U.S. Supreme Court holds off on abortion pill ruling until midnight Friday

Alito’s two-day-long pause, issued Wednesday, keeps a ruling from U.S. District Court for the Northern District of Texas Judge Matthew Kacsmaryk on hold. The Supreme Court is considering whether to allow mifepristone to stay on the market amid the appeals process, or implement changes.

This is the second short-term stay from Alito. The first, issued on Friday, April 14, was set to expire Wednesday at midnight.

Kacsmaryk’s ruling in early April suspended the U.S. Food and Drug Administration’s 2000 approval of mifepristone, the first of two prescriptions used in medication abortions.

The federal government had requested the 5th Circuit place that ruling on pause during the appeal, but that three-judge panel declined.

Instead, the 5th Circuit ruled that while the case advances, doctors would need to prescribe mifepristone under the guidelines that were in place before the FDA made changes during 2016 and 2021.

That ruling would have meant that mifepristone would no longer have been approved for up to 10 weeks gestation, but seven weeks.

Patients would have to attend three in-person doctor visits instead of one, all adverse events would have to be reported to the FDA and prescribing and administration of the medication would have reverted to pre-2016 instructions.

It would have prevented doctors from prescribing mifepristone via telehealth or the medication being sent through the mail.

The generic version of mifepristone would no longer have been approved.

Alito’s second, short-term stay of both lower court rulings ensures that access to mifepristone stays exactly as it is now through Friday at 11:59 p.m.