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food and drug administration
Republicans Are Trying, But They Can’t Stop Abortion Pills
Despite RFK Jr.’s review of mifepristone, two things will remain true: Abortions pills will still be extremely safe, and abortion pills will still be available—everywhere.
May 20, 2025
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 The fact that Secretary Kennedy has asked the FDA to reevaluate the medications based on a single, unpublished junk science report is absurd.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.
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Abortion Rights Defenders 'Sound the Alarms' Over RFK Jr. Attack on Mifepristone
"Hawley is pointing to new junk science to motivate RFK Jr. and FDA to review the science on mifepristone," said one public health scientist. "The science is clear: Mifepristone is safe."
May 15, 2025
Abortion rights defenders and scientists expressed deep concern after U.S. Health and Human Services Secretary Robert F. Kennedy Jr.'s remarks about mifepristone, a key medication used to end pregnancies, at a Wednesday congressional hearing.
During the Senate Health, Education, Labor and Pensions Committee hearing, Sen. Josh Hawley (R-Mo.) inquired about the secretary's previous pledge to conduct "top-to-bottom review" of mifepristone, asking, "Do you continue to stand by that and don't you think that this new data shows that the need to do a review is, in fact, very pressing?"
Kennedy, one of President Donald Trump's most controversial Cabinet picks, responded by describing the data cited by Hawley as "alarming," suggesting that "the label should be changed," and confirming that he has asked Marty Makary, commissioner of the Food and Drug Administration (FDA), "to do a complete review and to report back."
Ushma Upadhyay, a public health scientist and professor at the University of California, San Francisco, posted the exchange on social media. She said that "Hawley is pointing to new junk science," and research has made clear "mifepristone is safe."
Hawley is pointing to new junk science to motivate RFK Jr. and FDA to review the science on mifepristone. I've been studying #abortion safety for a decade. The science is clear: mifepristone is safe. Let me tell you about a couple of **peer-reviewed and published** studies I've done... 🧪
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— Ushma Upadhyay, PhD, MPH ( @ushma.bsky.social) May 14, 2025 at 9:20 PM
In one study of Upadhyay's studies, "among 11,000 medication abortions, less than a third of one percent (0.3%) had a serious adverse event," the expert noted. In another from last year, she continued, "we found that telehealth abortion was just as safe and effective as published estimates of in-person care. Serious adverse events were 0.25%."
However, anti-abortion groups have seized on the paper cited by Hawley—published in April by the think tank Ethics & Public Policy Center—to pressure the Trump administration to restrict mifepristone further, or even remove it from the market.
The April paper conflicts with a mountain of research. A 2023 New York Timesreview found that "more than 100 scientific studies, spanning continents and decades, have examined the effectiveness and safety of mifepristone and misoprostol, the abortion pills that are commonly used in the United States. All conclude that the pills are a safe method for terminating a pregnancy."
Upadhyay said Wednesday that "one crappy report cannot silence decades of peer-reviewed high-quaility published research."
Other critics of RFK Jr.'s comments similarly stressed medical conclusions about mifepristone's safety.
"Mifepristone has a 25-year record of safety and efficacy under the FDA's watch, but now anti-abortion extremists are peddling junk science in an effort to deny people access to it," the group Power to Decide said on social media Thursday. "The reality is that medication abortion is safe, widely used basic healthcare."
The Center for Reproductive Rights also responded on social media, declaring, "SOUND THE ALARMS!"
"Let us be clear: President Trump, who once suggested injecting bleach, should not be making decisions about our healthcare, and RFK Jr. should not be interfering with our ability to access medication that's been PROVEN SAFE AND EFFECTIVE," the center said. "In putting this target on mifepristone—and therefore on abortion access at large—Trump's administration is making it clear that they do not care about science, or our health and safety. They only care about taking away our rights. But we refuse to let that happen."
"We'll be in court on Monday, fighting to protect mifepristone and make sure this VITAL, LIFESAVING medication is accessible and available to anyone who needs it," the center added, referring to oral arguments for Whole Woman's Health Alliance v. FDA, a case aimed at eliminating restrictions that impede access to mifepristone.
The ACLU pointed out in a Wednesday statement that the "pseudo-science paper" at the center of Hawley and Kennedy's exchange echoes calls made in Project 2025—a Heritage Foundation-led guide for a far-right overhaul of the federal goverment, from which Trump unsuccessfully tried to distance himself on the campaign trail—to severely restrict access to medication abortion.
"Secretary Kennedy just revealed that he has ordered the FDA to consider making it harder for people to get medication abortions based on propaganda pushed out by a Project 2025 sponsor," said Julia Kaye, senior staff attorney for the ACLU's Reproductive Freedom Project. "Even leading anti-abortion advocates admit this junk science is 'not a study in the traditional sense,' and is 'not conclusive proof of anything,' but that clearly won't stop extremist politicians from waving it around as a basis to restrict abortion."
"We should all be scared if our access to safe, FDA-approved medications turns on President Trump's gut instinct rather than credible scientific evidence," she warned. "This new FDA review has nothing to do with science and everything to do with teeing up nationwide restrictions on abortion."
Kaye added that "if the FDA moves forward with this politically motivated review, that is a dangerous sign that the president is going back on his promises to voters not to restrict abortion access even further."
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'Absolute Bloodbath' as Trump Administration Eviscerates Federal Health Agencies
"There is no way this makes Americans healthier."
Apr 01, 2025
HIV prevention. Anti-tobacco advocacy. The safety of mining workers.
All are among the health priorities that evidently have no place in U.S. President Donald Trump and Health and Human Services Secretary Robert F. Kennedy's vision to "Make America Healthy Again," following the mass firing of 10,000 people at the nation's top health agencies on Tuesday.
The layoffs hit the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), with some staffers informed of their dismissal after they arrived at work—only to be told to return home.
Kayla Tausche at CNN reported that laid off employees at the HHS building in Rockville, Maryland were forced to do a "walk of shame" past dozens of their former colleagues who were lined up outside the building, waiting to learn their own fate.
The employees who were laid off Monday evening into Tuesday are the latest of more than 100,000 federal workers who have lost their jobs since Trump took office and placed billionaire tech mogul and megadonor Elon Musk at the help of the so-called Department of Government Efficiency. Last week, Kennedy said the federal health agency workforce would be reduced from about 82,000 to 62,000 people, with the restructuring making room for what he called "the Administration for a Healthy America" at HHS.
"We're going to do more with less," said the secretary, who has expressed skepticism about the scientifically proven benefits of vaccinations and claimed without evidence that the rate of chronic disease rose over the four years that former President Joe Biden was in the White House.
Kennedy said last week that communications for the health agencies would be brought under his control in the "restructuring," and many of the layoffs impacted people responsible for relaying information to the public.
Twenty people who handle public communications for one National Institutes of Health (NIH) program analyzing the genes of volunteers for health research were among those placed on administrative leave Tuesday—a precursor to being laid off, one official toldUSA Today.
The FDA's Office of Media Affairs was also disbanded, as well as most of the 50-person communications team for the agency's Center for Drug Evaluation and Research, which manages information on drug approvals, shortages, and potential risks.
"The general public likely won't feel the results of these HHS layoffs immediately," said Larry Levitt, executive vice president of KFF. "But eventually, these layoffs will affect the health information available to people, access to care and prevention, and oversight of health and social services."
Other impacted employees include those in internal agencies focused on the health of senior citizens, people with disabilities, and minority communities, and workers studying asthma, lead poisoning, radiation damage, and the health effects of extreme heat and wildfires.
The administration appeared to see HIV prevention as a key target, placing the director of the National Center for HIV, Viral Hepatitis, STD, and TB Prevention on administrative leave and dismantling teams that do HIV research and surveillance.
Despite his claims last week about wanting to fight chronic disease, Kennedy did not outline plans to better equip the federal government to fight heart disease, diabetes, and other chronic conditions. At the CDC, The New York Times reported Tuesday, "entire departments studying chronic diseases and environmental problems were cut."
In a post on LinkedIn on Tuesday, former FDA Commissioner Robert Califf, who served under Biden and former President Barack Obama, said the agency "as we've known it is finished" and warned the federal government was losing critical institutional knowledge by firing thousands of people.
"I believe that history will see this [as] a huge mistake," said Califf. "I will be glad if I'm proven wrong, but even then there is no good reason to treat people this way. It will be interesting to hear from the new leadership how they plan to put 'Humpty Dumpty' back together again."
Journalist Sam Stein of The Bulwarkcalled the mass firings "an absolute bloodbath" with a "generation of scientists, healthcare officials being wiped out."
Brown University professor Dr. Craig Spencer said the country "will regret this."
"These are the people who make sure the medications you and your children take are safe. These are the people who perform and oversee research on cancer, infant health, and so, so, so much more. These are the people who make sure new devices that physicians and patients use are effective," said Spencer. "And now, thousands of them are gone. There is no way this makes Americans healthier."
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