Document ID: ./input/supremecourt_opinions/opinions/20pdf/20a34_3f14.pdf
Page Number: 10

8 

FDA v. AMERICAN COLLEGE OF OBSTETRICIANS AND 
GYNECOLOGISTS 
SOTOMAYOR, J., dissenting 

weeks or later.10  A woman seeking a medication abortion 
may therefore be left with fewer than three weeks to find 
an accessible clinic that will provide mifepristone, schedule 
and  receive  the  required  counseling,11  and  make  an  ap-
pointment to collect the medication in person, all while try-
ing to determine the safest way to travel to the clinic and 
perhaps wondering whether she will bring COVID–19 back 
home with her. 
  What rejoinder  does  the Government  have  to the possi-
bility that refusing to suspend the FDA’s in-person require-
ments  for  mifepristone  during  the  COVID–19  pandemic 
will cause some women to miss the 10-week window alto-
gether?  No cause for concern, the Government assures this 
Court,  because  even  if  the  FDA’s  in-person  requirements 
cause women to lose the opportunity for a medication abor-
tion, they can still seek out a surgical abortion.  What a cal-
lous response. 
  As the Government acknowledges, surgical abortions are 
far  more  invasive  than  medication  abortions.    Medication 
abortion involves taking two pills and the equivalent of an 
early miscarriage.  When a woman undergoes surgical abor-
tion, she requires local anesthesia and sometimes sedation, 
her cervix is stretched with dilating rods, a tube is inserted 
through her cervix into her uterus, and, depending on the 
particular procedure, various medical tools are used to re-
move fetal tissue from her uterus.  On top of this, surgical 
abortions carry all the same (and likely greater) risks of ex-
posure to COVID–19 as do medication abortion’s in-person 
requirements. 
  The  Government  insists  that  requiring  women  to  un-

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10 See Branum & Ahrens, Trends in Timing of Pregnancy Awareness 
Among  US  Women,  21  Maternal  &  Child  Health  J.  715, 719, 721–722 
(2017). 

11 The required counseling can take place in person or via telemedicine, 

although the patient must then sign a disclosure form in person.