Despite legal uncertainty about medication abortion drug, procedures will continue in Minnesota

WASHINGTON — Medical abortions, which have become increasingly common in the state, will continue in Minnesota, even if legal objection prevails to mifepristone, the drug used in the procedure.

Planned Parenthood clinics and other facilities that provide abortion services in Minnesota are preparing for a negative ruling by Judge Matthew Kaksmarek by reassuring patients that medical abortions will continue — even if they no longer include the drug mifepristone.

The future of mifepristone was thrown into doubt when a judge in Amarillo, Texas, on Friday revoked the 23-year-old’s Food and Drug Administration approval of mifepristone in his ruling. In his decision on a case brought by anti-abortion groups, Kaksmarek said adverse reactions to mifepristone have not been reported by the FDA and that the drug is not safe.

About an hour after the ruling, a Washington state judge ruled in another case inconsistent with the Texas decision, ordering the FDA not to make any changes to the availability of mifepristone in the 18 states, including Minnesota, that filed the lawsuit.

The Biden administration said it would appeal Kamarek’s decision.

“If it continues, it will deny women in every state access to the drug, regardless of whether abortion is legal in the state,” President Biden said in a statement.

Ultimately, the Supreme Court may determine whether Mifepristone is still on the market in the United States due to dueling court rulings.

Medical abortion, available only to patients in the first 10 weeks of pregnancy, became legal in the United States in 2000, when the drug mifepristone was approved by the Food and Drug Administration. Medical abortions often involve taking mifepristone and another drug called misoprostol 24 to 48 hours apart. The first drug stops the development of pregnancy and the second causes cramping and bleeding like those caused by a miscarriage.

If mifepristone is taken off the market, medical abortions in Minnesota will include only misoprostol and misoprostol.

“It’s going to be somewhat less effective…and it makes the process longer and more painful,” said Paulina Briggs, executive director of the WE Health clinic in Duluth. “We’re just going to educate our patients to be ready for that.”

Medical abortions rose in popularity during the pandemic, when in-person appointments with doctors were hard to come by, and telemedicine offered a way for patients to get prescriptions of mifepristone and misoprostol at home.

According to data from the Minnesota Department of Public Health, there have been 6,179 surgical abortions and 3,711 medical abortions in the state. Two years later, in 2021 and in the midst of a pandemic, there have been 3,976 surgical abortions and 6,154 medical abortions in the state.

The popularity of medical abortion has continued, Briggs said. Patients can take medication in the comfort of their own home. They can get help from a telemedicine or clinic, which costs less than in-clinic treatment. The cost of the teleprocedure is $412 at the WE Health clinic. Meanwhile, a surgical abortion for a patient in the first 11 weeks of pregnancy and a medical abortion at home in the clinic, both procedures involving ultrasound, cost $700.

Medicines needed for a medical abortion can be obtained by mail or in person at a clinic or drug store, though Walgreens has stopped dispensing mifepristone in 21 states as Republican attorneys general threatened legal action against pharmacies that dispense the drug. It didn’t affect Walgreens stores in Minnesota, where the attorney general is a Democrat who has vowed to protect abortion rights.

Like others who have decried efforts to ban mifepristone, Emily Pesek, vice president of communications for Planned Parenthood in north-central states, said the drug has been in use in the United States for more than 20 years and has been shown to be safe.

“The medical abortions were safe, effective and convenient,” Pesek said. It called efforts to ban mifepristone “irresponsible and wrong”.

“Taking Mifepristone off the market is a political attack,” Pesek said.

The new one-pill medical abortion protocol involves taking one misoprostol tablet every three hours for a total of three doses.

“Every patient’s experience will be different after that,” Pesek said.

Paul Stark, a spokesman for Minnesota Citizens Concerned for Life, said the anti-abortion group supported removing mifepristone from the market due to concerns about its safety and the approval process used by the Food and Drug Administration. He said abortions would continue without access to mifepristone and that the opposition was based on concerns about “the health of the mother”.

“We want to protect everyone,” Stark said.

Meanwhile, abortion rights advocates have criticized Kacsmarek’s decision, including Sen. Tina Smith, D-Minnesota, a former Planned Parenthood executive.

“I’m angry,” said Smith. “One ultra-conservative activist judge tried to strip millions of women of safe and effective medical abortions across the country. This ruling is nothing more than an ultra-nationalist, anti-democratic abortion ban.”

The American Medical Association also criticized the ruling as “reckless and dangerous” judicial interference in the provision of health care that “contradicts science and evidence.”

“The court’s disregard of established scientific facts in favor of speculative claims and ideological assertions will cause harm to our patients and undermine the health of the nation,” said AMA President Jack Resnick.