Bob Ferguson continues to fight against abortion pill restrictions

If the judge sides with Ferguson, the Food and Drug Administration could be required to reconsider its policies on the drugs used in more than half of all abortions. The FDA's response is expected Dec. 6, according to Brionna Aho, a spokeswoman for the attorney general's office.

“We continue to fight for reproductive freedom, including access to mifepristone,” Ferguson said in a press release announcing the motion. “The FDA must remove its unnecessary and unlawful restrictions on this safe and effective drug.”

In a joint lawsuit with 18 other attorneys general filed last year in the U.S. District Court for the Eastern District of Washington in Spokane, Ferguson and his associates argued that restrictions on mifepristone were illegal and that the FDA should reevaluate its guidelines for the drug should.

In April 2023, Judge Thomas O. Rice approved a preliminary injunction requested by Ferguson preventing the FDA from interfering with the availability of mifepristone in Washington, Oregon, the District of Columbia and 16 other states that joined the lawsuit.

Rice's ruling last year was made public on the same day Another decision on mifepristone came in a Texas court case in favor of abortion opponents who argued that the already unusually restrictive rules governing mifepristone were inadequate. That ruling, which would have overturned FDA approval of the drug, made its way to the U.S. Supreme Court, where the court dissented in June, ruling unanimously that the anti-abortion advocates who filed the lawsuit in Texas There was no legal right to sue.

Even if this case is dismissed, the abortion lawsuits are unlikely to be resolved. Trump has publicly bragged about the reversal Roe v. Wade This was made possible by the Supreme Court decisions he made during his first presidency, while abortion was an issue in both federal and state elections that year.

Mifepristone is limited under a so-called Risk Evaluation & Mitigation Strategy, a set of regulations that the FDA requires for just 73 drugs. This includes those with proven addictive effects or known to cause birth defects, for example opioids, thalidomide and isotretinoin. Mifepristone is also restricted under a guideline called Elements to Assure Safe Use, which typically applies to drugs that pose a high risk.

For years, abortion rights advocates and providers have argued that restrictions on mifepristone are scientifically unfounded and burdensome, pointing out that there are no similar requirements when mifepristone is prescribed for purposes other than abortion. Mifepristone is also often used to treat high blood sugar in patients with Cushing's syndrome.

“There's really no scientific or medical support for it,” said Sarah Prager, a Seattle-area abortion provider and professor of obstetrics and gynecology at the University of Washington.

According to Prager, recent changes in mifepristone prescribing have made providing mifepristone to patients even more difficult. “Every single provider must now be registered with every pharmacy that dispenses the medication for them,” she said. “In addition, mifepristone is a medication that is safer than many over-the-counter medications and should have NO restrictions on use.”

The Washington Attorney General's Office agrees, saying, “The stigma and administrative burden associated with 'special certification' to prescribe and dispense an abortion drug deters many health care providers and pharmacies from even registering for it.” But Without the FDA rules, “any qualified health care provider could prescribe mifepristone—just like any other prescription drug, including high-risk medications like opioids.”

Oregon Attorney General Ellen Rosenblum, who is leading the lawsuit with Ferguson, agrees: “The restrictions are simply not medically necessary.” In medication abortions, mifepristone is typically combined with a second drug, misoprostol, to end a pregnancy. The same FDA rules do not apply to misoprostol. which can also be used alone to terminate a pregnancya protocol that reproductive health care providers have indicated they would switch to if mifepristone is further restricted.

Beyond broader access issues, the attorney general's office is also concerned that current restrictions on mifepristone could raise patient privacy concerns, particularly for those seeking treatment in Washington from states that have since enacted anti-abortion policies Dobbs v. Jackson Women's Health was decided more than two years ago. That's because restrictions on mifepristone currently include written agreements stating that the drug is used to induce an abortion or clear up a miscarriage, evidence that could expose patients to investigation or prosecution by anti-abortion state officials.