Resources on Medication Abortion and Alliance for Hippocratic Medicine v. FDA - Reproductive Freedom for All

Formerly NARAL Pro-Choice America

Mifepristone Memo

Resources on Medication Abortion and Alliance for Hippocratic Medicine v. FDA

TO: Interested Parties
FROM: Reproductive Freedom for All
DATE: March 25, 2024

Tomorrow, the U.S. Supreme Court will hear oral arguments in Alliance for Hippocratic Medicine v. FDA, a baseless federal lawsuit that seeks to increase restrictions on mifepristone, one of two medications used in medication abortion, despite the medication’s proven safety and effectiveness.

The lawsuit could lead to more barriers to accessing medication abortion nationwide—including in states where the right to abortion is protected. This would have devastating consequences for people who need mifepristone for abortion care or miscarriage management.

Medication abortion using mifepristone, which has been used safely for more than two decades, accounts for more than half of all abortion care nationwide and is now even more important in a post-Dobbs world. If access is restricted, more than 64.5 million people will face increased barriers to abortion care, impacting their ability to make their own decisions about their lives, bodies, and futures.

Attacking medication abortion care is the latest attempt to further roll back abortion access nationwide. Anti-abortion groups—and the politicians they bankroll—have ramped up attacks on it as part of their strategy to push access to care entirely out of reach. In fact, the group behind this case, the Alliance for Hippocratic Medicine, is a right-wing organization cooked up specifically to engineer an attempt to end access to mifepristone.

Reproductive Freedom for All is working with our partners across the reproductive rights, health, and justice movement to collect signatures for the People’s Petition, which advocates for everyone to have access to medication abortion.


Medication abortion care has long been deemed a safe and effective option for ending an early pregnancy. It has been approved by the FDA for use for more than 20 years and typically involves taking two different medications: A pill called mifepristone is taken first, and the second medication, misoprostol, is taken 24-48 hours later.

  • Medication abortion care has been safely used for decades—in fact, with a safety record of over 99%, mifepristone is safer than Tylenol. Attacks on medication abortion care are not based on science—they are politically motivated.
  • According to a new analysis from the Guttmacher Institute, medication abortion accounted for 63% of all abortion care in 2023.
  • Polls show that the majority of Americans want medication abortion with mifepristone to be legal and accessible. Two-thirds support abortion pills remaining accessible—including 51% of Republicans.
  • Lying about medication abortion care is part of anti-abortion extremists’ effort to block access to all care. They deploy disinformation to support their unpopular agenda, and one study they pushed — which was then cited by Judge Kacsmaryk in this case — has already been exposed to contain patently false information and was retracted.
  • The truth is this: Medication abortion care helps give people the freedom to make their own decisions about their lives and families. Without it, millions of people could face insurmountable barriers to accessing care.


  • In November 2022, the anti-abortion extremist group Alliance for Hippocratic Medicine filed this baseless lawsuit through “judge-shopping” by filling it in a specific Texas federal district court to ensure that the Trump-appointed, anti-abortion extremist Judge Matthew Kacsmaryk heard the case.
  • In April 2023, after hearing arguments, Judge Kacsmaryk ruled to block the FDA’s approval of mifepristone and remove the drug from the market nationwide. The FDA and mifepristone manufacturer, Danco, appealed the decision soon after to the U.S. Court of Appeals for the Fifth Circuit and asked for Kacsmayrk’s ruling to be put on hold while litigation continued. The Fifth Circuit ruled to let much of the order take effect, but kept the FDA approval of the drug in place.
  • Later that April, the FDA and Danco appealed to the U.S. Supreme Court, which granted a stay, blocking Judge Kacsmaryk’s order in full while litigation continues, allowing the full appeal to proceed at the Fifth Circuit.
  • In May 2023, the Fifth Circuit heard arguments over whether to reverse Judge Kacsmaryk’s order.
  • In August 2023, the Fifth Circuit issued a ruling similar to its April decision attempting to reinstate unnecessary restrictions on mifepristone. Because of the Supreme Court’s April 2023 stay, the appellate court’s decision does not immediately take effect, leaving medication abortion on the market for now.
  • In September 2023, the FDA asked the U.S. Supreme Court to take up the case, which they did, scheduling oral arguments for March 26, 2024.


As you continue your coverage of Alliance for Hippocratic Medicine v. FDA and efforts to block access to medication abortion care, Reproductive Freedom for All is happy to serve as a resource. Please reach out to [email protected].