Mifepristone is under grave attack by anti-abortion extremists
Anti-abortion extremists, right-wing media demagogues, and GOP politicians push flimsy justifications to restrict or ban mifepristone.
Three years after the right-wing MAGA Majority on SCOTUS ruled in favor of striking down Roe and Casey in Dobbs, mifepristone is under serious attack in the USA, and that is because anti-abortion extremists are pushing lies and misinformation that falsely paints mifepristone as “dangerous” under the guise of “protecting women”, such as a junk science-laden “study” published to justify such draconian restrictions.
The FDA is set to “review” the latest data on mifepristone, and HHS head Robert F. Kennedy Jr. will use those findings to call for restrictions/bans on mifepristone.
Lisa Needham at Daily Kos on the state of abortion 3 years after Dobbs (06.24.2025):
Republicans in Texas are proposing to go after companies where patients can order abortion pills online. They would face civil liability for “the wrongful death of an unborn child”—aka an abortion.
The law would also allow for civil suits against websites that just share information about abortion pills and any financial company that processes orders for abortion pills. The FDA has now committed to a full review of mifepristone, which is not a thing that really happens with drugs that have been legal and safe for decades. But conservatives see that as the best way to achieve a nationwide medication abortion ban.
Jessica Valenti at Abortion, Every Day on abortion bans and their impact on medication abortion three years after the Dobbs ruling (06.24.2025):
Here’s the good news: as complicated as the medical landscape has been, the abortion rights movement has risen to the occasion. They’ve adapted along with every restriction and ban.
Abortion funds ensure patients can afford their procedures and travel, abortion navigators are on the phone and online every day, booking train tickets and hotels, and shield state providers have become that little Dutch boy with their finger in the dam—staving off total devastation by shipping pills across state lines.
That interstate access—made possible by abortion medication and telehealth—has been the saving grace of the last three years: pills account for more than 60% of abortions in the U.S., and 1 in 4 abortions are now provided via telehealth.
That’s not to say their legal strategy is all future-looking. Furious that the number of abortions has gone up and women are obtaining care despite state bans, conservatives are going all in on taking down abortion pills and telehealth.
Anti-abortion activists and legislators have taken what’s best described as a spaghetti-at-the-wall approach: major lawsuits to roll back FDA approval; attempts to revive the Comstock Act, and state legislation that classifies the pills as a controlled substance or makes providing them a felony.
They’ve been lobbying the FDA and Trump administration using junk science that says mifepristone is unsafe despite all credible evidence to the contrary, and—most recently—have launched a full-scale campaign to claim that abortion pills are poisoning the groundwater, harming the wildlife, and making women infertile.
It’s as desperate as it sounds. But with so many balls in the air, they’re sure to catch at least one.
Even with abortion more popular than ever, Republicans wasted no time after Dobbs diving into extremism: So-called "equal protection" bills that would punish patients as murderers were introduced in more than a dozen states this year—with increasing co-sponsors and decreasing pushback. Unable to get enough state legislators on board, the abortion ‘abolitionists’ behind these policies have started running in local elections. And winning.
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Most offensively, lawmakers are doing all this while co-opting terms like ‘trafficking’ and ‘coercion’ to make it seem as if their efforts are all about protecting women. It’s an especially disgusting move given these same legislators will reject even the most nominal ‘exceptions’ for women’s lives or raped children.
So, Hawley is going after mifepristone. In 2023, medication abortions made up 63 percent of all abortions in the country. Making mifepristone unavailable nationwide would radically decrease the availability of abortion. It would ensure, even in blue states, that abortions become much harder to obtain.
The problem for Hawley and his fellow anti-choicers is that mifepristone is extremely safe. From 2000, when mifepristone was first approved for medication abortions by the Food and Drug Administration, through 2022, there were 32 deaths from taking mifepristone for a medication abortion. Not 32 per year — 32 total in 22 years, during which there were 5.9 million medication abortions. During that same period, there were 4,218 adverse events of any kind, including 1,049 hospitalizations, 604 incidents of blood loss requiring a transfusion, and 418 infections, 75 of which were severe.
Hawley knows full well that this is not an actual study. It’s a polemic with political conclusions, not scientific ones. The same day it came out, Hawley sent a letter to Marty Makary, Trump’s pick to lead the FDA, breathlessly declaring that it is time to “revisit and restore the FDA’s longstanding safety measures” about mifepristone. And though this isn’t really the point, you can apparently only find Makary’s letter to Hawley announcing the FDA’s review on Hawley’s X account, rather than a more normal place like the FDA Newsroom on the official FDA website.
Rachel Jones and Dr. Jamila Perritt at The Nation on the right-wing misinformation-laden campaign to ban mifepristone (06.04.2025):
The large body of research on the combined regimen of mifepristone and misoprostol has found that serious adverse events—like hemorrhage or sepsis—are very rare across studies, generally far below 1 percent of all abortions. Likewise, the combined regimen is highly effective, resulting in a completed abortion in more than 95 percent of abortions. Mifepristone is safer than commonly prescribed medications like penicillin and Viagra, and safer than childbirth.
The fact that their findings are such clear outliers means that readers, including policymakers, should approach this paper with a high level of scrutiny. However, the authors have made it difficult to fully evaluate the validity of their findings. Importantly, they do not offer specifics about their methodology, including failing to name the dataset they purchased and the medical diagnosis and treatment codes they used to conduct their analysis—something that is commonly disclosed in studies so that other researchers can attempt to replicate and build on the findings.
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One of the ways that the authors identify cases to be included in their paper is through the prescription of mifepristone. This is especially problematic because mifepristone is used for other types of care, including miscarriage management (also referred to as “spontaneous abortion” in the medical field), labor induction, and treatment of hyperglycemia in Cushing syndrome. The most common adverse event this paper found is referred to as “other abortion-specific complications,” experienced by 5.68 percent—more than half of their “adverse events”—of their counted abortions. However, the authors also indicate that this category includes “codes specifically related to an abortion or miscarriage (emphasis ours), as well as life-threatening mental health diagnoses.” Thus, it is likely that in some instances the authors have conflated induced abortions with miscarriages in an analysis purportedly focused on induced abortion.
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Critiquing this paper, and others like it, is not just as an academic exercise. When the antiabortion movement goes on research fishing expeditions, there are real-life consequences. Lawmakers like US Senators Josh Hawley and Steve Daines have already touted this flawed paper as evidence that the FDA should severely restrict access to mifepristone. Secretary of Health and Human Services Robert F. Kennedy Jr. mentioned the paper during a congressional hearing calling on the FDA to look into mifepristone, despite the fact that decades of research has shown it to be safe, effective, and that it can be a lifesaving medication for those who need it.
Using flawed studies and scientific journal publications, abortion opponents are building a body of research meant to question the safety of the abortion pill mifepristone, a key target for the movement.
The effort comes as federal officials have expressed a willingness to revisit the drug’s approval — and potentially impose new restrictions on a medication used in the vast majority of abortions.
Mainstream medical researchers have criticized the studies, highlighting flaws in their methodology and — in the case of one paper published by the conservative think tank Ethics and Public Policy Center (EPPC) — lack of transparency about the data used to suggest mifepristone is unsafe. The vast body of research shows that the drugs used in medication abortion, mifepristone and misoprostol, are safe and effective in terminating a pregnancy.
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Released in April, the EPPC paper suggests that mifepristone results in serious adverse events for 1 in 10 patients — substantially higher than the widely accepted figure of .3 percent complication rate most research has attributed to the pill. The paper appears to count what other researchers say are non-threatening events, such as requiring follow-up care to complete the abortion, or visiting an emergency room within 45 days of an abortion — even if the patient did not end up requiring emergency care — as serious adverse effects. That paper also did not go through peer review, a standard process for scientific research in which other scholars review a study’s findings and methodology before it can be published.
Another paper, a commentary piece published this week in the journal BioTech, challenges the commonly cited statistic that mifepristone has a lower complication rate than acetaminophen, or Tylenol, tracing the history of the comparison and arguing that it is mathematically flawed. The paper’s author, Cameron Loutitt, is a biomedical engineer by training and director of life sciences at the Charlotte Lozier Institute, a research arm of the anti-abortion group SBA Pro-Life America.
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A miscarriage and a medication abortion are medically indistinguishable, and patients will sometimes visit an emergency room to ensure the drugs worked, or if they suspect possible complications. In places where abortion is illegal, patients may also tell health care providers they experienced a miscarriage to minimize their legal risk. Studies like the Lozier Institute paper suggest complications from medication abortions are being undercounted.
Cameron Oakes at Rewire News Group on mifepristone safety (05.23.2025):
The nation’s top public health official ordered a review of mifepristone, one of two drugs used in medication abortions, and questioned its safety.
Citing research that has not been peer-reviewed nor published in a medical journal—the standards that generally confer credibility on scientific research—recently released by the anti-abortion Ethics and Public Policy Center, Health and Human Services Secretary Robert F. Kennedy Jr. said in a May 14 congressional hearing that he found the report’s conclusions on mifepristone “alarming.”
“At the very least, the label should be changed,” he added.
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How does mifepristone work?
Mifepristone is one of two drugs commonly used in medication abortions in the U.S. It blocks progesterone, which prepares the uterus for a fertilized egg, and ultimately halts a pregnancy’s progress. It is also sometimes used to treat miscarriages, endometriosis, and fibroids, induce labor, and, in limited circumstances, treat high blood sugar in people with Cushing’s syndrome.
Mifepristone is not taken alone for medication abortion regimens; it must be used with another medication, called misoprostol, to be effective.
The anti-abortion movement’s war on mifepristone, if they are successful at achieving their depraved goals, will notch another big win in reshaping the state of abortion access in America.