We're closing our coverage of the ruling by a judge in Texas to suspend the use of abortion drug mifepristone.

The decision could limit access to the drug for millions of women. It comes almost a year after the landmark case Roe v Wade was overturned.

If you'd like to continue reading about this ruling, you can find more of our coverage here.

Not exactly. A competing court ruling means the pill is likely to be legal in a patchwork of states.

In his ruling, Judge Kacsmaryk in Texas said his stay would be on hold for seven days, so that the Department of Justice would have time to appeal.

That appeal is likely to happen as early as Monday, in the US Court of Appeals for the Fifth Circuit, which is known for being a conservative court.

The court could keep the judge's decision on hold while it reviews the case, or it could allow the decision to go ahead after the seven-day hold expires.

From there, the decision could be appealed all the way to the Supreme Court.

In the meantime, a Washington court has ruled that the FDA must keep the status quo, allowing mifepristone's approval, in 17 states and the District of Columbia that had filed that suit.

Image source, Reuters

The attempt to ban mifepristone is based on "ideological assertions" and "flies in the face" of scientific evidence, the American Medical Association has said.

A statement, external from the group, which has a membership of more than 270,000, said the ruling "threatens to upend access to a safe and effective drug that has been used by millions of people for more than 20 years".

"The court’s disregard for well-established scientific facts in favor of speculative allegations and ideological assertions will cause harm to our patients and undermines the health of the nation," it said.

"By rejecting medical facts, the court has intruded into the exam room and has intervened in decisions that belong to patients and physicians.

"The court’s rebuff of scientific facts also undermines informed decisions, erodes trust in institutions, exacerbates social divides, and places individual and collective health at risk."

It added that mifepristone "has been studied extensively for over two decades and has been proven to be safe time and time again".

Born in Florida, the Trump-appointed, Christian judge has been a long-time member of the conservative legal group the Federalist Society.

He has campaigned for Texas senators Ted Cruz and John Cornyn and Texas Governor Greg Abbott.

The 46-year-old previously worked for First Liberty Institute, a conservative legal group, and he had been a federal prosecutor in Texas.

His 2019 confirmation was opposed by abortion rights groups and LGBTQ advocates.

Image source, Getty Images

Judge Matthew Kacsmaryk decided that the Federal Drug Administration’s authorisation of the abortion pill mifepristone was improper.

He heard a lawsuit filed by the Alliance for Hippocratic Medicine, an anti-abortion organisation, argues there are three reasons why the drug should be be removed from shelves.

The group argued mifepristone - which had been approved for 20 years - was never properly studied by the US Food and Drug Administration(FDA).

The decision is on hold for seven days to allow for the Biden administration to appeal to the US Court of Appeals for the Fifth Circuit.

If you're just joining us, here's a quick round-up of all the latest reaction to the ruling in the US suspending the use of the abortion pill mifepristone:

• On Friday, a Trump-appointed federal judge in Texas ordered a hold on the Food and Drug Administration's (FDA) approval of mifepristone.
• The pill was first approved in 2000 and accounts for more than half of all pregnancy terminations in the US.
• The judge, Matthew Kacsmaryk, claimed that, in approving the drug the FDA had failed to consider its "psychological effects" and its safety record.
• The decision has drawn criticism from pro-abortion groups and medical associations.
• The ruling will not go into effect for seven days to allow the government time to appeal.
• An Obama-picked judge in Washington state has also issued a competing ruling ordering that access to the drug be preserved in 17 states.

Image source, Getty Images

Attempts to limit access to abortion are spreading across the US "like a malignant tumour", House Minority Leader Hakeem Jeffries has said.

The New York congressman succeeded Nancy Pelosi as the leader of the Democratic Party in the House of Representatives in January.

Writing on Twitter, the top ranking Democrat said: "A rogue Judge just suspended FDA approval of mifepristone.

"The Extreme MAGA Republican assault on abortion care is spreading across America like a malignant tumor.

"We must all speak up, show up and stand up until the far-right uprising is peacefully and democratically crushed."

Robin Levinson King
BBC News

Image source, Getty Images

In the US, drugs are approved by the Food and Drug Administration (FDA). Review teams are made up of medical experts, who are tasked with determining if a drug is safe.

In his ruling, Judge Kacsmaryk - who does not have a medical degree - found that allowing the drug to remain on the market meant that plaintiffs "are likely to suffer irreparable harm".

Legal scholars say this ruling is a direct challenge to the authority of the FDA - if he can decide that a review panel of experts erred, than another judge could do the same for other controversial drugs.

This could make drug makers wary about developing new drugs, experts caution, because they will not be able to rely on FDA approval.

Conversely in Washington, Judge Rice specifically said he could not weigh in on mifepristone safety: “It is not the Court’s role to review the scientific evidence and decide whether mifepristone’s benefits outweigh its risks."

Image source, Reuters

The Biden administration has called Judge Matthew Kacsmaryk's ruling the "next big step toward the national ban on abortion" and said it plans to fight the decision.

In a statement, external, President Joe Biden said: "Today a single federal district judge in Texas ruled that a prescription medication that has been available for more than 22 years, approved by the FDA and used safely and effectively by millions of women here and around the world, should no longer be approved in the United States.

"The Court in this case has substituted its judgment for FDA, the expert agency that approves drugs. If this ruling were to stand, then there will be virtually no prescription, approved by the FDA, that would be safe from these kinds of political, ideological attacks."

It added that the ruling "another unprecedented step in taking away basic freedoms from women and putting their health at risk".

"This does not just affect women in Texas – if it stands, it would prevent women in every state from accessing the medication, regardless of whether abortion is legal in a state," he said.

The attempt to ban mifepristone is a step towards a nationwide abortion ban and could throw the US "into chaos", Senate Majority Leader Chuck Schumer has said.

Writing on Twitter, Schumer said the people who brought the case had "sought out an extremist judge who is vehement in his desire to take women’s rights away".

"This ruling from an activist judge is wildly out of step with the law and sets a dangerous new precedent," he said.

"Senate Democrats are relentlessly working to protect a women’s right to choose from this extreme MAGA Republican agenda."

• For over 20 years of use, the FDA, the American College of Obstetrics and Gynaecologists (ACOG) and other mainstream medical organisations have maintained that both mifepristone and misoprostol are safe for use.
• US studies say the two-step medication regime is about 95% effective in ending pregnancy, external and requires further medical follow-up less than 1% of the time.
• Increasingly, anti-abortion campaigners have said that abortion medication, which they call"chemical abortion", is risky and ineffective
• But their claims of widespread harm are not supported by leading medical organisations, such as the World Health Organization and the American Medical Association
• According to the FDA, there are five deaths per million users of mifepristone, external. In comparison, a 2001 study, external found there were about 20 deaths per million users of penicillin, due to an allergic reaction to the commonly prescribed antibiotic.

Two legal scholars who filed briefs in the Texas mifepristone lawsuit, in favour of keeping the drug on the market, react:

I. Glenn Cohen, Harvard Law School: "The Texas decision is bad news for FDA but not unexpected... There are silver linings.

"The fact that there are two dueling rulings requiring that the FDA do opposing things makes it likely (though nothing is certain) that the Supreme Court will take the case quickly.”

Allison Whelan, Georgia State University College of Law: "The politics and ideology motivating Judge Kacsmaryk’s decision could not be made any clearer by the inflammatory anti-abortion language used throughout the opinion.

"He cherry-picks the studies he cites to support his conclusion that abortions are unsafe or harm those who get abortions, without citing the many studies that refute those conclusions."

Groups opposed to abortion have applauded the Texas court ruling. They argued that the drug is not safe, though the FDA, the American College of Obstetrics and Gynaecologists and other mainstream medical organisations maintain mifepristone is safe.

March for Life: "This action by the court will save lives and ensure that the health and safety of women and girls is not compromised for the sake of advancing a pro-abortion political agenda.

"This is a significant victory for the doctors and medical associations we represent and more importantly, the health and safety of women and girls."

Alliance Defending Freedom: “The FDA never had the authority to approve these hazardous drugs and remove important safeguards.

"This is a significant victory for the doctors and medical associations we represent and, more importantly, the health and safety of women and girls.”

Image source, Getty Images

Leaving a trip to Tennessee, Vice-President Kamala Harris condemned the breaking abortion pill ruling in Texas.

“It is contrary to what makes for good public health policy to allow courts and politicians to tell the FDA what it should do,” Harris said.

She continued to say, "As a general matter, I'll say that there is no question that the president and I are going to stand with the women of America and do everything we can to ensure that women have the ability to make decisions about their health care, their reproductive health care".

The Department of Justice has issued a statement from Attorney General Merrick Garland announcing their intention to appeal the Texas court's decision.

“The Justice Department strongly disagrees with the decision of the District Court for the Northern District of Texas in Alliance for Hippocratic Medicine v. FDA and will be appealing the court’s decision and seeking a stay pending appeal," the statement reads.

"Today’s decision overturns the FDA’s expert judgment, rendered over two decades ago, that mifepristone is safe and effective. The Department will continue to defend the FDA’s decision."

The statement adds that the "Department is committed to protecting Americans’ access to legal reproductive care."

Image source, Reuters

Democratic Congresswoman Alexandria Ocasio-Cortez has called on the Biden administration to ignore the ruling suspending the sale of mifepristone.

Speaking on CNN, Ocasio-Cortez said that many of the judges appointed during the presidency of Donald Trump were "completely unqualified” and had caused an “unprecedented and dramatic erosion of the legitimacy” of the courts.

“The Biden administration should ignore this ruling," she said.

“Republicans knowingly put these folks on the bench because they… knew that they would get outcomes like these,” she said.

“This is an effort to subvert the will of the American people."

She added that mifepristone had been legal and on the market for 23 years and that banning it now was "like someone coming out… and outlawing… aspirin because they felt like it”.

“There is no medical evidence, there is no new study” to support the ruling, she said.

The Food and Drug Administration (FDA) failed to consider the "psychological effects" of mifepristone before originally approving it in 2000, according to the judge who issued Friday's ruling.

US District Judge Matthew Kacsmary, who was appointed by former US President Donald Trump, said that women undergoing chemical abortion often experience "intense psychological trauma and post-traumatic stress", and that the FDA's "failure [to account for this] should not be overlooked or understated".

He added that the drug was also not tested for "under-18 girls undergoing reproductive development".

Image source, Getty Images

Several senior Democratic Party politicians have reacted with anger to Judge Matthew Kacsmary's ruling earlier tonight.

Outspoken Massachusetts Senator Elizabeth Warren wrote on Twitter: "One Trump-appointed judge in Texas thinks he knows better than decades of scientific evidence and ruled to block access to medication abortion nationwide."

She continued to say, "we can’t let one right-wing extremist overrule women, their doctors, and the scientists at" and urged the Biden administration to appeal.

Oregon Senator Ron Wyden, who heads the Senate Finance Committee that oversees Food and Drug Administration (FDA), said "I believe the Food and Drug Administration has the authority to ignore this ruling.”

"The FDA, doctors, pharmacies can and must go about their jobs like nothing has changed and keep mifepristone accessible to women across America," his statement read.

The attempt to ban mifepristone is "unprecedented and harmful", Planned Parenthood has said.

Writing on Twitter, the group, which provides sexual healthcare and advocates for reproductive rights, said: "Today, in an unprecedented and harmful decision, a federal judge in Texas ruled that the FDA’s approval of mifepristone — one of the two medications used in the most common medication abortion regimen in the US — was unlawful, threatening access nationwide.

"This won't go into effect for at least 7 days. We'll keep you up to date. We'll always be fighting for your care, no matter what."

The attempt to ban mifepristone shows Republicans hope to introduce a nationwide ban on abortion, the Democratic Party has said.

A tweet from the party's official Twitter account read: "MAGA Republicans aren’t stopping at Roe v. Wade. They will continue pushing their extreme anti-choice agenda to try to ban abortion nationwide.

"Democrats will do everything in our power to fight back to ensure access to abortion care is protected."

Roe v Wade was a 1973 Supreme Court ruling which held that the right to privacy guaranteed by the US constitution should include a woman's liberty to choose to have an abortion.

The decision was overturned by the court - on which conservatives currently hold a six to three majority - in June of last year.