What dueling abortion pill rulings mean for Mass.

Efforts to limit if not ban abortion nationwide may have pierced protections in Massachusetts for the first time. In a preliminary ruling, a federal judge in Texas has ordered the Food and Drug Administration to take mifepristone, one of two medications used to induce an abortion, off the market.

The order issued Friday was scheduled to take effect in seven days. The Biden administration filed an appeal within hours, according to NPR. A separate decision from a federal court in Washington state contradicted the Texas ruling.

The judge in Washington, acting on a lawsuit filed by Democratic Attorneys General from 17 states, not including Massachusetts, ordered the FDA to maintain the availability of mifepristone. The drug has been approved for abortions in the U.S. for more than two decades, and is widely considered safe and effective for most patients in early pregnancy.

Massachusetts Gov. Maura Healey said, in a statement, that she is “prepared to take immediate action to protect access to this important medication.” Healey’s office said she’ll outline a plan on Monday.

Drug policy is controlled by the FDA, not states, a lesson Massachusetts learned in 2014 when the state tried to halt sales of a powerful new painkiller.

Abortion is still legal in Massachusetts. But while advocates and lawyers on both sides of this issue appeal the use of mifepristone, confusion may disrupt the use of medication abortions, which are nearly half of the abortions conducted in the commonwealth, and more than half of those conducted nationwide.

Rebecca Hart Holder, director of the abortion rights group Reproductive Equity Now, said anyone planning a medication abortion within the next week should keep their appointment, but she expects more patients will seek surgical abortions to avoid any legal uncertainty.

The Texas ruling “is playing with our lives in a really disgusting and disingenuous way,” said Hart Holder. “People are not going to know what’s legal, what’s not legal, when they can access and where they can go to access care.”

Anti-abortion advocates in Massachusetts said they are grateful the Texas court is moving to stop what the ruling calls a dangerous drug.

“This decision will, by definition, save lives,” said Massachusetts Family Institute President Andrew Beckwith. “And, because of its nationwide implications, it serves to restrain the rampant evil of abortion even here in the Bay State.”

Even if the Texas judge’s preliminary ruling is allowed to stand, medication abortions will still be available in Massachusetts.

Planned Parenthood League of Massachusetts said it is prepared to continue medication abortions with just misoprostol, the pill typically used in combination with mifepristone. Abortions using just misoprostol are complete without the need for surgery in 93% of pregnancies up to 10 weeks, the recommended threshold for a medication abortion. Using both drugs increases the rate to 99%.

Dr. Tara Kumaraswami, an obstetrician and gynecologist at UMass Memorial Medical Center, said she should be allowed to give patients the most effective abortion care.

“I want to ensure that my patients have access to the best options possible,” she said, “that they are able to choose what’s best for them.”

If mifepristone is removed from the market, the Massachusetts Medical Society warned it could have a disproportionate impact on rural areas like southeastern and western Massachusetts, which lack clinics that provide abortions.

But the ruling from Judge Matthew Kacsmaryk in Texas reflects concerns among some abortion rights opponents about the easy access to the procedure that pills provide. David Franks, board chair at Massachusetts Citizens for Life, said in an email that pills taken without medical supervision can be dangerous. He called the FDA’s approval of mifepristone irresponsible and said the agency’s decision to relax rules around use of abortion pills was reckless.

“Judge Kacsmaryk’s ruling,” said Franks, “exemplifies the continuing strength of our democracy: no one, even in the name of science, is beyond the reach of public reason.”

Massachusetts U.S. Rep. Ayanna Pressley, a Democrat, said the Texas judge’s ruling represents a potentially “devastating threat” to millions, and would be felt most heavily by people of color.

“If allowed to go into effect, this ruling, like all abortion restrictions, would fall hardest on Black, brown, low-income, LGBTQ, Indigenous folks, the disabled, and more of the most marginalized,” Pressley said in a written statement.