A federal appeals court on Wednesday partially upheld a Texas ruling restricting access to medication abortion, and reproductive rights advocates are bracing for a “showdown” before the U.S. Supreme Court, with implications for residents of Massachusetts.

According to Reproductive Equity Now, the Fifth Circuit Court of Appeals decision will not lead to changes in mifepristone access until the Supreme Court rules in the case, which the advocacy group says will likely take place in 2024.

Mifepristone was approved by the Food and Drug Administration more than 20 years ago and supporters say it’s “a safe and effective method of ending a pregnancy.” If the appeals court ruling is upheld, access to mifepristone would be restricted in all 50 states, Reproductive Equity Now said.

The Washington Post reported Wednesday that the three-judge panel of the conservative court said the FDA’s “decisions to allow the drug mifepristone to be taken later in pregnancy, be mailed directly to patients and be prescribed by a medical professional other than a doctor were not lawful.”

“In loosening mifepristone’s safety restrictions, FDA failed to address several important concerns about whether the drug would be safe for the women who use it,” Judge Jennifer Walker Elrod wrote in the opinion, according to the Post. “It failed to consider the cumulative effect of removing several important safeguards at the same time.”

If upheld, the Fifth Circuit’s decision would result in “additional trips to the clinic for patients, disproportionately restricting access to care for both rural and low-income communities, who may not be able to afford to take time off of work or find child care in order to travel to a clinic,” Reproductive Equity Now said.

“We are extremely disappointed that the Fifth Court upheld medically-unnecessary, politically-driven restrictions on mifepristone, but we are certainly not surprised,” said Reproductive Equity Now President Rebecca Hart Holder. “A rigged, far-right federal judiciary continues to play politics with our bodily autonomy and reproductive freedom. Today’s decision is yet another sign that anti-abortion forces will use any means necessary to attack abortion access nationwide, even in states like Massachusetts. The Dobbs decision was not the end of their assault and we should be clear-eyed about the looming threat. The good news is that nothing about mifepristone access will change until the Supreme Court hears this case, though we expect a showdown at the highest court.”

In April, after a federal judge in Texas suspended FDA approval of abortion pill mifepristone, Gov. Maura Healey issued an executive order that her team said was meant to clarify that a state law passed last year to protect abortion access from out-of-state prosecution extends to the pills as well.

Healey also announced in April that the University of Massachusetts Amherst had ordered 15,000 doses of mifepristone to stockpile in event of a shortage and to help “ensure sufficient coverage in the state for more than a year.”

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