Washington DC - The Supreme Court appeared poised on Tuesday to reject restrictions imposed by a lower court on an abortion pill widely used in the United States to terminate pregnancies.

Dozens of demonstrators gathered outside as the nation's highest court heard its first significant abortion case since the justices overturned the constitutional right to the procedure nearly two years ago.

A majority on the conservative-dominated court appeared skeptical during 90 minutes of oral arguments about the legal standing of the anti-abortion groups and doctors who brought the case against the abortion pill mifepristone.

The abortion opponents are seeking to restrict access to mifepristone, claiming it is unsafe, and anti-abortion doctors are being forced to violate their conscience by intervening on patients who suffer complications from using the abortion pill.

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"These are life-threatening situations in which the choice for a doctor is either to scrub out and try to find someone else, or to treat the woman who's hemorrhaging," said Erin Hawley, a senior counsel at Alliance Defending Freedom representing the anti-abortion groups.

Solicitor General Elizabeth Prelogar, representing the administration of President Joe Biden, countered that such a scenario was "remote" and abortion opponents are unable to "identify a specific doctor who faces imminent harm."

"They have said that they fear that there might be some emergency room doctor somewhere, someday, who might be presented with some woman who is suffering an incredibly rare complication and that the doctor might have to provide treatment," Prelogar said.

A conservative District Court judge in Texas, an appointee of Republican presidential candidate Donald Trump, issued a ruling last year that would have banned mifepristone, which was approved by the Food and Drug Administration (FDA) in 2000.

An appeals court overturned the outright ban because the statute of limitations on challenging the FDA's approval had expired but imposed restrictions on access to the drug.

The conservative appeals court reduced the period during which mifepristone can be used from 10 weeks of pregnancy to seven weeks, blocked it from being delivered by mail, and required the pill to be prescribed and administered by a doctor.

Justice Ketanji Brown Jackson, a liberal, said she was worried that there is a "significant mismatch in this case between the claimed injury and the remedy that's being sought."

"What [the anti-abortion doctors] are asking for here is that in order to prevent them from possibly ever having to do these kinds of procedures, everyone else should be prevented from getting access to this medication," Jackson said.

Justice Neil Gorsuch, a conservative, expressed similar concerns.

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"This case seems like a prime example of turning what could be a small lawsuit into a nationwide legislative assembly on an FDA rule or any other federal government action," Gorsuch said.

Jessica Ellsworth, a lawyer for Danco Laboratories, the mifepristone manufacturer, said she had "significant concerns" about courts replacing the scientific judgment of experts and the "FDA's gold standard review process."

Only two justices – conservatives Clarence Thomas and Samuel Alito – appeared sympathetic to the anti-abortion groups that brought the suit against the FDA's approval of mifepristone.

"You think the FDA is infallible?" Alito asked Ellsworth at one point.

Medication abortion accounted for 63% of abortions in the country last year, up from 53% in 2020, according to the Guttmacher Institute.

Some 20 states have banned or restricted abortion since the Supreme Court in June 2022 overturned the landmark Roe v. Wade ruling that enshrined the constitutional right to abortion for half a century.

Polls repeatedly show a clear majority of Americans support continued access to safe abortion, even as conservative groups push to limit the procedure or ban it outright.

The Supreme Court is expected to issue a decision in the abortion pill case by the end of June – four months before the presidential election in which abortion is almost certain to be a major topic.