from the pill. From September 2002 through December 2018, more than 1,000 of the 3.7 million abortion pill usages have led to hospitalization.

From September 2002 through December 2018, the FDA reports at least 24 chemical abortion (mifepristone) related deaths and nearly 100 reported uses have led to ectopic pregnancy.