Almost two-thirds of US abortions are induced with pills. The drug mifepristone blocks the pregnancy hormone progesterone, ending the growth of the fetus. Mifepristone was designed for abortions: its primary purpose, from its development through its regulatory approval and now on the market, has always been to allow women to control their own bodies and lives by ending their pregnancies. Because it exists as a tool of women’s independence, mifepristone has been the object of controversy, misinformation and intense scrutiny for the entirety of its existence.
The anti-abortion movement – including several prominent Republican lawmakers – is looking to undo that. Since the 2022 Dobbs v Jackson Women’s Health Organization decision that eliminated the nationwide right to abortion, women living in anti-choice states have relied increasingly on mifepristone, particularly pills shipped by mail from providers in pro-choice states who prescribe the drug via telehealth. It is estimated that as many as 20% of abortions in the US are now accessed via telehealth appointments, a technological marvel that has allowed many people living in anti-choice states to avert the worst consequences to their lives, health and dignity that were threatened by the Dobbs decision by circumventing the unjust abortion bans that their states have attempted to impose on them. Dobbs has already been devastating for American women, causing needless deaths, driving up maternal mortality, derailing women’s lives, constraining their prospects, and injuring their standing as equal citizens. The post-2022 explosion of telehealth abortion using mifepristone is the reason why the consequences have not been even worse.
Now, Trump’s new FDA commissioner, Marty Makary, is under pressure to restrict access to the drug. Pressed by reporters at the Semafor World Economy Summit late last month, Makaray said that he had “no plans” to review the status of mifepristone. But he added a crucial caveat: that he would reconsider the drug’s accessibility if new information emerged about the drug’s safety. “If the data suggests something or tells us that there’s a real signal, we can’t promise that we’re not going to act on that data,” he said.
As if on cue, a conservative think tank published a new study just days later that purported to find that mifepristone caused serious adverse effects in more than 10% of patients. The study was rapidly amplified on conservative social media, and was pushed by several Republican senators who had previously called on Makaray to ban mifepristone at his March confirmation hearing. Missouri’s Josh Hawley, the author of a book on “manhood” who once raised a fist in solidarity with the January 6 insurrectionists, declared in a statement directed at Makaray: “Well, the new data is here. And it’s a signal that can’t be missed: Mifepristone is not safe.” Hawley went on to urge the FDA to restrict access to the drug and revert to pre-pandemic regulations, in which mifepristone could only be dispensed by a doctor after multiple in-person visits: a regulatory regime that would cut off abortion access to millions of women in anti-choice states.
But the study that is being proposed as a pretext for restricting abortion access has come under scrutiny from doctors and statisticians for its questionable methodology. Drawing from insurance claim data from 2017 to 2023, the EPPC study claims that 10% of women who take mifepristone experience “sepsis, infection, hemorrhaging, an emergency room visit, or another serious adverse event within 45 days”. This would be alarming if it were true, but it isn’t.
