Supreme Court upholds access to mifepristone: What the abortion pill ruling means in Tennessee (2024)

Tennesseans' only in-state option for abortion care just survived a U.S. Supreme Court challenge.

Tennessee has one of the strictest abortion bans in the country: the medical procedure is banned without exceptions for rape and incest. Legislation passed this year makes it a felony to recruit or transport a minor for an illegal abortion without parental consent.

That leaves mifepristone, the widely used abortion pill approved by the FDA in 2000, the only option for people seeking abortion. It's not sold in state, but Tennesseans can still order it from out of state.

On June 13, two years afteroverturning the constitutional right to an abortion, the Supreme Court went the other direction and tossed out a challenge to mifepristonethat would have curbed access to the drug and jeopardized the independence of the Food and Drug Administration.

The unanimous court said the anti-abortion doctors who challenged the FDA’s loosening of rules forhow mifepristone can be prescribedand dispensed lacked a legitimate basis to bring their suit.

What is mifepristone?

Mifepristone is used to end a pregnancy that is less than 70 days developed. The pillsare takenabout two days apart.

Mifepristone stops the “supply of hormones that maintains the interior of the uterus. Without these hormones, the uterus cannot support the pregnancy and the contents of the uterus are expelled,”according to the Mayo Clinic.

There is essentially no precedent for a lone judge overrulingthe medical decisions of the Food and Drug Administration. Mifepristone is one of two drugs used for medication abortion in the United States, along with misoprostol, which is also used to treat other medical conditions.

What SCOTUS ruling means for Tennesseans

Tennesseans, and the rest of the country, will likely see more challenges to the FDA approval of mifepristone. The SCOTUS ruling didn't take steps to protect mifepristone, it just threw the challenge out on a technicality.

"I think it does nothing more than preserving the status quo," Bryan Davidson, the policy director at ACLU of Tennessee, told USA TODAY Tennessee. "People in Tennessee are managing their abortions with mifepristone, which is proven to be safe and effective," he said.

Can I buy mifepristone even with the TN abortion ban?

The short answer is yes, but there's risks. According to Plan C Pills, a public health creative campaign seeking to normalizing self-directed abortion, Tennesseans can still get abortion pills by mail from telehealth providers in other states with shield laws, which protect clinicians who provide reproductive health care regardless of where a patient lives.

They can also get abortion pills on their own from alternative providers, like international online clinics and websites that sell pills.

Tennessee state laws concerning abortion can only target healthcare providers, not those receiving care.

What is Tennessee's abortion ban?

Tennessee's near-total abortion ban went into effect in August 2022 after the U.S. Supreme Court abolished the right to an abortion.

The Tennessee General Assembly in April 2023 created a medical condition exception to the ban, which allows physicians to perform an abortion if they determine “using reasonable medical judgment” that abortion is necessary “to prevent the death of the pregnant woman or to prevent serious risk of substantial and irreversible impairment of a major bodily function of the pregnant woman.”

Under the ban, convicted physicians face criminal penalties up to 15 years in prison, $10,000 in fines and having their medical license revoked.

Tennessee ban prevents even life-saving abortions, plaintiffs argue

Seven women denied abortion and two obstetricians urged a Nashville court in April to block the state's abortion ban for people with dangerous pregnancy complications.

The three-judge panel on the case has not yet ruled.

Lawyers argued that the exception in Tennessee's abortion ban that permits abortions to save the pregnant person's life or prevent serious injury is so vague that physicians are not performing medically necessary abortions that may actually have been legally permitted.

Linda Goldstein, an attorney for the plaintiffs, said in April the vagueness of the exception is creating a chilling effect by “sowing confusion throughout Tennessee’s medical community,” adding that it “seems calculated to deter care and intimidate physicians.” Goldstein urged the judges to look beyond the words of the exception and analyze how it is being applied.

“This court is not obligated to close its eyes as to whether the statute is working or not,” she said.

Whitney Hermandorfer, director of the Tennessee Attorney General’s Office strategic litigation unit, said the addition of the medical exception, created nearly a year after the ban was put in place, was a “physician friendly development” and gives doctors the necessary leeway that plaintiffs claim is lacking.

She argued the plaintiffs had not met the necessary burden to prove the medical exception is unconstitutionally vague, which Hermandorfer said is a “very high hurdle to clear.”

Poll shows Tennesseans don't agree with legislature's strict ban

A majority of Tennessee women across all political ideologies are self-identifying as "pro-choice," according to new poll released by Vanderbilt University, mirroring a large political gender gap seen across a number of health-related issues.

Bipartisan support for at least some abortions in certain cases has been steadily growing in the Volunteer State over the past decade, with a slim majority of Tennesseans identifying as "pro-choice" for the first time in a November 2022 poll, months after the state implemented one of the strictest abortion bans in the nation.

According to the most recent Vanderbilt poll released last month, 52% of registered voters consider themselves either "definitely" or "somewhat" pro-choice. Vanderbilt defined the terms as either supporting a "woman’s right to choose an abortion" or supporting "restricting access to abortion."

Approval ratings for the General Assembly, currently controlled by a Republican supermajority, have plummeted in recent years. Less than half of voters approve of the job the Tennessee legislature is doing, compared to a 60% approval rating in May 2020. The poll found 46% currently approve of the General Assembly's work.

Vanderbilt Poll co-director John Geer noted a disconnect between state policy and Tennessean opinion, such as on issues like abortion and gun safety, could be driving the low approval rating.

“State government appears to be paying a bit of a penalty for pursuing policies that are out of touch with Tennesseans," Geer said in May.

Melissa Brown, Angle Latham and Evan Mealins contributed to this report.

Allie Feinberg reports on politics for Knox News. Email her: allie.feinberg@knoxnews.com and follow her on X, formerly known as Twitter, @alliefeinberg.

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