• US Attorney General Merrick Garland said states can't ban FDA-approved pills used to end pregnancies.
  • The FDA's decision on the safety and efficacy of the drug mifepristone could not be overruled.
  • Medication abortion with pills accounts for 54% of all abortions in the US, according to the Guttmacher Institute.

US Attorney General Merrick Garland said Friday that states can't ban the abortion medication mifepristone "based on disagreement with the FDA."

The US Food and Drug Administration had already ruled on the pill's "safety and efficacy," and that decision could not be overturned by states seeking to limit access to abortion, he said.

Garland's comments came moments after the US Supreme Court handed down a decision overturning 50 years of precedent over Americans' right to abortion.

"Women who reside in states that have banned access to comprehensive reproductive care must remain free to seek that care in states where it is legal," Garland said. "Moreover, under fundamental First Amendment principles, individuals must remain free to inform and counsel each other about the reproductive care that is available in other states."

Since the FDA approved the abortion pill mifepristone in 2000, self-managed at-home abortions — which can be done in the first 11 weeks of pregnancy — have become increasingly common in the US. In 2020, medication abortion with pills accounted for 54% of all abortions in the country, according to preliminary data collection from the Guttmacher Institute.

In December 2021, the FDA authorized abortion pills to be permanently sent by mail. In April 2021, the Biden administration lifted a federal ban on mail-order abortion pills. The goal was to ensure safe abortion care during the pandemic, when Americans were being urged not to travel and to avoid in-person treatments where possible.

Previously, the Supreme Court voted to ban the abortion pill from mail delivery, making it the only prescription medication to have such restrictions, until the April reversal.

How the abortion pill works

Self-managed abortions are typically done using two pills together: mifepristone and misoprostol.

First, someone takes mifepristone, which blocks the production of progesterone, a hormone needed to sustain a pregnancy.

Right after, or up to two days later, they then take misoprostol, a drug that causes the uterus to contract and pushes the embryo or fetus out of their body, Yale University gynecologist Dr. Mary Jane Minkin previously told Insider .

"You will be experiencing, in a sense, a miscarriage," Minkin said.

Misoprostol normally causes cramping and bleeding one to four hours after a patient takes it, according to Planned Parenthood.

Sometimes a self-managed abortion is only done with mifepristone, but research has shown that using both drugs in tandem leads to better outcomes because it prevents the potential need for surgery to remove the fetus. After, a patient will have a follow-up appointment with a doctor to make sure the abortion is complete.

One major manufacturer of mifepristone pills, Danco Labs, said the company was "prepared for any surge" in orders following the Supreme Court decision.

"Our supply is stable and plentiful," a spokesperson said, according to ABC.

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