Mifepristone is a drug that blocks progesterone’s action on the uterus, making it incapable of supporting a pregnancy. When used in combination with another drug, misoprostol, it can be used to induce a medication abortion without surgery. The two-drug combination was approved by the US Food and Drug Administration for use up to 10 weeks after the last menstrual period in 2016, and by 2019, medication-based abortions accounted for approximately 42 percent of all abortions in the US.
Research has shown that medication abortion using mifepristone and misoprostol is safe and effective, with a 2015 study from the University of California, Los Angeles finding that 99.6 percent of more than 30,000 women seeking a medication abortion were able to terminate their pregnancies. An analysis of clinical trials published in 2013 found that just 0.3 percent of over 45,000 women studied required hospitalization due to complications when using the two-drug combination. The mortality rate for the medications is less than 0.001 percent.
Despite its safety, regulation of mifepristone has been a source of controversy, with conservative lawmakers and anti-abortion activists seeking to restrict its availability. In April 2022, the Biden administration removed restrictions that required people seeking medication abortion to receive the drugs in person from a healthcare provider, a policy put in place during the COVID-19 pandemic. However, a federal judge in Texas issued a restraining order in April 2023 that would block federal approval of mifepristone within seven days of the order. On the same day, a federal judge in Washington State ruled that no changes can be made to the drug’s availability in 17 states where abortion is legal or in Washington, D.C.
The future of medication abortion in the US remains uncertain as legal battles continue. However, advocates for reproductive rights argue that medication abortion is a safe and effective way for people to access abortion care, particularly in areas with limited access to abortion providers. As the debate continues, it is essential to prioritize science-based approaches to reproductive healthcare and ensure that all people have access to the full range of reproductive healthcare options.