1). “Since When is Emergency Contraception 'Controversial'?”, May 30, 2025, Jessica Valenti, Abortion, Every Day, at < https://jessica.substack.com/
2). “ ‘Rolling Thunder’: Inside conservatives’ strategy to curb abortion pill access: Abortion opponents hope a new report will spur the GOP to ban abortion pills and defund Planned Parenthood”, May 7, 2025, Alice Miranda Ollstein, Politico, at < https://www.politico.com/news/
3). “Mifepristone for Abortion in a Global Context: Safe, Effective and Approved in Nearly 100 Countries”, July 2023, Gilda Sedgh & Irum Taqi, Guttmacher Institute, at < https://www.guttmacher.org/
~~ recommended by dmorista ~~
Introduction by dmorista: In Item 1)., “Since When is ….”, Jessica Valenti discusses the Right-wing attack on Medication Abortion (that now accounts for 63% of all abortions). It is in Attacks on Abortion Pills in the first section of the article noting that:
“Attacks on Abortion Pills
“Looks like anti-abortion groups realized their junk science on mifepristone didn’t land the way they hoped—so now they’re rolling out a second study, hoping this one might just stick.
“You might remember that last month, a conservative think tank released a wildly misleading report claiming that 1 in 10 people who take mifepristone experience 'serious adverse events.' Medical experts immediately panned the so-called ‘study’ from the Ethics and Public Policy Center (EPPC): Brittni Frederiksen, associate director of Women’s Health Policy at KFF, said there were so many red flags, 'I can’t imagine any medical journal that would accept this.' (And sure enough—they didn’t!)
“Abortion, Every Day also uncovered video of EPPC president Ryan Anderson admitting that the goal was to 'eliminate' abortion medication—and colluding with national anti-abortion groups to weaponize the fake research.
“One of the biggest reasons the study didn’t gain traction—and the critique that caught the most public attention—was that it wasn’t peer reviewed. So color me shocked that anti-abortion leaders are now loudly touting a new 'peer-reviewed” study—this time from the extremist Charlotte Lozier Institute (CLI).
“In fact, the term ‘peer-reviewed’ shows up four times in a Catholic News Agency article about the research—a piece that reads more like a press release than journalism.
“This new CLI study takes aim at a popular (and effective) pro-choice talking point: that abortion medication is safer than Tylenol. It’s a fact often shared by reproductive health experts and advocates to underscore how over-policed and unnecessarily restricted abortion pills are.
“CLI claims that abortion rights activists are being misleading and 'oversimplifying.' Which is pretty fucking ironic, considering CLI is the same group that spits out ‘research’ so terrible it gets retracted in the rare instances it actually gets published.
“Here’s the truth: All credible data shows that serious complications with abortion pills are exceedingly rare. Serious adverse events involving medication abortion occur less than 0.5% of the time. And yes—complications from medication abortion are absolutely less frequent than those associated with Tylenol.
“Anti-abortion groups are trying to shift the narrative because their original mifepristone study became a national punchline. But the fact that their only 'peer-reviewed' rebuttal focuses on a snappy pro-choice catchphrase rather than the substance of their own collapsing argument? That’s just pathetic.
“Unfortunately, the junk science won’t stop here. On Monday, Abortion, Every Day will publish a full deep dive into another anti-abortion “study”—one that reveals a lot about conservatives’ next move to criminalize abortion.”
The “video of EPPC president Ryan Anderson admitting that the goal was to 'eliminate' abortion medication” is available in the Weird Science section of “Americans Are Outraged Over Adriana Smith”, May 19, 2025, Jessica Valenti, Abortion, Every Day, at < https://jessica.substack.com/
InUSDA Reg Changes
Item 2)., “ ‘Rolling Thunder’: Inside conservatives’ ….”, the article looks at a wide array of the actions the Forced-Pregnancy / Forced-Birth Operatives are taking to try to get closer to their ultimate goal of criminalizing abortion and birth control and of frequent “show trials” and ongoing executions of women who leave Dark Ages Red States to obtain legal abortions elsewhere but then who return to the Heartland of Fascist America in the South and Midwest. And of course their ultimate goal is to impose their agenda on the entire country, including all the blue states.
Finally in Item 3)., “Mifepristone for Abortion ….”, the authors review some of the data about the use and availability of Mifepristone and Misoprostol on a worldwide scale. They point out that:
“Mifepristone is used in a two-drug abortion regimen that has proven safe and effective in numerous studies worldwide. It blocks the hormone progesterone, which is needed for a pregnancy to continue; misoprostol, the second drug in the regimen, then causes uterine cramping to expel the pregnancy. Mifepristone was first approved in France and China in 1988, and as of May 2023, 96 countries have approved its use. The World Health Organization (WHO) abortion care guidelines recommend combined use of mifepristone and misoprostol, or use of misoprostol alone, as safe and effective methods of ending a pregnancy.”
The reality is that the mifepristone and misoprostol combination is by far the safest and most cost effective method of ending unwanted pregnancies. For that reason the Forced-Pregnancy / Forced-Birth Operatives are resorting to yet another propagandistic and disinformational campaign to move towards their goal of complete abortion and birth control bans in the entire U.S. and the evil Trump Regime is working in many ways to support this agenda.
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Since When is Emergency Contraception 'Controversial'?
Click to skip ahead: Attacks on Abortion Pills looks at a second study on mifepristone that conservatives are hoping will distract from the disastrous flop of their first. In the States, news from Virginia, Nebraska, Kentucky, and more. In Attacks on Birth Control, the cultural campaign targeting young women. Anti-Abortion Strategy has the latest in crisis pregnancy center nonsense from Vermont, West Virginia, and Montana. In the Nation, catch up on what’s happening with Trump’s ‘big, beautiful’ bill defunding Planned Parenthood. You Love to See It has good news from Oklahoma and Wisconsin. And in AED News, a very special thank you to Grace.
Attacks on Abortion Pills
Looks like anti-abortion groups realized their junk science on mifepristone didn’t land the way they hoped—so now they’re rolling out a second study, hoping this one might just stick.
You might remember that last month, a conservative think tank released a wildly misleading report claiming that 1 in 10 people who take mifepristone experience “serious adverse events.” Medical experts immediately panned the so-called ‘study’ from the Ethics and Public Policy Center (EPPC): Brittni Frederiksen, associate director of Women’s Health Policy at KFF, said there were so many red flags, “I can’t imagine any medical journal that would accept this.” (And sure enough—they didn’t!)
Abortion, Every Day also uncovered video of EPPC president Ryan Anderson admitting that the goal was to “eliminate” abortion medication—and colluding with national anti-abortion groups to weaponize the fake research.
One of the biggest reasons the study didn’t gain traction—and the critique that caught the most public attention—was that it wasn’t peer reviewed. So color me shocked that anti-abortion leaders are now loudly touting a new “peer-reviewed” study—this time from the extremist Charlotte Lozier Institute (CLI).
In fact, the term ‘peer-reviewed’ shows up four times in a Catholic News Agency article about the research—a piece that reads more like a press release than journalism.
This new CLI study takes aim at a popular (and effective) pro-choice talking point: that abortion medication is safer than Tylenol. It’s a fact often shared by reproductive health experts and advocates to underscore how over-policed and unnecessarily restricted abortion pills are.
CLI claims that abortion rights activists are being misleading and “oversimplifying.” Which is pretty fucking ironic, considering CLI is the same group that spits out ‘research’ so terrible it gets retracted in the rare instances it actually gets published.
Here’s the truth: All credible data shows that serious complications with abortion pills are exceedingly rare. Serious adverse events involving medication abortion occur less than 0.5% of the time. And yes—complications from medication abortion are absolutely less frequent than those associated with Tylenol.
Anti-abortion groups are trying to shift the narrative because their original mifepristone study became a national punchline. But the fact that their only “peer-reviewed” rebuttal focuses on a snappy pro-choice catchphrase rather than the substance of their own collapsing argument? That’s just pathetic.
Unfortunately, the junk science won’t stop here. On Monday, Abortion, Every Day will publish a full deep dive into another anti-abortion “study”—one that reveals a lot about conservatives’ next move to criminalize abortion.
In the States
Who said it’s just Republican men who say stupid shit about women and abortion? The Guardian has unearthed audio of Virginia gubernatorial nominee Winsome Earle-Sears saying that women who consent to sex are automatically consenting to pregnancy.
Earle-Sears, who is Virginia’s current lieutenant governor, said that women who have sex “already made a choice.” She insisted on a podcast—just days after Roe was overturned—that “we need to make our choices before we’re pregnant, not, you know, after.”
The idea that consent to sex is consent to pregnancy is common in anti-abortion extremism. In fact, I wrote a whole column about it:
Earle-Sears has also called abortion “genocide,” and said she wanted a total abortion ban with just an exception for women’s lives.
Her comments aren’t exactly a surprise: Just last week, I told you Earle-Sears refused to say whether she’d sign an abortion ban as governor, and it wasn’t so long ago that she opposed an abortion rights amendment.
But the timing couldn’t be worse for Earle-Sears, who is trying to run away from her anti-abortion extremist beliefs. She’s well-aware that Virginia is overwhelmingly pro-choice, and is several points behind Democratic opponent Abigail Spanberger. The Guardian notes that she’s even scrubbed anti-abortion language from her campaign website.
Remember, Virginia is the only state in the South without a serious ban or restriction—so what happens there is incredibly important not just for people in the state, but the region.
Meanwhile, a Nebraska anti-abortion group is collecting signatures to get a new measure on the ballot—one that would codify a total abortion ban in the state constitution, and grant personhood to fertilized eggs, embryos, and fetuses.
The move comes just months after anti-abortion groups enshrined a 12-week ban into the state constitution, calling it a ‘reasonable middle ground’. But we knew it would never stop there.
The Omaha World Herald reports that Choose Life Now started petitioning in February. And while the group doesn’t have the serious funding that most ballot measure campaigns start with, their strategy is to target church congregations.
If you want a sense of who this group really is, consider that spokesperson Rose Kohl said Nebraska is being punished for codifying a ban that allows abortions in the first few weeks of pregnancy:
“She pointed to strong storms that have wreaked millions of dollars in damage in the state in recent years, and to the extreme and worsening drought that has rattled the state's agricultural industry…”
Sometimes I can’t believe people like this exist.
This is interesting/too bad: The American Civil Liberties Union of Kentucky has dropped their legal challenge against the state’s abortion ban. You may remember this case: Late last year, the group sued on behalf of ‘Mary Poe’—a pseudonymous woman who wanted an abortion, arguing that the state ban violated her right to privacy and self-determination under the Kentucky constitution.
She later traveled out of the state to end her pregnancy, but remained a plaintiff in the suit. Today, the Kentucky ACLU dropped the challenge, noting in a release that they won’t be providing details about the dismissal; they just reiterate that “decisions about health care are and should remain private.”
Executive director Amber Duke says they’re strategizing next steps:
“In the meantime, our work to address the commonwealth’s maternal mortality rates and lack of widespread paid leave coverage will continue as long as Kentucky remains a forced-birth state.”
For information on how to get an abortion, check out AED’s Resource page and YouAlwaysHaveOptions.com.
Finally, New Orleans Public Radio has a story on the fantastic billboard campaign that The Brigid Alliance is running in Louisiana, Florida, and Georgia. The group also has mobile billboards driving around college campuses. All of the ads tell people that they can still get abortions—and direct them on how to get help.
If this campaign sounds familiar, it’s because conservative media went on a tear about it earlier this month. Multiple outlets accused the Brigid Alliance of “targeting” college students and crisis pregnancy centers…by running billboards near them. (Who’s a snowflake now??)
The Brigid Alliance’s executive director Sara Sipple makes clear what the priority is:
“It's really important for people across the U.S. to know and understand that there is support for them if they cannot afford to travel to their abortion care, that there are organizations who will support them to help them get there.”
Quick hits:
Colorado abortion clinics have seen an uptick in harassment and trespassing;
More on the lawsuit challenging the Kansas law that overrides pregnant women’s advance directives;
And love to see abortion care workers unionizing in Pennsylvania!
Attacks on Birth Control
We all know the anti-abortion movement has contraception in its crosshairs. And while Republicans are too smart to try to ban birth control outright (so far, at least), they have no problem making less obvious moves: like lawmakers blocking legislation to protect birth control, or falsely conflating birth control and abortion.
Some of them manage to do both at the same time: Who could forget when Sen. Joni Ernst voted against the Right to Contraception Act, lying that the bill would “mandate access to abortion drugs for women and girls of all ages.” She was talking about emergency contraception. 🤡
What I worry about most these days, though, is the cultural attack against contraception—namely, the rise of TikTok and Instagram influencers posting anti-birth control bullshit aimed at young women. What makes this particular cultural campaign so insidious is that it’s often couched in feminist-sounding rhetoric about medical sexism and ‘listening to your body.’ Not to mention, it’s delivered by young, aspirational women themselves.
Consider the latest big TikTok trend: Mostly-female creators posting videos that jokingly and not-so-jokingly list “propaganda I’m not falling for.” The lists are mostly beauty and wellness trends—think lip filler, pilates, or raw milk. But more and more, women are posting videos that list “birth control” as the ‘propaganda’ they refuse to fall for. Yes, birth control—one of the most important advances for women’s health and freedom. Propaganda.
I shouldn’t be surprised: TikTok is rife with anti-birth control nonsense. The disinformation was so bad, in fact, that the platform finally had to delete troves of videos. But naturally, more videos just popped up to replace them.
And it's not just social media. Check out this headline in the popular financial news website The Street: “Target, Walmart quietly sell controversial birth control product.”
Since when is emergency contraception something “controversial” that pharmacies need to “quietly” sell? We’re talking about a birth control method that was approved in 1998, and went over the counter nearly twenty years ago!
As much as I’d like to write this off as just another clickbait-y headline, we can’t ignore that this is just part of a broader anti-birth control cultural panic—a panic designed by conservatives to provide justification for restrictions on contraception.
I mean, it’s not a coincidence that all this is happening at a time when Republican governors like Virginia’s Glenn Youngkin are vetoing birth control protections, or when the official policy of the Trump administration is that everyone needs to get pregnant and give birth right-fucking-now.
Mark that down as propaganda I’m refusing to fall for.
Anti-Abortion Strategy
If there’s one thing conservatives love, it’s funneling money to crisis pregnancy centers—and letting them operate without any real oversight. Just look at what happened in Vermont this week: lawmakers rolled back a law that was meant to stop these fake clinics from lying to women.
The original law banned deceptive advertising by crisis pregnancy centers. But anti-abortion groups sued, claiming the rules violated their free speech rights. Instead of fighting it out, the state made a deal to dismiss the lawsuit by weakening the law.
Worse still, this isn’t just a Vermont problem. We’re seeing a disturbing trend: states and cities backing off regulations on crisis pregnancy centers after getting hit with lawsuits. Their argument? That they have a First Amendment right to mislead women.
A case like this is unfolding right now in California—and more are sure to come.
Meanwhile, West Virginia Gov. Patrick Morrisey just signed a new law into effect that expands state funding and support for anti-abortion crisis pregnancy centers. SB 537 creates the “Mothers and Babies Pregnancy Support Program,” which provides $3 million to programs that shame and lie to women.
West Virginia Sen. Rollan Roberts said, “If we’re going to have these mothers have their babies, we’re going to have to do something to help them.”
Here, let me fix that: “If we’re going to have these mothers force these women to have their babies, we’re going to have to pretend to do something to help them.”
Finally, Montana Gov. Greg Gianforte signed a law called the “Pregnancy Center Autonomy and Rights of Expression Act,” which is just as bad as it sounds. The law bans local governments from enacting pretty much any regulations on crisis pregnancy centers.
In the Nation
The biochemist responsible for the development of mifepristone, Étienne-Émile Baulieu, has died at 98.
Rachel Cohen at Vox reports on the “unlikely alliance” of organizations supporting a bill to make childbirth free.
A coalition of over 150 anti-abortion groups are urging Congress to defund Planned Parenthood. Assholes.
Finally, do you want to catch up on what happened with Republicans’ ‘big beautiful bill’ defunding Planned Parenthood? Watch Democracy Now’s segment with Reproductive Freedom for All president Mini Timmaraju, who says this “crisis of forced birth” is all by design:
You Love to See It
If you need a reminder that good things can still happen, I’ve got you covered:
Starting November 1, Oklahoma will require health insurance plans to cover six months of birth control pills at once. The change is thanks to SB 176, which became law this week—though without the signature of anti-abortion extremist Gov. Kevin Stitt.
Idaho passed a similar bill back in January. According to the Kaiser Family Foundation, a third of female contraceptive users missed taking their birth control because they couldn’t access their next supply of pills in time. (It can be especially difficult for those who live in rural areas.) Having access to months of a prescription at once can prevent that from happening.
Finally, Wisconsin is about to get its first nonprofit, independent abortion clinic! Care for All Community Clinic will open its doors in Milwaukee next week and start seeing patients on June 10. They’ll be offering abortion care up until 21 weeks and 6 days (the state limit).
The timing couldn’t be better: a release from the group reports that in Wisconsin, “just three full-time brick and mortar clinics have shouldered the entire state’s demand for abortion care.” That means patients leaving the state, and long wait times for those seeking care.
Executive director Ali Kliegman says, “Public support for abortion access remains consistently high throughout our nation.” (She’s right!!!) “Wisconsin residents deserve easy and timely access to abortion and other sexual and reproductive health care services.”
“The abolition movement is part of the personhood movement..In their view, if the anti-abortion movement is serious about the idea that a fetus is a person just like any other, then we can’t avoid punishing women, because we punish women for any other homicide.”
AED News
In the early days of Abortion, Every Day, I got a very kind email from a reader offering to help with research for the newsletter. I couldn’t believe my luck—this young woman was brilliant, driven, and had the exact skills I was in desperate need of. That reader was Grace Haley, who went on to become AED’s incredible researcher—and the fact-checker for my book, Abortion.
For those who’ve been reading for a while, I’m betting you’ve chatted with Grace in the comments section or in AED live chats on debate nights. So it’s no surprise that a few of you have written in lately asking where she’s been.
The good news is that Grace hasn’t gone far—she’s now the Managing Editor at Abortion in America (AIA), where she’s documenting the personal stories of people impacted by abortion bans. It’s one of the most important abortion rights projects happening right now, and I couldn’t be prouder that AED played even a small role in Grace’s journey there.
And don’t worry, this isn’t goodbye. I’m confident that we’ll be collaborating with AIA in the future, and—of course—Grace will always be part of the AED family. (In fact, keep an eye out for a project coming soon
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Rolling Thunder’: Inside conservatives’ strategy to curb abortion pill access
Abortion opponents hope a new report will spur the GOP to ban abortion pills and defund Planned Parenthood.
Anti-abortion rights demonstrators march to the Supreme Court on January 24, 2025. The movement is launching a new push to ban the drugs used in most abortions. | Bryan Dozier/Middle East Images via Getty Images
The nation’s most influential anti-abortion groups have a new plan to roll back access to the procedure for millions of Americans in what they’re calling the “biggest opportunity for the pro-life movement” since toppling Roe v. Wade.
The effort, which the groups have privately named “Rolling Thunder,” is the movement’s first concerted attempt under the second Trump administration to target abortion pills, and aims to convince the FDA, Congress and courts to crack down on their use.
While the Trump administration paid little attention to the medication in its first months in office, and even filed a court brief to preserve access, the activists are counting on a report from the conservative think tank Ethics and Public Policy Center to light a fire under those in power.
The paper, published last week, purports to show significantly more patients have experienced serious side effects after taking mifepristone than previously known. Medical experts and abortion-right supporters say it exaggerates the danger of a medication that more than 100 scientific studies have found are safe and effective.
The report’s release comes on the heels of top Trump officials — including Health Secretary Robert F. Kennedy Jr. and FDA chief Marty Makary — expressing openness to new data on the pills’ safety and efficacy.
“One of the things that we have the ability to do now with this data is to pressure the FDA and lawmakers to reconsider, if not suspend, their approval of this medication until they can do more research into it,” Maria Baer, a podcast host for the Colson Center for Christian Worldview, said on a private Zoom call last week where anti-abortion leaders discussed the strategy. The groups on the call included Susan B. Anthony Pro-Life America, Americans United for Life, the Ethics and Public Policy Center, Students for Life and Live Action.
Mifepristone, one of two drugs used in roughly two-thirds of all abortions in the U.S., is a longtime target of conservative activists who consider it the primary driver of the increase in abortions since Roe’s fall in 2022 and the method millions of women are using to circumvent state bans.
The groups also hope to wield the report to pressure Congress to strip the remaining federal funding from Planned Parenthood — which they consider the country’s best-known purveyor of the drugs — and give conservative legal groups fodder to prosecute doctors who prescribe the pills to patients who live in states with abortion bans.
Missouri Republican Sen. Josh Hawley told POLITICO he plans to introduce legislation — inspired by the groups’ report — that would restrict access to the pills and make it easier for patients who have taken them to sue the manufacturers, Danco and GenBioPro. He is also joining the groups’ pressure campaign on the FDA.
“Dr. Makary is in no doubt about my position on this,” Hawley said, adding that he’s frustrated the agency has not yet acted to prohibit mail delivery of the pills. “This was much the topic of conversation during his [confirmation] hearings, and I have to say, his position now doesn’t sound a lot to me like the ones he took during hearings. During the hearings, he said, ‘I’m going to review all the data. I have an open mind.’ And then he promptly turned around and said, ‘Oh no, I’m definitely not going to do anything.’”
An FDA spokesperson said in a statement that the agency “rigorously evaluates the latest scientific data, leveraging gold standard science to make informed decisions,” and balances a “science-based approach” with “practical, common-sense considerations.” Responding to Hawley’s accusation, the spokesperson also pointed to recent remarks by Makary saying he wouldn’t rule out changes to mifepristone regulations “if the data suggests something or tells us that there’s a real signal.”
The anti-abortion coalition is lobbying senior officials at FDA and HHS and on Capitol Hill, circulating petitions calling on the administration to put restrictions on the pills, and drafting a letter for lawmakers to sign demanding the agency take action.
Ryan Anderson, the president of the Ethics and Public Policy Center, demurred when asked whether he has secured meetings with agency officials, telling POLITICO he “obviously can’t share information about our confidential conversations” and noting that “it’s only been a week” since the report’s publication. But his allies on the Zoom call suggested they have conveyed the information to those in power.
“Right away it is very clear that the release of this data … has gotten attention at the highest levels in the administration and on Capitol Hill,” said Marjorie Dannenfelser, the president of Susan B. Anthony Pro-Life America.
Planned Parenthood and other abortion-rights supporters are slamming the report as “junk science” as they mount their own pressure campaign to save their funding — highlighting that the paper was released directly by the conservative think tank and not published in a medical journal where it would have been vetted by outside experts in the peer review process. Activists on the Zoom call pushed back on those criticisms, arguing that academia is “broken” and they couldn’t trust the peer reviewers not to leak or “sabotage” their effort.
Dr. Christina Francis, the CEO of the American Association of Pro-Life OBGYNs and member of the coalition of conservative doctors that challenged the 25-year-old FDA approval of the pills, also warned the groups not to misrepresent the paper, noting that is is “not a study in the traditional sense” and “not conclusive proof of anything.” Still, she and others argued it’s valid evidence that merits further research and immediate government action.
“Providing women with the truth about the harms of chemical abortion, and encouraging the Trump FDA to bring doctors back into the equation and reinstate the original [President Bill] Clinton FDA safety provisions, will save lives and it will help protect women,” Anderson said in a statement.
The anti-abortion activists stressed on their Zoom call that while they are publicly calling for the restoration of previous federal restrictions on the drugs — including bans on online prescriptions and mail delivery of the pills and cutting off their use after seven weeks of pregnancy instead of the current 10 — they view that as only a “first step.” If they achieve that, they plan to keep fighting for the drug to be removed from the market entirely.
Anderson presented three core talking points the groups will use to push Congress and the Trump administration in that direction.
First, that it’s not possible to fulfill Kennedy’s pledge to “Make America Healthy Again” without cutting off access to the pills. Second, that Trump pledged to “reverse damaging policies” enacted by the Biden administration, and that should include FDA rules easing access to the drugs. And third, while President Donald Trump promised on the campaign trail to leave regulation of abortion to states, “You’re not leaving it to states if California can mail pills to Texas.”
The groups believe the administration will be receptive to their push based on recent remarks by Kennedy and Makary leaving the door open to changing how mifepristone is regulated. Makary said in a speech last week that while he has “no plans” at the moment to roll back access to the drug, that could change.
“I believe as a scientist, that you’ve got to evolve as the data comes in,” he said. “So if the data suggests something or tells us that there’s a real signal, then I — we can’t promise we’re not going to act on that.”
And Kennedy said in his January confirmation hearing and again in a February interview that Trump has asked him to study the drug’s safety.
“Kennedy has said he wants to dig into this question of harms to women, and you provided him this data,” Dannenfelser said on the Zoom call. She then previewed how she plans to address the health secretary directly. “Now you’ve got great data, HHS director. You’ve got data, administration, that you can dig into, and you can go ahead and also do your own studies.”
Baer, who advises the coalition on messaging, said they will also work to change public perception of the pills with a series of online and in-person events around the country, kicking off with a May 14 webinar.
“We need to help to create a better, more accurate sense of this medication culturally, which is that it is not something to be taken lightly,” she said. “It shouldn’t be prescribed lightly, and it shouldn’t be thought of as an easy or uncomplicated fix to a crisis.”
Americans United for Life CEO John Mize added that another piece of the “Rolling Thunder” plan is to use the report on mifepristone to sue doctors in states with shield laws who prescribe the pills across state lines. They’re partnering with the group Center for Client Safety, which describes its mission as, “Shutting down abortion facilities to protect women and save preborn lives.” Their theory is that they can bring False Claims Act cases against the doctors for telling patients that the drugs are safe.
Brittni Frederiksen, the associate director for Women’s Health Policy at the nonpartisan health care think tank KFF, is among those skeptical of the groups’ findings. She highlighted, for instance, that the report lists ectopic pregnancies — when an embryo implants outside the uterus — as an “adverse event” from the pills when the pills do not cause ectopic pregnancies. Rather, according to the FDA, ectopic pregnancies are a contraindication, meaning patients are told not to take the pills in that instance because they will not work. Also, a large percentage of the harms listed in the EPPC report are patients who needed a follow-up surgical abortion because the pills did not end their pregnancies — which she and other experts argue is a known potential outcome disclosed on the medication’s label and not an “adverse event.”
“There’s just so many things wrong with it and so many red flags,” said Frederiksen. “I can’t imagine any medical journal that would accept this.”
Groups that support abortion rights are working to counter the “Rolling Thunder” campaign, defend mifepristone as safe and effective and lobby Congress to maintain federal funding for Planned Parenthood and other reproductive health providers.
Progressive advocates, granted anonymity to share deliberations that have not been made public, are pleased the groups’ report has gotten little coverage outside of conservative media and that few GOP lawmakers besides Hawley have promoted it. Still, they are considering writing to the FDA urging the agency to maintain access to the pills. That way, they reason, they can have firmer ground to sue the agency if the Trump administration does impose restrictions on the drugs.
Planned Parenthood’s advocacy arm is also mobilizing to save the hundreds of millions of federal funding it receives each year. The group held more than 100 events in key congressional districts around the country — focusing on the Carolinas, Iowa and Pennsylvania — during Congress’ recesses in March and April. They have also bought ads in Colorado, Iowa and New Jersey arguing that defunding the group would negatively impact patients, and are flying some of those patients to Washington, D.C., in the coming weeks to lobby Congress.
“It’s awfully convenient that a few days after Marty Makary says that he had no plans to restrict mifepristone, but that he’d be open to considering new science, some new trash science just happens to land in his lab,” said Angela Vasquez-Giroux, vice president of communications of Planned Parenthood Action Fund. “We will continue to do what we’ve always done, which is make sure that as many people as we can reach understand the difference between what they put out and real science.”
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Mifepristone for Abortion in a Global Context: Safe, Effective and Approved in Nearly 100 Countries
Authors
In late 2022, US anti-abortion groups filed a baseless lawsuit to revoke approval by the US Food and Drug Administration (FDA) of mifepristone, one of two drugs widely used to end an early pregnancy. These anti-abortion groups attempted to spin a false narrative that has been widely debunked by scientists and medical authorities and is contradicted by the reality of decades of medication abortion provision in the United States and around the world. The case, Alliance for Hippocratic Medicine v. FDA, is working its way through federal court proceedings, and any decision will likely be appealed to the US Supreme Court.
Claims that question the safety of mifepristone fly in the face of extensive evidence demonstrating the drug’s safety since it was approved by the FDA in 2000. And evidence on its use and safety in the United States is just the tip of the iceberg: Mifepristone has been around for nearly 40 years, and there is abundant evidence from other countries, as well as from the global scientific community, that it is safe and effective and, in fact, protects women’s health.
Approved and Commonly Used in Nearly 100 Countries
Mifepristone is used in a two-drug abortion regimen that has proven safe and effective in numerous studies worldwide. It blocks the hormone progesterone, which is needed for a pregnancy to continue; misoprostol, the second drug in the regimen, then causes uterine cramping to expel the pregnancy. Mifepristone was first approved in France and China in 1988, and as of May 2023, 96 countries have approved its use. The World Health Organization (WHO) abortion care guidelines recommend combined use of mifepristone and misoprostol, or use of misoprostol alone, as safe and effective methods of ending a pregnancy.
Drawing on 2017 evidence for 24 high-income countries, Guttmacher researchers found that medication abortion (typically mifepristone and misoprostol together) accounted for at least half of all abortions in the majority of high-income countries. In Finland, Sweden and Norway, medication abortion accounted for about nine out of every 10 abortions. The study also found that the proportion of abortions using medication increased steadily over time in the 11 countries that had trend data. A 2021 study found the proportion of all abortions done with medication ranged from 87% to 98% in five Nordic countries.
Routinely Used Beyond 10 Weeks
While the US FDA has approved mifepristone for use only through 10 weeks of pregnancy, other countries allow access to the medication later into pregnancy. This provides a longer window for pregnant people to reap the benefits of this safe and effective method. Indeed, in 2017, medication abortion accounted for 78% of abortions performed between nine and 12 weeks’ gestation in Sweden, as well as 68% of those in Norway and 29% of those in England and Wales.
Considered Essential Medicine by the World Health Organization
Mifepristone and misoprostol are recognized by WHO for decreasing the incidence of unsafe abortions—i.e., those performed using a method not recommended by WHO or by someone lacking the necessary skills—because the medications can be used to safely terminate pregnancies in settings where pregnant people may not otherwise be able to access appropriate care. By reducing a leading cause of maternal mortality worldwide, these drugs protect women’s health.
WHO maintains a model essential medicines list containing medications deemed important to health systems worldwide. Since 2005, WHO has included both mifepristone and misoprostol on this list, which is meant to provide guidance to countries in their own selection of essential medications. In 2019, WHO upped the status of mifepristone and misoprostol, classifying them as “core” essential medications for basic health care systems, a category comprised of “the most efficacious, safe and cost-effective medicines for priority conditions” that should be available in health care systems at all times. As of 2017, mifepristone was included in the essential medications lists of at least 16 countries.
Harmful Effects if the United States Bans Mifepristone
Medication abortion accounted for more than half of all US abortions in 2020, and more than 98% of these used a combined regimen of mifepristone and misoprostol. Although abortions can safely be performed with misoprostol alone, if mifepristone becomes unavailable, it is unclear whether all current providers using the two-drug regimen would offer abortion care using misoprostol alone and to what extent patients would take up this method. If use of misoprostol by itself did not fully replace the combined regimen, the demand for procedural abortions could increase—potentially leading to delayed care and logistical hurdles for many patients. This situation would play out within the current US landscape in which 13 states have banned abortion almost completely, leaving many people with fewer abortion options already. Lack of access to mifepristone may also mean that some abortion providers who currently offer only medication abortion would stop providing it altogether. In such a scenario, residents of 10 states could experience disproportionately large drops in the share of people living in counties with an abortion provider.
Furthermore, eliminating access to medication abortion with mifepristone could exacerbate existing racial and socioeconomic divides in access to abortion care. Mifepristone and misoprostol can be prescribed via telehealth in many areas, reducing costs associated with obtaining an abortion, such as transportation and child care, and allowing for more flexible scheduling. Abortion restrictions disproportionately impact marginalized groups, and the elimination of medication abortion with mifepristone as an option would further increase existing inequities in access to care.
United States Increasingly an Outlier as Other Countries Expand Abortion Access
Abortion is an experience shared by tens of millions of people around the world. According to recent estimates, 73 million abortions occur annually worldwide and 930,000 occur each year in the United States.
The US Supreme Court decision to end the federal constitutional right to abortion in June 2022 made the United States an outlier, bucking the decades-long global trend toward liberalizing abortion laws. Between 2000 and 2022, 50 countries have expanded the legal grounds for abortion, while only the United States and two other countries (Poland and Nicaragua) have rolled back abortion rights.
If the FDA’s long-standing approval of mifepristone is revoked, the United States will be an anomaly once again, by denying access to a medicine that has been deemed critical to public health by WHO and other global health experts and that has been approved for use in countries around the world.
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