Texas Ruling & What You Can Do

Graphic: @liberaljanee

Since Roe v. Wade ended, much of the battle over legal abortion has focused on access to medication abortion pills. Opponents of abortion have long wanted to block the use of mifepristone not only in states with abortion bans but also nationwide. Today they got their wish.

The result is a current legal quagmire, with the F.D.A. facing contradictory legal judgments. We’re going to break it down for you.


Medication abortion consists of two types of pills: mifepristone and misoprostol. In combination, these drugs are up to 99% effective at ending a pregnancy prior to ten weeks gestation. The pills are extremely safe – they’ve been used by millions of Americans since receiving F.D.A. approval in 1999 – and account for about half of abortions in the United States today. 

In November, anti-abortion organizations and doctors sued in Texas to challenge the F.D.A.’s approval of mifepristone. They argue that mifepristone is unsafe, despite a complication rate lower than most over-the-counter drugs (such as Tylenol). Research has clearly established the safety and efficacy of these pills. On merit, the suit may seem far-fetched. But the plaintiffs made sure to file their suit (a practice some experts call “judge shopping”) in a division of a Federal District Court with a specific judge: Trump-appointee Matthew Kacsmaryk, who has long-standing and widely known views against abortion.

At the same time, the Democratic attorneys general of sixteen states (and Washington, D.C.) have a case in Washington state to protect the availability of mifepristone. 

What Happened Today

With his ruling today, Kacsmaryk has blocked the F.D.A.’s approval of mifepristone, and thus removed it from the market nationwide, even in states where abortion access is otherwise protected. This decision is unprecedented and puts at risk, not just abortion access, but the healthcare needs of many Americans who need mifepristone for miscarriage management or in labor and delivery. However, right now, there is a stay on the ruling: the federal government has seven days to seek emergency relief from the Fifth Circuit (which is a conservative-dominated court). This ruling and the stay apply nationwide.

At the same time in the Washington case, a federal judge in the Washington state case has issued an order barring the F.D.A. from changing the status quo. This applies only to the sixteen plaintiff states and Washington, D.C.

Thus, the F.D.A. is currently under two contradictory legal orders.

What Happens Next

The federal government will apply for emergency relief in the Fifth Circuit within the next seven days.
There will be an appeal, and the F.D.A. may work around the ruling (when the risk is low, the F.D.A. can give manufacturers permission to keep distributing products). 

Many abortion providers have also been preparing for misoprostol-only abortion protocols in anticipation of this decision (though this regimen is slightly less effective and more likely to require follow-up care), should it remain in effect.

How Are ABC Fund Grantees Responding?

Several of our Abortion Bridge Collaborative (ABC) Fund grantees are addressing these unprecedented attacks:

Online Abortion Resource Squad is coping with floods of requests for information on misoprostol-only protocols on the abortion subreddit they run. 

Self-Managed Abortion; Safe & Supported and I Need An A are sharing up-to-date information about how folks can manage their abortions safely using only misoprostol, as well as what to expect in clinics. 

Reprocare’s Piggybank will help abortion seekers get the funding they need for their appointments, many of which may be more expensive as clinics change the care they offer. 

Abortion care advocates are busy doing everything they can to navigate this confusing and rapidly changing legal environment, but they need our support.

What You Can Do

Give to the ABC Fund
Our fund is designed to support organizations and projects engaging in the most critical work delivering abortion care, defending abortion access, and advancing reproductive justice.

We are designed to deploy resources that meet the immediate needs brought on by this ruling. 

Attend Our ABC Fund Briefing on April 25, 1-2 pm PT / 4-5 pm ET
Please join us for our funder briefing on April 25 to discuss takeaways and impacts from this moment and highlight the work of the fund in its first six months of grantmaking. Register here. 

Read About ABC Fund’s Impact
In the past six months alone, the ABC Fund has granted more than $3 million to 21 reproductive justice organizations. Our grants have kept clinics from closing, replenished Worker Aid funds, and assisted clinics that are expanding into abortion-friendly states, among many other things. We recently released our first impact report. Read everything we’ve been able to accomplish, together.

This moment requires creativity, flexibility, and fast action on the part of the providers and organizers on the ground – and this responsiveness requires trust-based, rapid philanthropic support.

Join us as we bridge and fund fearlessly together. 

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