Federal district courts in Texas and Washington issued conflicting rulings April 7 regarding access to the abortion pill mifepristone, setting up a likely Supreme Court hearing to sort out the national ramifications.

In the Texas ruling, Judge Matthew J. Kacsmaryk castigated the Food and Drug Administration (FDA) for stonewalling judicial review of the abortion pill’s approval for two decades. “Had FDA responded to Plaintiffs’ petitions within the 360 total days allotted,” he said, “this case would have been in federal court decades earlier. Instead, FDA postponed and procrastinated for nearly 6,000 days.”

The judge also took the FDA to task for making changes to the abortion pill regimen that removed safety restrictions and thus endangered pregnant women.

“FDA acquiesced on its legitimate safety concerns—in violation of its statutory duty,” the judge said, adding, “Whether FDA abandoned its proposed restrictions because of political pressure or not, one thing is clear: the lack of restrictions resulted in many deaths and many more severe or life-threatening adverse reactions.”

Further, Kacsmaryk said, the mailing of chemical abortion drugs is a clear violation of the Comstock Act, a federal law that specifically renders illegal the mailing of “[e]very article or thing designed, adapted, or intended for producing abortion … and [e]very article, instrument, substance, drug, medicine, or thing which is advertised or described in a manner calculated to lead another to use or apply it for producing abortion.”

Kacsmaryk’s ruling placed a hold on mifepristone, although it paused the ruling for seven days to allow for appeals. The U.S. Department of Justice quickly appealed, sending the case to the U.S. 5th Circuit Court of Appeals, which is expected to act quickly on the case.

“By illegally approving dangerous chemical abortion drugs, the FDA put women and girls in harm’s way, and it’s high time the agency is held accountable for its reckless actions,” said Erik Baptist, senior counsel for Alliance Defending Freedom. Baptist argued the case before the court on March 15. “This is a significant victory for the doctors and medical associations we represent and, more importantly, the health and safety of women and girls.”

Shortly after the Texas ruling, Judge Thomas O. Rice, in the U.S. District Court for the Eastern District of Washington, ordered the FDA not to make any changes that would restrict access to the abortion pill in any of 17 states that had sued to expand access to the abortion pill.

The states affected by Rice’s ruling are: Washington, Oregon, Arizona, Colorado, Connecticut, Illinois, Delaware, Michigan, Nevada, New Mexico, Rhode Island, Vermont, Hawaii, Maine, Maryland, Minnesota and Pennsylvania, in addition to Washington, D.C.

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