Lawsuits and legislation across the country would restrict access to or ban mifepristone, often based on the same arguments promoted by anti-abortion groups that experts say are not rooted in scientific evidence. A hearing in the Louisiana case, which may determine future telehealth access to abortion drugs, was held in tardy February in the U.S. Courthouse. John M. Shaw in Lafayette, Louisiana. (Photo: Greg LaRose/Louisiana Illuminator)
As telehealth access to abortion drugs has increased in the years since the U.S. Supreme Court’s Dobbs decision, anti-abortion groups and attorneys general in states with abortion bans are accelerating efforts to ban access to the drugs, including by trying to overturn the U.S. Food and Drug Administration’s approval.
Louisiana Attorney General Liz Murrill sued the FDA in October and asked a district court to strike down a 2023 rule allowing telehealth prescribing of mifepristone, part of a two-drug regimen commonly used to terminate pregnancies before 10 weeks. The lawsuit involves Rosalie Markezich, a Louisiana resident who claims the man is her boyfriend he urged her to take pills.
Louisiana officials argue that doctors in states without abortion bans should not be able to prescribe the drugs and mail them to a state where it is illegal, and say Markezich would not be harmed if the 2023 rule did not allow the drug to be mailed to her boyfriend. Murrill asked the court to block the 2023 rule with a preliminary injunction, and if granted, could restrict access to people across the country.
A ruling in this case is pending, as is another lawsuit involving abortion pills in Missouri last year, FDA approval of the generic brand mifepristone.
Apart from court cases, legislatures across the country they are also considering legislation to limit or ban mifepristone, which is also used to treat miscarriages and high blood sugar in some patients. Louisiana designated the drug a controlled substance in the same category as Xanax and Valium, and the South Carolina House of Representatives passed a similar bill in February.
According to experts, whether in court briefings or before state policymakers, there is a lot of repeated talk about abortion drugs that is not based on facts or scientific evidence. Here are some of the most common:
1. According to extensive scientific research, the rate of stern adverse events associated with the employ of mifepristone is less than 0.5%.
Republican lawmakers and anti-abortion interest groups cited an April 2025 article arguing that mifepristone is risky and causes a much higher rate of stern adverse events than reported by the FDA. This article, which has not been peer-reviewed, was published by the Ethics and Public Policy Center, a conservative advocacy group that works with groups such as Alliance Defending Freedom, a conservative law firm that has handled many anti-abortion lawsuits, including the Dobbs case.
A report by the Policy Center shows that the rate of “serious adverse events” is almost 11% based on commercially available data on health claims. Experts deny that the center defined a stern adverse event the same way the FDA does, as a condition that requires hospitalization, is life-threatening or disabling, and causes eternal damage or death.
Dr. Mitchell Creinin, an obstetrician-gynecologist at the University of California, Davis Health, who has studied the safety of mifepristone since studies began in 1992, said there is overwhelming evidence that the drug is sheltered and the risk of stern side effects is extremely low. In report published by the Family Planning Society, Creinin identified errors in the way events were calculated in the strategic center’s analysis, alleging there was double counting of problems involving the same patient, and said the report included stern adverse events that did not meet FDA criteria, including trips to the emergency room.
“The idea is to play with the science and make it say what you want it to say,” Creinin said.
One 2015 study by Creinin combined all relevant published studies on mifepristone and misoprostol from 2005 to 2015, a total of 20 studies involving 33,846 women up to 70 days of pregnancy, and found that stern outcomes requiring blood transfusions and hospitalization occurred in less than 1% of cases.
2. In early pregnancy, it is not necessary to test the Rh blood level.
A common argument from anti-abortion groups like Students for Life of America, including in their amicus brief in a Louisiana court, is that telehealth abortion cuts off doctors’ ability to check a pregnant patient’s Rh status before abortion, which they say could jeopardize the health of future pregnancies.
At some point in the pregnancy, the doctor will test the pregnant woman’s blood to determine whether she is Rh positive or Rh negative. If you know your blood type, e.g. A or O, the positive or negative sign associated with your type is the Rh factor. Sometimes the pregnant patient’s marker is positive and the fetus is negative, which may result in the patient’s body recognizing the pregnancy blood cells as foreign. This may cause a pregnant patient to develop antibodies against blood cells. There must be enough of these cells to trigger a reaction, which does not appear until after the first trimester, about 12 weeks. In such cases, treatment to prevent antibody formation may be used.
According to the American College of Obstetricians and Gynecologists, these antibodies can also develop after miscarriage, ectopic pregnancy and abortion and may affect future pregnancies.
However, in its amicus brief filed in a Louisiana court, the organization said the risk of stern complications from Rh problems before 12 weeks of pregnancy is low and affects a petite minority of the population, so restricting access based on such a sporadic result would be a “disproportionate response.”
Creinin said research shows that there are not enough fetal cells present in early pregnancy to trigger an immune response such as: 2023 study of 506 first-trimester abortion patients, all but one of whom were below the threshold of immune response. Most countries in the world do not recommend treating patients with this disease in early pregnancy, and this is also the recommendation in the USA.
“There is really good evidence that says you don’t have to do this,” Creinin said.
3. The patient does not need an ultrasound before taking mifepristone.
According to the FDA, a pregnant woman does not need to have an ultrasound or visit a doctor in person to receive mifepristone. Ultrasounds were not required before the FDA stopped requiring in-person visits, and most pregnant patients do not have ultrasounds in early pregnancy until at least eight weeks of pregnancy, even if they intend to keep them. Symptoms of an ectopic pregnancy, where the embryo implants in the fallopian tube instead of the uterus, usually begin in the seventh to eighth week of pregnancy, and mifepristone is only approved for employ for up to 10 weeks.
The mortality rate for ectopic pregnancy is extremely low, at less than 50 deaths per year, and if someone has significant risk factors for ectopic pregnancy, Creinin said, it should be evaluated earlier. This is part of the telehealth visit counseling.
4. Taking mifepristone at home does not cause disproportionately high traumatic experiences.
Anti-abortion organizations such as the Justice Foundation have filed friend’s reports in a Louisiana court for people who said taking abortion medications and undergoing treatment at home led to traumatic outcomes because they were unprepared for what they would see.
This can happen, says Jessie Losch, director of government affairs for the American Society of Reproductive Medicine, but most doctors first advise patients on what to expect and what they might see after taking the pills, including the passage of fetal tissue.
Losch acknowledged that there may be a discrepancy between hearing about what to expect and seeing it in person, but that’s not a reason to take away the option from those who benefit from the opportunity to choose when and where treatment will take place. This may be especially critical for victims of violence, Losch said.
“I understand why someone might be surprised by the reality, but we can’t control it through legislation,” she said.
Although there is little recent research that specifically examines the management of abortion at home, one 2022 Family Planning Society study among over 3,100 participants, it was found that 98.4% were satisfied with the experience and approximately 95% felt that self-management was the right choice for them.
5. There is no evidence to support the claim that taking mifepristone is harmful to the environment.
That argument largely comes from the anti-abortion group Students for Life of America, which argues that mifepristone pollutes water supplies and argues that the FDA should have conducted an environmental assessment, including impacts on endangered species, before easing restrictions on the drug. Many states have considered legislation to impose environmental restrictions on the drug or laws requiring providers to instruct patients to collect fetal tissue in medical waste collection kits and return it to the provider, rather than flushing it.
The U.S. Environmental Protection Agency may also conduct a review that could be used to restrict access in the future. – reported the United States Newsroom.
Losch said it found no evidence that mifepristone is detectable in drinking water or that it has harmful effects on wildlife, including the hormonal structure of fish and other aquatic animals.
In 1996, the FDA’s Center for Drug Evaluation and Research released the finding no significant impact on water supply with mifepristone.
“Center[…]concluded that the product can be manufactured, used and disposed of without expected negative effects on the environment,” the conclusions stated. This included endangered or threatened species.
This story was originally produced by News from the USwhich is part of States Newsroom, a nonprofit news network that includes the Ohio Capital Journal and is supported by grants and a coalition of donors as a 501c(3) public charity.
