A federal district judge heard oral arguments Wednesday in a controversial case that could decide the fate of the Food and Drug Administration’s approval of the abortion drug mifepristone — a decision that would have broad ramifications nationwide.

The case, Alliance for Hippocratic Medicine v. FDA, could block access to mifepristone, which is used for abortions and for miscarriage management. Medication abortions, which involve taking mifepristone and a second drug, misoprostol, make up the majority of abortions in the United States.

The lawsuit was filed last year by the Alliance Defending Freedom against the FDA on behalf of three physician groups that belong to the Alliance for Hippocratic Medicine — the American Association of Pro-Life Obstetricians and Gynecologists, the American College of Pediatricians and the Christian Medical and Dental Associations — and four individual physicians.