Okla. Court Clarifies Medication Abortion Ruling, Setting Stage for Supreme Court Action

October 30, 2013 — In response to a request from the U.S. Supreme Court, the Oklahoma Supreme Court on Tuesday clarified that a 2011 state abortion law (HB 1970) requiring physicians to follow FDA protocols for medication abortion drugs "effectively bans all medication abortions," the Washington Post reports (Barnes, Washington Post, 10/29).

Background on Case

The Oklahoma law requires physicians to follow FDA guidance on medication abortion, rather than guidelines from the American College of Obstetricians and Gynecologists and the National Abortion Federation that currently are used (Women's Health Policy Report, 10/7). An Oklahoma trial court judge struck down the law last year, and the state Supreme Court in December issued a brief affirmation of that decision (Liptak, New York Times, 10/29).

In June, the U.S. Supreme Court agreed to review the law, pending clarification from the Oklahoma Supreme Court on its understanding of the statute. In their request to the Oklahoma court, the Supreme Court justices asked whether the state judges thought the law bars use of the abortion drug misoprostol, even when physicians follow FDA protocol. They also asked whether the state measure prevents physicians from using the cancer drug methotrexate to treat ectopic pregnancies (Women's Health Policy Report, 10/7).

Details of Tuesday's Ruling

The state court on Tuesday said the Oklahoma law indeed prohibits mifepristone and methotrexate because FDA has not specifically approved either medication as an "abortion-inducing drug," as required under the state statute (Savage, "L.A. Now," Los Angeles Times, 10/29).

The court noted, "Ninety-six percent of medication abortions in the United States are now provided according to a regimen different from the one described in mifepristone's F.D.A.-approved label" (New York Times, 10/29).

The judges also wrote that the law is "so completely at odds with the standard that governs the practice of medicine" that it is clear lawmakers' only intent was to prevent women from obtaining abortions (Washington Post, 10/29).

Next Steps

According to the New York Times, now that the Oklahoma court has answered the high court's request, the case could be decided this term. However, the justices could opt to dismiss the case and wait for a narrower one focusing on whether states may require adherence to the FDA protocol for mifepristone.


Oklahoma Attorney General Scott Pruitt (R) in a statement said, "The Oklahoma Supreme Court erred in striking down the law." He added, "We believe they have erred yet again by interpreting the law more broadly than the Legislature intended" (New York Times, 10/29).

Center for Reproductive Rights President Nancy Northup said in a statement that the decision "strongly reaffirms that this blatantly unconstitutional law was designed to not only rob women of the safe, legal and effective option of medication to end a pregnancy at its earliest stages, but also threaten the health, lives and future fertility of women suffering ectopic pregnancies" ("L.A. Now," Los Angeles Times, 10/29).