What does mifepristone entail?
Mifepristone, previously approved in the United States, has demonstrated both safety and efficiency over the years. Opponents of abortion have claimed the drug is dangerous and that the FDA did not conduct thorough enough reviews before approving it. A lawsuit was filed by anti-abortion doctors and medical institutions, asserting that the FDA breached the law in its management of mifepristone. Had the verdict in the 5th Circuit prevailed, the availability of mifepristone for telehealth medication abortions would likely have been jeopardized, potentially impacting abortion accessibility even in states where it's authorized.
The Supreme Court decided on Thursday that the anti-abortion doctors and medical organizations involved in challenging mifepristone's access lacked the legal authority to bring a case. The court's judgement might leave room for more challenges involving mifepristone in the future.
Understanding How Mifepristone Functions
Mifepristone is the other pill used in a medication abortion, as opposed to a surgical procedure. Additionally, it is known as "RU-486" or "Korlym" and is available under brand name "Mifeprex."
Mifepristone obstructs the hormone progesterone, which contributes to the maintenance of the uterine lining and allows for continuation of a pregnancy. The healthy uterine lining sustains the fertilized egg, embryo, and fetus.
When progesterone is blocked, the uterus expels its contents.
A person undergoing a medication abortion would take mifepristone and then, after 24 to 48 hours, take misoprostol. The latter aids in emptying the uterus via heavy bleeding and muscle contractions.
Both pills can be taken as soon as someone learns they are pregnant and up to 70 days or less since their last period.
Medication abortion using this method is 99.6% successful in terminating pregnancies, according to studies.
Mifepristone's Safety Record
Data from numerous studies and 23 years of legal use indicate that mifepristone is highly safe and effective, according to 12 of the nation's leading medical associations, including the American College of Obstetricians and Gynecologists and the American Medical Association, who signed an amicus brief in the Texas case. This method for abortion is also available in over 60 other countries.
Since mifepristone's US approval in 2000, there have been only 5 deaths associated with every 1 million people who used it, which equates to a 0.0005% death rate.
Mifepristone's safety is comparable to that of over-the-counter pain relievers like ibuprofen and acetaminophen, as per various studies.
CNN's data analysis indicates that mifepristone is even safer than many common prescription medicines. The risk of death from penicillin, an antibiotic utilized to treat bacterial infections such as pneumonia, for instance, is four times greater than with mifepristone. The death risk while taking Viagra—used to address erectile dysfunction—is almost 10 times higher.
Potential Adverse Effects of Mifepristone
Mifepristone typically doesn't have severe side effects, but any drug can induce minor, transitory effects.
Mifepristone side effects may consist of dizziness, weakness, vomiting, headache, diarrhea, nausea, and fever or chills, according to the FDA.
Major adverse events such as blood loss, hospitalization, or a drastic infection occur in less than 0.3% of patients, reports the amicus brief written by medical associations.
The Frequency of Mifepristone Usage
The mifepristone-misoprostol combination is the most common abortion method in the United States.
Guttmacher Institute's data, a research and policy organization advocating for sexual and reproductive health that supports abortion rights, reveals that this method has been increasingly widespread in the two decades since its availability, increasing from fewer than ten percent in 2001 to 53% in 2020 and 63% in 2023.
Leave Mifepristone Aside
Regardless of the mifepristone ruling, misoprostol would still be accessible and might be used on its own for medication abortions.
Misoprostol's only FDA-approved usage is for treating and preventing gastric ulcers. Off-label, some doctors utilize it singularly for an abortion and even for other off-label obstetric or gynecological purposes, such as inducing labor.
Studies show that misoprostol alone is effective and safe for terminating pregnancies in the first trimester. However, the classic two-drug combination is considered more effective.
The review of numerous studies suggests that approximately 78% of people who solely took misoprostol experienced complete abortions, with more than 93% of pregnancies terminated efficiently. At most, 0.2% of instances experienced severe complications necessitating a transfusion or hospitalization.
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When people use misoprostol alone for a termination, they may require a higher dosage for it to be effective, and the adverse reactions could be more severe, according to Dr. Melissa L. Wong, an obstetrician/gynecologist and a member of Physicians for Reproductive Health.
“Misoprostol remains highly effective and safe. Mifepristone, meanwhile, typically has no side effects since it halts the pregnancy hormone. While misoprostol may not be as well-tolerated due to potential adverse reactions such as nausea, vomiting, diarrhea, and occasional fever, these effects are still within the realm of normal and tolerable for anyone.”
CNN's Devan Cole and Ariane de Vogue provided contributions to this report.
