Two conflicting rulings Friday by federal judges in Texas and Washington over the legality of the abortion medication mifepristone has left access to the drug in limbo for women across the United States.
Massachusetts Governor Maura Healey swiftly responded to the Texas ruling, which placed a seven-day stay on the order to suspend the U.S. Food and Drug Administration’s approval of the medication.
“Mifepristone will stay available in Massachusetts. You have my word,” Healey said in a Tweet Friday night.
A separate ruling by a judge in Washington state would protect access to the drug in 17 states, including Connecticut, Rhode Island, Maine, and Vermont, where attorneys general sued over the issue in February.
Massachusetts is not part of the Washington lawsuit and the decision’s impact on the state was not immediately clear late Friday night.
Either way, one legal observer said, the question over access to mifepristone, which was approved over 20 years ago by the FDA, will likely be settled in a federal appeals court or at the US Supreme Court.
“The fact that there are two dueling rulings requiring [the] FDA do opposing things make it likely (though nothing is certain) that the Supreme Court will take the case quickly,” I. Glenn Cohen, a professor and deputy dean at Harvard Law School, wrote in an e-mail Friday night.
If the Texas decision, which came in response to a lawsuit filed by an antiabortion group, were to go into effect, “then it would apply nationwide, including Massachusetts,” he wrote.
Healey, who called mifepristone “the gold standard,” said her administration is “prepared to take immediate action to protect access to this important medication.”
What that action will look like remains unclear. Healey will hold a press conference on Monday to discuss her plans.
Massachusetts Attorney General Andrea Campbell’s office did not respond to a message seeking comment Friday night.
Campbell tweeted Friday night saying that “medication abortion is safe, effective & REMAINS AVAILABLE” but she did not specifically mention mifepristone.
Mifepristone is one of two drugs used for medication abortion in the United States, along with misoprostol.
In a statement released late Friday, President Joe Biden sharply criticized the Texas ruling as “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,” Biden said.
The Justice Department has already filed an appeal “and will seek an immediate stay of the decision,” Biden said.
Cohen said the appeal will be filed with the 5th circuit. The court is in New Orleans, which covers Texas. Any further appeals would go to the Supreme Court, he said.
Danco Laboratories, the manufacturer of Mifeprex, the branded product for generic mifepristone, issued a statement Friday night that said the company joined the case as a defendant and will seek a stay while appealing the ruling.
The company said Mifeprex has been used by more than 5 million women since its approval in 2000.
“This is a dark day for public health, especially for reproductive rights and the reliance on science and medical expertise to guide decisions about what drugs are safe and effective and should be available to patients,” Abby Long, Danco’s director of public affairs, said in the statement.
“The court’s order fails to account for the meticulous, well-documented FDA decision-making process that led to the initial 2000 approval and the subsequent approvals setting the conditions under which Mifeprex has been distributed for 23 years,” she said.
Mifepristone is part of a two-drug regimen used in medication abortion.
If the drug is no longer available in Massachusetts, patients can switch to using only the second drug, misoprostol, according to Dr. Katharine White, a complex family planning specialist at Boston Medical Center.
The single-drug regimen requires more doses, is less effective in eliminating a pregnancy, and carries more possible side effects, but it is commonly used in countries where mifepristone is banned, she said.
“People are still going to get good evidence-based care in the commonwealth and elsewhere tomorrow and Monday and a week from now, but more people will suffer needlessly as a result of this decision if it is upheld, which is the point,” said White, who is also an associate professor obstetrics and gynecology at Boston University Chobanian & Avedisian School of Medicine. “It’s going to be a more miserable experience with more follow-up required than it needed to be, and that’s not by accident.”
White said she was in contact with multiple colleagues Friday night discussing the Texas ruling and the common feelings were “outrage, sadness, and feeling resolute to continue.”
“The community has been holding its breath for weeks since the oral arguments in this case,” she said. “It’s incredibly disappointing but not surprising.”
She said providers are “anxiously awaiting any guidance from the FDA or the Biden administration.”
“Doctors were advised by lawyers to expect chaos and confusion in the days following this ruling, and it looks like they were correct,” she said.
Correction: An earlier version of this story misidentified the U.S. Food and Drug Administration. The Globe regrets the error.