Abortion pills: What is the dispute about their sale to the public?

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The fight over abortion pills has been escalating since before Roe v. Wade was overturned, but the pills’ availability is in danger now more than ever.

With pills now accounting for the majority of abortions, opponents of the procedure are focusing on legislatures and courts to erect barriers. But that’s triggering thorny legal questions, foremost of which is playing out in a federal court in Texas over whether the FDA has the final say on whether the pills are safe.

Abortion pills have been available in the U.S. For decades, and while the FDA says that medical evidence shows they are safe and effective, the drugs have been subject of fights over manufacturing, distribution, insurance coverage and who can provide them.
Confusion around the drugs continues in the U.S., where nearly half of adults say they are not sure whether medication abortion is legal in the state they live in, according to a recent KFF survey.
How often are abortion pills used?
Over half of abortions in the U.S. occur via abortion pills, according to the Guttmacher Institute, a research organization that supports abortion rights.

Abortion pills are often accessed online and mailed to patients, effectively working to circumvent state bans and restrictions that took effect after the Supreme Court overturned Roe v. Wade.
How do abortion pills work?
Medication abortion normally consists of two pills: mifepristone and misoprostol.

Mifepristone is approved by the FDA to be used alongside misoprostol to end a pregnancy during the first 10 weeks — this includes elective abortions and miscarriages.
A patient first takes 200 milligrams of mifepristone orally to stop the pregnancy from growing. This is followed 1-2 days later by 800 milligrams of misoprostol taken buccally — placed between the gums and cheek — which causes cramping and bleeding to empty the uterus.
The mifepristone-misoprostol combination regimen has been found to be at least 95% effective at terminating a pregnancy.