In April, for what appears to be the first time in history, a federal court in Texas1 invalidated the US Food and Drug Administration’s (FDA) approval of a drug—after more than 20 years on the market with a strong safety and efficacy record. The drug, mifepristone, blocks progesterone and has a range of uses, from treatment for Cushing syndrome to, when used together with misoprostol, ending a pregnancy and managing miscarriage. The 2-drug regimen is used for more than 50% of abortions in the US.