Republicans Are Trying, But They Can’t Stop Abortion Pills

In a disturbing advancement of the Project 2025 playbook for eradicating abortion, Health and Human Services Secretary Robert F. Kennedy Jr. is using the release of a new pseudo-study as a pretense for the Food and Drug Administration to review mifepristone’s safety and efficacy. The use of this widely discredited self-published report is a clear political maneuver by the Trump administration and anti-abortion extremists to curb access to telehealth abortion and end access to mifepristone more widely, against the scientific evidence and the will of the American public.

I am a public health researcher and abortion access advocate and have been tracking access to the abortion pill since it was first approved in France in 1988. I feel confident that, regardless of the outcome of this illegitimate review, two things will remain true: Abortions pills will still be extremely safe, and abortion pills will still be available—everywhere.

Abortion pills are safe. Period. The fact that Secretary Kennedy has asked the FDA to reevaluate the medications based on a single, unpublished junk science report is absurd. We have mountains of data and decades of clinical experience documenting their safety, whether provided through an in-person visit at a clinic or, since 2020, via telehealth. The World Health Organization has also said that abortion pills are safe even when taken without medical supervision, also known as self-managed abortion. Data support the safety of all of these forms of access.

As activists and clinicians expand these new routes of access to abortion pills, we are providing an immediate, practical solution for people who need abortion access, and thereby reducing the harm that abortion bans create.

Abortion pills are everywhere. As courts and legislatures have been systematically blocking access to abortion across the country, clinicians and activists—myself included—have been setting up and illuminating innovative routes of access that reach people where they are with safe abortion access, including in states with restrictions. As a result of our collective efforts, abortion pills are now readily available by mail for $150 or less—and free for those who can’t afford any amount—in all 50 states, even states with bans. Access routes currently include telehealth from U.S. providers operating from states with laws that shield them from prosecution, international telehealth services that mail pills to the U.S., community networks that send pills by mail for free, and e-commerce vendors that mail pills to all states.

An organization I co-founded, Plan C, tracks these different services to learn about their offerings, including whether they do a medical screening, what type of pills they offer, and how much they cost. Our ongoing investigations—which include mystery shopping and laboratory testing to verify that the pills are real—document a rich ecosystem of abortion pill access. These are real services providing practical, affordable, medically-safe abortion access, even in states with bans. They are all discoverable online. We index and share this information through our Guide to Pills so that people can learn about this ecosystem, and those who are seeking abortions know that they still have options.

These routes of access, combined with the clinic-based care options that exist in states that still allow it, have been so successful in reaching people that there are now even more abortions occurring in the United States than prior to the Supreme Court decision that overturned Roe v. Wade. Guttmacher, a leading abortion research organization, reports that clinician-provided abortions in the United States rose by more than 100,000 between 2020 and 2024, and that figure does not even include self-managed abortions or abortions facilitated by telehealth shield providers prescribing across state lines into states with bans. The Society of Family Planning also has been documenting abortion post-Roe and reports that these shield providers are serving approximately 10,000 people per month in states that totally or partially ban access to care.

As activists and clinicians expand these new routes of access to abortion pills, we are providing an immediate, practical solution for people who need abortion access, and thereby reducing the harm that abortion bans create, particularly for populations underserved by healthcare systems. We are also showing a new way forward for modern abortion access and laying the groundwork for eventual policy change (which will likely only be possible after our U.S. democracy is restored).

This scenario has already played out in other countries, with resulting improvements in abortion access. For instance, it was largely based on the experiences of patients in Ireland who received abortion pills by mail from Women on Web to safely terminate their pregnancies that parliament liberalized abortion access. In Mexico, the widespread grassroots sharing of information about how to use misoprostol—a widely available ulcer medication—for abortion, ultimately paved the way to policy reform, with abortion pills now officially registered in the country.

For decades, abortion pills have been so severely restricted by politics and overregulation that envisioning a radically different future in which the pills are universally available by mail—or even over the counter—is difficult for most. But this future is coming. Many would say it is largely already here. And, what is particularly notable, given the current FDA safety review based on fabricated claims about the “dangers” of abortion pills, is that these new, modern routes of access are possible precisely because abortion pills are so safe. They are safer than Tylenol, safer than Viagra, and research has demonstrated time and again that they are absolutely safe enough to put directly in the hands of the person who needs them.