The Supreme Court will hear arguments on Tuesday regarding an abortion case, the first since conservative justices overturned the constitutional right to abortion two years ago. This case will determine the accessibility of a medication used in the majority of abortions in the U.S. last year.

Anti-abortion advocates are urging the judges to approve a decision from a right-leaning federal appeals court which would restrict the availability of mifepristone, one of the two medications used in abortion procedures.

The return of the high court to the complicated issue of abortion is happening in a political and regulatory environment that has been changed by the 2022 abortion ruling, resulting in numerous Republican-led states implementing strict bans or limitations on abortion.

The court’s decision had immediate implications on the political landscape, and the result of the upcoming case, which is anticipated to be determined by the beginning of summer, could impact elections for both Congress and the presidency.

If a decision is made in favor of those who oppose abortion, the real-life effects would be significant. It could result in the suspension of sending mifepristone through mail and at major pharmacy locations, shortening the time frame in which it can be used from 10 to seven weeks, and putting an end to the increasingly common use of telehealth appointments for obtaining the medication.

The FDA and pharmaceutical companies caution that this result could also weaken the overall drug approval process by allowing judges to question the agency’s scientific decisions.

Medical professionals and organizations who are against abortion believe that the FDA’s recent changes to regulations on obtaining the drug are unjustified and could put the health of women at risk throughout the country. However, the administration and Danco Laboratories, located in New York, who produces the drug mifepristone, defend that it is one of the safest drugs ever approved by the FDA.

One potential outcome is that the Supreme Court could refrain from addressing the more controversial elements of the case but still retain the availability of mifepristone. The government and Danco contend that the individuals challenging the case do not have the legal authority, or standing, to file a lawsuit. If the top court concurs, the case would essentially be dismissed and the previous ruling overturned.

The Supreme Court has scheduled another case involving abortion. In the upcoming month, the justices will be debating whether a federal law concerning emergency medical care at hospitals should include abortions, even in states where they are otherwise prohibited.

The legal battle over mifepristone began five months after the Supreme Court overturned the ruling of Roe v. Wade. Initially, abortion opponents claimed a major victory when U.S. District Judge Matthew Kacsmaryk, a Trump appointee in Texas, issued a broad ruling nearly a year prior that would have completely revoked the drug’s approval. However, the 5th U.S. Circuit Court of Appeals upheld the FDA’s original approval of mifepristone, while still recognizing the changes that were made by regulators in 2016 and 2021 to make it easier to administer the drug.

The Supreme Court put the appeals court’s modified ruling on hold, then agreed to hear the case, though Justices Samuel Alito, the author of the decision overturning Roe, and Clarence Thomas would have allowed some restrictions to take effect while the case proceeded.

Mifepristone is one of two drugs, along with misoprostol, used in medication abortions. Their numbers have been rising for years. More than 6 million people have used mifepristone since 2000. Mifepristone is taken first to dilate the cervix and block the hormone progesterone, which is needed to sustain a pregnancy. Misoprostol is taken 24 to 48 hours later, causing the uterus to contract and expel pregnancy tissue.

Medical professionals have stated that in the event that mifepristone becomes unavailable or difficult to acquire, they would instead use only misoprostol, which is less efficient at terminating pregnancies.