SCOTUS rules on the abortion pill

On 13 June 2024, the United States Supreme Court ruled that abortion drugs can remain on the market. The background is that in 2000, the Food and Drug Administration (FDA), which approves pharmaceutical products for sale to the public, allowed the sale of the abortion drug Mifepristone (RU486), usually used in conjunction with Misoprostol (Cytotec) to end a pregnancy by medical means.

The case before the Supreme Court was brought by emergency room doctors, who have to deal with the traumatic effects of adverse reactions to the drugs. The case alleged that the FDA was arbitrary and capricious in approving the drugs without the need for minimal safeguards, as well as in removing the reporting of almost all adverse events, in not requiring a physician to prescribe the drug, and in allowing it to be mailed out directly to the user.

An amicus brief, signed by 2743 women who had suffered severe adverse reactions, was tendered as part of the case. The Supreme Court, in a unanimous decision, rejected the case on the technical grounds that the doctors did not have standing to bring it before the Court. Obviously, this opens the way for a subsequent case to be brought by those who do have standing.

Crucial measures

The safeguards are important, and they are common practice virtually everywhere the drugs are used. In France, for example, medical abortions using these drugs must be performed at government-operated hospitals and clinics, typically with or adjacent to emergency room facilities. Women are screened for numerous medical conditions that rule out use of the two drugs. Ultrasound is used to determine the gestational age and to rule out tubal pregnancy.

After women are given the drugs, they are monitored on-site for approximately four hours, with their blood pressure taken every half hour, so that allergic reactions, cardiopulmonary “events,” hemorrhaging and the like can be treated promptly before they become life-threatening. The doctor must also ensure that electrocardiogram equipment and resuscitative cardiopulmonary equipment are at hand.


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It is interesting to note that Searle, the pharmaceutical company that manufactures Misoprostol under the brand name Cytotec, has consistently opposed the use of that drug for labour induction and abortion.

A 23 August 2000 letter from Searle, posted on the FDA’s website, reiterates its opposition to these off-patent uses and lists “serious adverse events” that have been reported:

“maternal and fetal death; uterine hyperstimulation, rupture or perforation requiring uterine surgical repair, hysterectomy or salpingo-oophorectomy; amniotic fluid embolism; severe vaginal bleeding, retained placenta, shock, fetal bradycardia and pelvic pain.”

Searle’s Cytotec patent expired in July 2000, so the drug is now off-patent.

High risk

In the US, without a prescription from a doctor, the woman can have the drugs mailed to her directly, so that she can use them at home to bring about the abortion. There are no safeguards in the event of adverse reactions, which have been numerous and severe.

Use of the drugs at home is especially popular in states where abortion is now prohibited or greatly restricted as a result of the Supreme Court’s 2022 decision overturning Roe vs Wade. It is estimated that medical abortions account for nearly two-thirds of all abortions in the US.

The amicus brief, relating some of the hundreds of thousands of adverse reactions, makes for horrifying reading. Without going into the detail related in the brief, these reactions experienced at home included heavy bleeding and passing clots the size of lemons for as much as eight weeks, the woman fearing that she was going to die, fainting, intense cramping, pain greater than any experienced before, even in childbirth, vomiting, nausea, the woman flushing the aborted baby down the toilet with all the trauma involved, and the feeling of guilt, shame and regret. One woman described it as the most traumatic experience of her life.

Let us pray that another case will be brought so that the Supreme Court can give a decision that redresses these issues.

Do abortion pills present an unacceptable health risk? Leave your thoughts below.

Fr John Flader is an American-born priest who arrived in Australia in 1968. A former director of the Catholic Adult Education Centre in Sydney, he has written "Question Time" for "The Catholic Weekly" since 2005.

Image credit: Pexels


Showing 12 reactions

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  • mrscracker
    Thank you for that Mr. Jurgen. Yes, there are always 2 lives at stake but one of those lives, if unwanted, is counted as having no value. A life unworthy of life.
  • Jürgen Siemer
    commented 2024-07-06 03:18:36 +1000
    Sergio, yes the risks of abortion drugs are low, …. except for the baby.
  • mrscracker
    You know, it never seems to fail that anything written by a member of the Catholic clergy is immediately countered by anti-Catholic folklore & narratives that have nothing to do with the subject at hand.
    Similar to the way some Evangelical writers are treated.

    It’s a perfect device to shut down discussion.
  • Juan Llor Baños
    commented 2024-07-06 01:22:06 +1000
    La cegada visión comercial abortista, apoyada por la indiferencia más atroz, que es capaz de justificar el limite de la violencia que es capaz del hombre. El silencio también es culpable.
  • Angela Shanahan
    commented 2024-07-05 23:25:52 +1000
    There was a huge fight about introducing this drug in Australia. The argument that it is less traumatic than a medical abortion was used by many women’s health groups . However they also wanted it to be available in places like Aboriginal communities in the Northern Territory, which would have been a disaster as these places have almost no health facilities. The elder women were very much against it.
    Administration of Mifepristone does require supervision, as in many countries in Europe. However this is the paradox for anti abortion people and the states where abortion is banned. Because if abortion is banned, and what she is doing is effectively illegal, it would be impossible for a woman who received the drug by mail to actually have any adequate on-site care while she takes the drugs.
  • Susan Rohrbach
    commented 2024-07-05 21:41:11 +1000
    Let us pray that priests can preach Humanae Vitae every week for the fifty years that they didn’t.
  • Sergio Rego
    commented 2024-07-05 20:42:13 +1000
    The risks of an unwanted or unsafe pregnancy are much greater than those of abortion drugs. It is not a fact that the risks they pose are high, quite the opposite. The risks related to abortions performed with inappropriate instruments are much greater.
  • Michael Cook
    followed this page 2024-07-05 12:43:01 +1000
  • Maryse Usher
    commented 2024-07-04 12:52:25 +1000
    So. We are back where we started, a new era of “back room” abortions, in truth. Dangerous, painful and traumatic (when she sees the little baby in the toilet) but cheap and private (until she gets to the hospital emergency room) alternative for women to kill their children. Will it ever be easy, painless, safe and guilt-free to get rid of the baby? 50 years of relentless “reproductive rights” and abortion is still horrible? I wonder why. Sarcasm aside, given that 60% of abortions are second abortions, according to South Australian stats, I also wonder how many women with a painful or complicated chemical abortion experience go on to conceive and then destroy their offspring again by this method?
  • Anon Emouse

    With respect, please re-title your piece. As you rightfully pointed out in your article, SCOTUS didn’t rule on the pill; they said that the litigants lacked sufficient standing to bring the suit (in essence, punting on the suit and declining to make a ruling on it). It would be more correct to say that they declined to rule on the pill.
    Now, philosophically speaking – if something causes such harm, as you state is contained with in the amicus briefs – it should be banned, correct? In that instance – what do you say about the harrowing accounts of the sins of the Catholic church, such as the residential schools in Canada, the Magdalene Laundries of Ireland, the Crusades, or the rampant sexual abuse in the mid to late 20th century in the US?
  • Tom Mullaly
    commented 2024-07-03 20:29:09 +1000
    The market wins again!
  • Fr John Flader
    published this page in The Latest 2024-07-03 20:13:41 +1000