Two federal judges have issued opposing rulings on abortion pills. Here's what happens.

One ​​invalidated F.D.A. mifepristone, an abortion pill. The other ordered the F.D.A. doing nothing to restrict the pill's availability.

Texas federal judge's ruling overturning Food and Drug Administration approval 23 years ago of the abortion pill mifepristone has the potential to be the most consequential abortion ruling since the Supreme Court overturned Roe v. Wade last June.

But there is a lot of uncertainty, especially because a federal judge in Washington state issued a contradictory ruling less than an hour later saying the F.D.A. should do nothing to restrict the availability of the pill in most states that allow abortion.

So the situation is complicated. Here's what we know and what it could mean.

What did the two rulings say?

Both rulings are preliminary injunctions, issued before the full cases were heard. been heard. But the dueling injunctions set up a legal showdown likely to reach the Supreme Court.

The ruling by U.S. District Court Judge Matthew J. North Texas, a Trump appointee who wrote critically about Roe v. Wade, says the 2000 FDA approval of mifepristone is invalid. It also suspends further decisions by the F.D.A. which expanded the use of mifepristone to terminate teenage pregnancies.

Legal experts said Judge Kacsmaryk's ruling appears to be the first time a court had acted to order that an approved drug be withdrawn from the market despite the objection of the F.D.A. If upheld, they said, it could impact the federal government's power to regulate other types of drugs.

Judge Thomas' decision O. Rice of the U.S. District The Obama-appointed court for the Eastern District of Washington orders the F.D.A. to maintain the status quo and prevent it from restricting the availability of mifepristone in states that have sued in this court. That lawsuit, brought by Democratic attorneys general, challenged restrictions imposed by the F.D.A. still mandates prescribing and dispensing mifepristone.

What is mifepristone and can patients still get it?

Mifepristone is the first pill of the two-drug medical abortion regimen that is used in more than half of pregnancy terminations in the United States. It blocks a hormone that allows a pregnancy to develop. For now, it is still available.

Judge Kacsmaryk immediately suspended his ruling for seven days to give the Justice Department, which represents the F.D.A., a chance to appeal to the Court of Appeals of the United States for the Fifth Circuit, and the Department of Justice has already filed a notice of appeal.

If the appeals court affirms the order of the judges or refuses to pause it until the case is heard in full, the Justice Department will most likely appeal that decision to the Supreme Court, which could quickly decide whether or not to suspend the injunction . The Supreme Court would also consider the federal judge's contradictory ruling in the Washington District Court case, legal experts said.

Even if the federal judge's ruling Texas is confirmed, several scenarios would allow mifepristone to remain available in the United States, at least for now. And if the drug ends up becoming unavailable in the United States, patients will likely still be able to get it overseas. Read on for more details.

How can a judge revoke the approval of a legal drug for 23 years?

The trial in the District Court of Texas, brought by a consortium of anti-abortion groups and doctors, argues that the F.D.A. failed to adequately review the scientific evidence or follow proper protocols when it approved mifepristone in 2000 and has since ignored the drug's safety risks.

The F.D.A. and the Department of Justice strongly disputed these claims and said the agency had undertaken rigorous reviews of mifepristone over the years, repeatedly reaffirming its decision to approve mifepristone. They cite numerous studies showing that serious c...