Mifepristone in the Courts

This article was published on February 7, 2023, and was updated on July 24, 2024, to reflect new information.

First and foremost, ACOG continues to remind all members, clinicians, the courts, and patients that the overwhelming weight of scientific evidence has conclusively demonstrated that mifepristone is safe and effective. Despite this fact, in states where abortion is banned or restricted, mifepristone may be difficult to get or unavailable for use in medication abortion. Even if available, mifepristone may also be subject to state-level restrictions on its use.

ACOG understands that the challenge to mifepristone approval in the lawsuit Alliance for Hippocratic Medicine v. FDA created and perpetuated legal complexity and caused widespread confusion among patients and clinicians, including ACOG members. ACOG, along with the American Medical Association, led a coalition of prominent medical associations in submitting an amicus brief explaining to the Supreme Court the wealth of evidence that mifepristone is safe and effective and the importance of access to this life- and health-saving medication. In July 2024, the Supreme Court determined the Alliance for Hippocratic Medicine did not have standing to bring this case. For now, mifepristone remains available under the current risk evaluation and mitigation strategy—also known as REMS—criteria. ACOG continues to strongly oppose burdensome and unnecessary restrictions on mifepristone.

ACOG remains deeply involved in litigation affecting access to abortion and other essential reproductive health care and is committed to ensuring that the courts receive evidence-based, reliable information from medical experts.

ACOG has issued clinical guidance on mifepristone to educate health care professionals about the provision of medication abortion up to 10 weeks of gestation. ACOG members with specific legal questions about mifepristone or abortion should consult their institution’s lawyers and can also reach out to the Abortion Defense Network, a program that connects people who have legal questions related to abortion care with attorneys who provide legal advice and representation in civil and criminal proceedings.

ACOG also understands that patients have questions about how they can be prescribed or use mifepristone. ACOG’s patient website includes a helpful Q and A with former Darney-Landy Fellow Kristyn Brandi, MD, MPH, FACOG, about abortion and miscarriage care through the use of mifepristone.

ACOG continues to monitor this rapidly evolving situation and will update our members in response to any additional changes regarding mifepristone.