The abortion pill is at risk of being banned across the US. His future is being decided by a conservative judge in Texas, who abortion opponents are asking to suspend his license.

Matthew Kaczmarekwho has been dChristian organization attorney and appointed federal judge by former U.S. President Donald Trump, heard arguments yesterday from two opposing sides: the Joe Biden administration and an anti-abortion group led by the Texas-based Equine Medical Association, which sued to overturn the federal license granted 22 years ago to mifepristone.

Kaczmarek asked the plaintiffs to explain how he would be able to revoke the license of a drug that has been on the market for years in the US.

The judge left open the possibility of issuing one more limited decisionallowing the drug to continue to be available, but imposing some restrictions that have been lifted under the Biden presidency, such as the requirement that mifepristone only be given in person and not sent by mail.

Kaczmarek pledged to issue his ruling “as soon as possible,” according to the few reporters in the courtroom in Amarillo, Texas.

This case could have very serious implications at the national level in the US, similar to the US Supreme Court’s decision in June, when it overturned the historic 1973 decision that protected the right to abortion at the federal level. Twelve of the 50 US states have since outlawed abortion altogether, while many others have adopted very strict restrictions, according to the Guttmacher Institute.

This time, the Texas court’s decision could affect all states, even those that protect the right to abortion, and affect the roughly 500,000 women who use the abortion pill each year. The plaintiffs are asking Kaczmarek to suspend sales of mifepristone until the case is resolved.

For Planned Parenthood president Alexis McGill Johnson, “the Amarillo case is a reminder to everyone who thought the Supreme Court’s decision didn’t apply to them because they live in a state that protects abortion rights.”

“Politics over science”

In November, a group of doctors and anti-abortion groups sued the Food and Drug Administration (FDA) for approving mifepristone, one of two abortion pills.

The plaintiffs accuse the FDA of choosing “politics over science” in approving the drug, which they say can cause complications. They also claim that the agency did not follow the proper approval process and did not adequately review the drug’s safety when used by girls under 18.

The FDA has reported overall 26 deaths related to the drug since 2000, when it was approved, a rate of 0.65 deaths per 100,000 people. By comparison, aspirin-related deaths are 15.3 per 100,000 people.

The plaintiffs chose to file their lawsuit in Amarillo, a Texas city far from major urban centers where Kaczmarek is the only federal judge.

His profile and his known position against abortion have raised concern among women’s rights advocates.

“It seems unbelievable that a simple judge from Texas could issue a decision that would have implications for a drug that has been approved by health authorities and has been available commercially safely for more than 20 years,” lamented Elisa Wells, founder of Plan C Abortion Pill Information Network.

Such a decision would be “devastating for women”, White House spokesperson Karin Jean-Pierre complained ten days ago.

Since 2000, more than 5.6 million women have used mifeprostone in the US.

Against Kaczmarek’s decision, whatever it is, will be appealed to the federal appeals court in New Orleans, also known for its conservatism. Ultimately, the case may end up before the US Supreme Court.