Ohioans can still use abortion drug mifepristone, but that could change

Mifepristone was used for 9,891 abortions in Ohio in 2021, according to the Ohio Department of Health.

By: - April 12, 2023 4:55 am

Since Roe v Wade was overturned last summer, abortion medication has been under fire as the abortion drug mifepristone is the subject of a federal lawsuit and some states are attempting to restrict access by threatening legal action against retail pharmacies and suppliers of the drug. (Adobe Stock).

An abortion drug remains legal in Ohio at the moment, but the legality of mifepristone hangs in the balance after a Texas federal judge suspended the Food and Drug Administration’s approval of mifepristone last week.

Trump-appointed U.S. District Judge Matthew Kacsmaryk stopped the FDA’s approval of mifepristone, the first in a two-drug regimen of mifepristone and misoprostol taken 24 to 48 hours apart to terminate a pregnancy. The FDA first approved the two-drug regimen in 2000.

“This is a very direct and targeted attack on a very specific drug for a very specific reason,”said Planned Parenthood of Greater Ohio Public Policy Director Danielle Firsich.

Mifepristone was used for 9,891 abortions in Ohio in 2021, according to the Ohio Department of Health. The drug was used the most in Franklin County (2,806), Summit County (2,008), and Cuyahoga County (1,643). 

Mifepristone and misoprostol

There is an alternative regimen for patients who wish to have a medication abortion that involves just the abortion drug misoprostol.

“It’s still a safe and effective regimen, it’s just not as patient-convenient or patient-centric as the current regimen,” said Planned Parenthood of Greater Ohio’s Chief Medical Officer Dr. Adarsh E. Krishen.

The mifepristone and misoprostol regimen gives patients more predictability with regard to when a pregnancy is going to end, he said.

“With the misoprostol regimen, there’s more variation in terms of the timing of when that pregnancy may end, as well as there’s prolonged bleeding after the use of the medication,” Krishen said. “If you are a person who needs to work or do other things in your life, it will be much more complicated and complex for you.”

With the misoprostol-only regimen, bleeding can last up to one to two weeks after taking the medication, the pain lasts longer, and patients tend to be more nauseous, Krishen said.

Bleeding stops within a few days, or sooner, with the mifepristone and misoprostol regimen, Krishen said.

Cramping occurs with both regimens, he said.

“If you are someone who is seeking abortion care or miscarriage … you will be able to continue to receive the same kind of care with the misoprostol only option,” Firsich said. “The only difference is the frustration, the chaos, and the confusion that decisions like these make.”

She said decisions like these make patients more hesitant to access abortion care and not understand the rights they have to care.

“It may make physicians more hesitant to provide certain types of care because they are afraid they may be doing something illegal or something they don’t have the authority to do now because of variations in state, local and federal laws,” Firsich said.

The Texas federal judge is not targeting misoprostol.

“(Misoprostol) has many other medical applications far outside of abortion care, so it would be very difficult to target misoprostol in the same way they are mifepristone,” Firsich said.

Fifth Circuit Court of Appeals

The United States Department of Justice filed an emergency stay motion with the Fifth Circuit Court of Appeals and is asking the 5th Circuit to respond to its request for a stay by noon on Thursday. Kacsmaryk’s ruling would take effect Friday unless the 5th Circuit puts it on hold.

“This is notoriously the most conservative appellate court in the country,” Firsich said.

She believes this ruling will eventually go to the United States Supreme Court.

Within hours of the Texas ruling on Friday, U.S. District Judge Thomas Rice, ruled mifepristone should continue to be available in 17 states and the District of Columbia. Ohio is not one of those 17 states.

What Ohio lawmakers, Ohio Right to Life is saying

Ohio House Minority Leader Allison Russo, D-Upper Arlington, condemned the Texas federal judge’s ruling.

“The FDA, a trusted federal agency, has determined it is safe for women to use this medication for their health care,” Russo said. “As lawmakers, we should ensure our policies reflect the expertise of trusted medical professionals.”

State Rep. Beth Liston, D-Dublin, said mifepristone has been proven safe and effective.

“A woman’s medical decisions should be left between herself and a medical professional. Not a judge in Texas,” said Liston, who has a medical degree.

State Rep. Anita Somani, D-Dublin, said maternal mortality will increase by taking away access to mifepristone.

“This ruling opens up the door to other medications like contraception becoming politicized and taken off the market. It is a dangerous precedent and hurts the FDA’s ability to do their job in a nonpolitical fashion,” said Somani, who is an OBGYN at OhioHealth.

Firsich shares those fears and said “this could lead to an incredible dangerous slippery slope.”

Ohio Right to Life is praising Kacsmaryk’s ruling.

“As a young woman carrying a child, I look forward to the day when such rulings are no longer necessary—declaring whether or not human life deserves to be protected,” Ohio Right to Life’s spokesperson Elizabeth Marbach said in a statement.

Abortion is currently legal in Ohio up to 22 weeks.

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Megan Henry
Megan Henry

Megan Henry is a reporter for the Ohio Capital Journal and has spent the past five years reporting in Ohio on various topics including education, healthcare, business and crime. She previously worked at The Columbus Dispatch, part of the USA Today Network.