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‘Legal and bureaucratic terrorism’: State physicians discuss court challenges to medication abortions

Following four separate rulings on mifepristone, physicians remain committed to providing medication abortions

“Confusion and fear.” That’s what Mindy Sobota ’95, primary care physician and associate professor of medicine, said is the goal of recent court rulings on the abortion pill mifepristone.

Since the Food and Drug Administration approved mifepristone for retail distribution in January, anti-abortion groups across the country have launched lawsuits to challenge the decision.

On April 7, a federal judge in Texas ruled to overturn the pill’s 23-year-long approval for in-clinic distribution by the FDA, citing safety concerns. That same day, a federal judge in Washington ordered that mifepristone remain widely available in the 17 Democratic-led states that challenged the Texas ruling in a lawsuit. Five days later, the Fifth Circuit court of appeals upheld the FDA’s original approval of the pill in 2000 but invalidated the drug’s approval for retail distribution in chain pharmacies such as Walgreens and CVS.

On April 21, the Supreme Court ruled that mifepristone will remain widely available while the case returns to the 5th Circuit for appeal.


With conflicting rulings, many physicians in Rhode Island — including Sobota — have found delivering patient care difficult.

“I found the Texas ruling shocking as a physician, because never before has an FDA-approved medication had this sort of ruling,” Sobota said. “It's really shaking my trust in the basic balance of power that underlies our country and its governance.”

When Sobota was a teenager in the 1980s, a family planning clinic near her house was bombed by anti-abortion groups, she said. In the 1990s, a colleague of hers was murdered for providing abortion care. Sobota said that now, “the tactics have really changed toward what I would call legal and bureaucratic terrorism at the level of federal rulings.”

“The confusion and conflicting information is incredibly frustrating,” said Benjamin Brown ’08 MD’12, assistant professor of obstetrics and gynecology at the Warren Alpert Medical School. “The chaos that we see from all of the legal rulings and all of the conflicting policies is part of the plan of folks who want to limit access to abortion.”

Sobota said her “biggest concern is that this will cause confusion for other physicians and health organizations when, in fact, what we're doing is legal.”

According to Benjamin Brown, who is an attending physician at Women and Infants Hospital, the confusion on what is and isn’t legal has not been limited to health professionals. He said that during visits, patients seeking abortions have told him, “I thought abortion wasn't legal anymore” — even though the right to an abortion is protected in the state of Rhode Island.

After each new ruling, Benjamin Brown connected with legal experts around the country “through phone calls and meetings and emails” to seek guidance on the legality of the care he provides.

As for student access to mifepristone, Tanya Sullivan, assistant clinical director of Brown Health Services, previously did not indicate if the on-campus pharmacy will apply to obtain certification from the FDA to fill mifepristone prescriptions. Sullivan declined to comment on the availability of mifepristone on campus following these court decisions.

CVS Director of External Communications Amy Thibaut also declined to comment on whether CVS will continue seeking certification to distribute mifepristone.

Sobota called on students, physicians and medical trainees to “stand up against what I would call a type of legal terrorism.”


“We're not going anywhere,” Benjamin Brown said. “We're going to be here to keep trying to make sure our patients can get the care that they need."

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Owen Dahlkamp

Owen Dahlkamp is a Section Editor overseeing coverage for University News and Science & Research. Hailing from San Diego, CA, he is concentrating in political science and cognitive neuroscience with an interest in data analytics. In his free time, you can find him making spreadsheets at Dave’s Coffee.

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