The Food and Drug Administration, which is battling to keep the abortion pill legal, and the anti-abortion organizations that launched the lawsuit will have the first chance to present their cases at a meeting on Wednesday in a lawsuit that attempts to reverse government approval of a popular abortion drug. 

The lawsuit, which aims to stop the more than 20 years of lawful use of abortion-inducing drugs, may have far-reaching effects in places where abortion is permitted, not just those where it is prohibited. More than half of pregnancies in the United States are ended with medication, and 40% of facilities that perform abortions only give abortion pills, not the surgical process. 

The plaintiffs’ request that Judge Matthew J. Kacsmaryk of the Northern District in Texas grant a preliminary injunction directing the F.D.A. to revoke its longstanding approval of mifepristone, the first pill in the two-drug medication abortion regimen, will be the main topic of discussion at the hearing on Wednesday. 

Trump appointee Judge Kacsmaryk, who has criticized Roe v. Wade in writing and who formerly worked for a Christian right legal group, did some unusual actions prior to the meeting. He requested the attorneys representing the parties in the case to keep silent about the upcoming hearing when they met with him last Friday, explaining that he would wait to announce it to the public and would only do so the night before. 

 Judge Kacsmaryk stated in a transcript of the Friday conference that other parts of the case have “brought a barrage of death threats and protestors and the rest” and that he wanted to prevent a “unnecessary circus-like environment” that might interfere with the attorneys’ testimony in court. 

News groups heard about the hearing and covered it in spite of the judge’s request. Members of pro-choice organizations intend to hold a protest outside the courthouse during the hearing, including by donning judge and kangaroo costumes to denounce what they call a “kangaroo court” and by driving a truck around the streets of the city with a billboard that reads “a majority of Americans support abortion access.” 

The lawsuit alleges that the FDA authorized mifepristone in 2000 without conducting a thorough examination of the scientific data or adhering to the correct procedures, and that the agency has since ignored the drug’s safety concerns. 

The F.D.A. and the Department of Justice, which is representing the F.D.A., have vehemently denied those allegations, claiming that the F.D.A.’s thorough reviews of mifepristone over the years had consistently reinforced its decision to approve the drug, which blocks a hormone that promotes pregnancy. 

The judge’s decision at the conclusion of the hearing on Wednesday is still up in the air. The majority of law professionals believe that he will decide eventually. 

The court has instructed attorneys to be ready to speak on the following topics during the hearing: 

Whether the claimants have the necessary legal grounds to file the claim 

Five anti-abortion organizations are listed as members of the Alliance for Hippocratic Medicine, which is the entity leading the lawsuits. The alliance was formed in August in Amarillo, where Judge Kacsmaryk is the sole federal court, shortly after the Supreme Court reversed Roe v. Wade. 

The four physicians who are plaintiffs in the case as well as some of the five organizations are located in the Amarillo region, according to Erik Baptist, senior counsel for the Alliance Defending Freedom, a conservative Christian legal advocacy group that is defending the plaintiffs. 

Because they have handled women who they claim have been harmed by abortion pills, the plaintiffs argue that they have the right to suit as parties who incurred damage from the FDA approval. According to legal experts, including some conservative legal academics, it might be challenging to prove that the plaintiffs have standing because the damage they are alleging could be seen as occurring after the F.D.A. approved the medication. Patients must first decide whether to take the medication before getting medical attention. 

The case could not continue if the court found that the plaintiffs lacked the necessary standing to file a lawsuit.