A recent ruling by U.S. District Judge Matthew J. Kacsmaryk threatens to limit access to medication abortions by challenging the safety of mifepristone, which has been used safely for over 20 years in the U.S. This decision contradicts the recommendations of numerous medical groups, who warn that the ruling could make it difficult to access the most common and affordable form of abortion. However, a federal appeals court has temporarily blocked the decision by Kacsmaryk, which was the first time a court suspended approval of a medication after rejecting the FDA's assessment. The FDA claims that between 2000 and June 2020, it received reports linking mifepristone to only 28 deaths out of the 5.6 million users. While the court's decision seems to rely on anecdotal evidence of adverse reactions to the drug, the medical community warns that this ruling undermines the scientific evidence that supports the drug's safety. Concerns remain around what the ruling means for off-label prescriptions, restrictions on midwives and nurse practitioners, and access to abortion and miscarriage care.