The abortion pill mifepristone is at the center of a legal battle as Missouri’s Attorney General Andrew Bailey, supported by attorneys general from Kansas and Idaho, seeks to limit its accessibility. They argue in a newly filed lawsuit in Texas that the drug’s availability has negatively impacted Missouri by reducing teenage pregnancies.
This legal action follows a ruling by the U.S. Supreme Court that dismissed a previous similar lawsuit due to a lack of standing by the original plaintiffs, which comprised anti-abortion doctors and medical organizations.
The attorneys general now claim that the states are adversely affected by the reduced “birth rates for teenaged mothers,” contributing to population decline and a loss of political representation and federal funding.
The lawsuit requests that the FDA reinstate previous restrictions on mifepristone, including mandating three in-person doctor visits, reducing the permissible gestational period from 10 to seven weeks, and prohibiting the mailing of the medication.
In a statement, Bailey emphasized the lawsuit’s goal of reinstating “long-standing safety requirements” for mifepristone usage, aimed at protecting women nationwide.
In contrast, Molly Meegan, from the American College of Obstetricians and Gynecologists, criticized the move as relying on “out-of-date and unscientific federal restrictions,” asserting that mifepristone is both safe and effective.
The FDA maintains that mifepristone is safe if used as directed, though it notes common side effects like cramping and bleeding.
Since its approval 28 years ago, the FDA reports only 32 deaths associated with mifepristone, though Bailey and his colleagues argue the drug poses significant risks.
The lawsuit also highlights the difficulty in tracking medication abortions under current regulations, complicating state law enforcement efforts to uphold abortion laws.
Impact on Teen Pregnancies and State Resources
Following the 2022 overturn of the constitutional right to abortion, Missouri enacted a near-total ban, with exceptions only for medical emergencies.
Data from Missouri’s Department of Health and Senior Services shows a sharp decline in abortions performed in the state, from over 5,000 a decade ago to just 167 by 2020. Despite this, many Missourians continue to obtain abortions by traveling to neighboring states or through mail-order medication.
A study published in JAMA reported an increase of over 26,000 self-managed medication abortions across the U.S. in the six months following the Supreme Court’s ruling.
The lawsuit estimates the cost of abortion medication to the state by considering the number of Medicaid recipients and the potential financial impact on public hospitals required to provide emergency care.
Bailey’s office argues that the increased access to abortion medication has led to a “loss of potential population” and that stricter FDA regulations could have prevented some abortions.
Referring to a study that suggests abortion bans did not increase teenage pregnancy birth rates, the filing emphasizes the role of online medication access in reducing expected birth rates for teens.
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