RU 486 Abortions: When “Between a Woman and Her Doctor” Turns Out to be False


Specifically, the law is a Chemical abortion is the “cash cow” of the abortion industry. Contrary to pro-abortion claims that abortion should be between a woman and her physician, the reality is that there is little to no “physician-patient relationship” in the chemical abortion context. Women are given drugs and sent home to self-abort without any medical supervision.

Of course, this allows abortion providers to “serve” more women in a day—and cash in on their abortions. Seeking to protect the health of women, many states, such as Oklahoma, have sought to pass legislation reining in such misuse.

This week, AUL partnered with 83 legislators to file an amicus brief supporting Oklahoma’s “Abortion-Inducing Drugs Safety Act” in the case Cline v. Oklahoma Coalition for Reproductive Justice. In June, the U.S. Supreme Court granted partial certiorari in the case, but directed the Oklahoma Supreme Court to clarify its interpretation of the law because that court had failed previously to provide any concrete analysis of the law.

Medical regulation that limits “chemical abortion” (abortion induced by drugs) by requiring abortion providers to abide by the guidelines found in the FDA-approved labeling for the drugs. The reason is simple: off-label use poses deadly risks for women. In fact, eight women have died of severe bacterial infection after using abortion-inducing drugs—and every one of those women was instructed to use the drugs in an unapproved manner.

The Oklahoma law requires that abortion providers abide by the administration protocol found in the “final printed labeling” (the FDA-approved label that accompanies the drugs) when administering chemical abortion. At this point in time, there is only one FDA-approved chemical abortion regimen in the United States—the Mifeprex (RU-486) regimen. The Mifeprex regimen involves the use of two drugs on separate days. On Day 1, women are to orally ingest mifepristone (brand name Mifeprex). On Day 3, women are to orally ingest a second drug, misoprostol. The drug “label” for Mifeprex outlines how BOTH mifepristone and misoprostol are to be used.

And yet plaintiffs in the case ignore all of this, and implausibly claim that the Oklahoma law bans all chemical abortions regardless of whether physicians are abiding by the FDA-approved protocol. The unfounded basis for this claim is the fact that the misoprostol label does not direct how it should be used in abortion—because the drug manufacturer does not want to include abortion use in the label. But the Oklahoma law specifically refers to RU-486 (Mifeprex) and the RU-486 label, which includes directions for misoprostol use.

In fact, all of the FDA materials (such as this explanation) and the Mifeprex (RU-486) label link the two drugs together in one regimen, controlled by the Mifeprex label. Even pro-abortion ACOG links the two drugs together in its review of chemical abortion. So plaintiffs’ claim that misoprostol is banned in Oklahoma is baseless; the law specifically directs physicians to follow the RU-486 (Mifeprex) label, and the Mifeprex label provides the FDA-approved use of misoprostol for chemical abortion.

Perhaps worse, the plaintiffs equate treatment of ectopic pregnancy with abortion, and claim that certain drugs can’t be used to treat ectopic pregnancy because the drug labels don’t mention abortion. Not only is such a claim a slap in the face to the thousands of women who have been treated for ectopic pregnancy, who never in their wildest dreams would have considered such a life-saving action to be an “abortion,” but it also defies the very language of the Oklahoma statutes.

Unlike the plaintiffs, Oklahoma and the rest of the world understand that treating an ectopic pregnancy is not the same thing as abortion. Oklahoma law clearly defines “abortion” to exclude any kind of treatment for ectopic pregnancy. As such, any drug used to treat an ectopic pregnancy would not be considered an “abortion-inducing drug” and would not be controlled by Oklahoma’s regulation of abortion-inducing drugs.

And this brings us to the U.S. Supreme Court’s partial grant of certiorari. The Court asked the Oklahoma Supreme Court to review the law and determine 1) whether the law prohibits the use of misoprostol to induce abortion, and 2) whether the law prohibits use of the drug methotrexate to treat ectopic pregnancies.

The answer to both the questions, for the reasons explained above, should be obvious. The Oklahoma Supreme Court should answer “no” to both questions—the law does not prohibit the use of misoprostol for abortion (as clearly stated in the Mifeprex label) and the law does not prohibit use of methotrexate for ectopic pregnancy (because treatment of ectopic pregnancy is not “abortion”).

To be certain, there is more litigation on the way, and it could be months before we have any answers—but the case remains alive, and that is what matters to Oklahoma right now. The law has not been permanently struck down. The quest nationwide to protect women from the abortion industry’s misuse of dangerous abortion drugs—misuse that has been linked to at least eight deaths—continues. And the U.S. Supreme Court’s partial grant of certiorari is an historic step in its first review of a chemical abortion regulation.


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