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Monday, May 20, 2024

Texas judge's ruling to ban mifepristone nationwide cites Wikipedia, contains pro-life talking points, and gets basic facts about abortion wrong: Experts say it's 'completely flawed'

Texas judge's ruling to ban mifepristone nationwide cites Wikipedia, contains pro-life talking points, and gets basic facts about abortion wrong: Experts say it's 'completely flawed'

Judge Matthew Kacsmaryk overturned FDA approval of an abortion medication with a ruling full of inaccuracies, legal and healthcare experts told Insider.

A Texas judge on Friday overturned the nationwide FDA approval of abortion medication with a ruling that legal and healthcare experts told Insider is full of inaccuracies.

In addition to citing the Wikipedia definitions for both "pregnancy" and "disease" in his ruling, Judge Matthew Kacsmaryk falsely claimed abortion medication "ultimately starves the unborn human until death" and made sweeping generalizations about the psychological impact of abortions on women who receive them — which health care providers told Insider aren't accurate.

"Whim and caprice aren't the same as facts and evidence, and are not an objective foundation for good law," Los Angeles attorney Vineet Dubey, co-founder of Custodio & Dubey LLP, a law firm specializing in injury, environmental litigation, and civil rights cases, said in a statement emailed to Insider, indicating the judge's ruling came "without the knowledge necessary to make an informed decision."

Dubey added: "Judges aren't intended to be subject matter experts outside of interpreting the law."


The ruling misstates how the drug works


The conservative, Trump-appointed Texas judge behind the ruling in the Alliance for Hippocratic Medicine v. FDA case has long supported the anti-abortion movement. His mother, Dorothy, is a microbiologist who began working at anti-abortion crisis pregnancy centers, his sister, Jennifer Griffith, told The Washington Post.

In his ruling, Kacsmaryk included common phrases used by anti-abortion activists, not scientists, and misinformation.

"Mifepristone — also known as RU-486 or Mifeprex — is a synthetic steroid that blocks the hormone progesterone, halts nutrition, and ultimately starves the unborn human until death," Kacsmaryk's ruling reads, calling those who provide the medication "abortionists."

But an OB-GYN told Insider the judge's interpretation of what the drug does is medically inaccurate.

"I would say that's not a medical description of the way that that it works," Daniel Grossman, MD, the director of the University of California San Francisco's reproductive health care program, Advancing New Standards in Reproductive Health (ANSIRH), told Insider.

Mifepristone, Grossman said, blocks the progesterone receptor early in the pregnancy to keep the lining of the uterus from getting thick enough for an embryo to successfully implant on it, causing the pregnancy to start to separate from the uterine wall. Working in tandem with a second medication called misoprostol, which causes the contraction of the uterus, the drugs cause the expulsion of the embryo.

The process is "kind of like having a really heavy, crampy period," according to Planned Parenthood.

"From a medical perspective, we call the developing pregnancy an embryo at this stage. Mifepristone and misoprostol are sometimes used before we can even see an embryo on ultrasound," Grossman told Insider. "So, that term 'unborn human' — that's not a medical term that we use."

He added: "And the language around nutrition and starvation is certainly very emotional language, but those aren't the medical terms that we use in this context."

Prior to implanting in the uterine lining and the development of a placenta, an embryo relies on nutrients from endometrial secretions, which are present during the second half of the menstrual cycle whether a pregnancy occurs or not, according to SITNBoston, a Harvard science publication.


"Inappropriate, unethical, and jarring" misinformation


But the medical processes and descriptions of how the drugs work weren't the only inaccuracies in the judge's ruling.

M. Antonia Biggs, PhD and social psychologist at ANSIRH, told Insider that Kacsmaryk was "perpetuating misinformation and propagating the myth that abortion causes mental health harm" through his ruling.

"What we do know is that abortion does not increase people's risk of having depression, anxiety, post-traumatic stress, suicidal ideation, or substance use disorders, which is completely against many of his claims," Biggs told Insider. "We also know that people do not come to regret their abortions."

In the ruling, Kacsmaryk writes that women who receive an abortion are at higher risk of death by suicide, "self-destructive tendencies, depression, and other unhealthy behavior aggravated by the abortion experience," citing studies debunked by the broader scientific community, Biggs said.

Kacsmaryk also claims women experience "intense psychological trauma" from seeing an expelled embryo.

Biggs said when she worked on a longitudinal research project called The Turnaway Study, examining the mental, physical, and socioeconomic consequences of receiving an abortion compared to carrying an unwanted pregnancy to term, the results showed the opposite — 95% said that they felt that it was the right decision for them.

"When we did find harm, any kind of psychological harm, it was not to people who had an abortion, but it was people who were denied abortion," Biggs told Insider. "So people who are denied abortion experience short-term, elevated levels of stress, anxiety, and low self-esteem."

Spreading such misinformation through an official judicial ruling, Biggs said, is "inappropriate, unethical, and jarring."

"When you're issuing a ruling that's going to impact people nationally, one would hope that that ruling would be evidence-based and that it would look at the body of evidence instead of cherry-picking studies that are really not in line with the scientific consensus on the topic," Biggs said, adding, "so many of the things in this ruling I would say are completely flawed. It's definitely not going to help or prevent mental health harm or physical harm as it claims – it's going to do the opposite."

Kacsmaryk did not immediately respond to Insider's request for comment.

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