A new national survey and a string of coercion cases are intensifying calls from Republican lawmakers, state attorneys general, and advocacy groups for the FDA to restore tighter safeguards on abortion medications—pressure that comes even as federal health officials say they are reviewing mifepristone’s safety and the FDA has cleared a second generic version.
Recent polling commissioned by SBA Pro‑Life America and conducted by McLaughlin & Associates found that 71% of likely voters support requiring an in‑person doctor visit before prescribing abortion pills, and 70% back screenings for abuse and coercion. A majority of respondents identified as pro‑choice. The online survey of 1,600 likely 2026 voters was fielded August 16–19, 2025 (±2.5 percentage points). (sbaprolife.org)
Access expanded under Biden‑era changes to the FDA’s Risk Evaluation and Mitigation Strategy for mifepristone. In December 2021 the agency removed the in‑person dispensing requirement, and in January 2023 it finalized a pharmacy‑certification process that allows dispensing in person or by mail where state law permits. (acog.org)
Advocates cite coercion and abuse cases. In Texas, attorney Mason Herring received a 180‑day jail sentence and probation after pleading guilty to drugging his pregnant wife’s drinks to induce an abortion; she later delivered prematurely. Separately, Texas resident Liana Davis has filed a civil suit alleging her boyfriend spiked her hot chocolate with abortion medication, leading to a miscarriage—allegations he disputes in a countersuit. And Louisiana resident Rosalie Markezich says she was pressured by a boyfriend to take pills obtained by mail; she has joined litigation and related actions targeting mail‑order prescribing, and Louisiana officials have sought the arrest of a California physician accused of sending the drugs. (apnews.com)
Safety claims are sharply contested. A 2025 analysis by the Ethics & Public Policy Center (EPPC), based on 865,727 insurance claims from 2017–2023, estimates that 10.93% of women experienced sepsis, infection, hemorrhage, or another serious adverse event within 45 days—roughly 22 times higher than rates summarized on the drug’s label. Pro‑life medical groups, including the American Association of Pro‑Life Obstetricians and Gynecologists (AAPLOG), have also warned clinicians to watch for rare but dangerous clostridial infections, and a Charlotte Lozier Institute‑linked, peer‑reviewed article challenged the oft‑repeated claim that abortion pills are “safer than Tylenol.” Mainstream medical bodies counter that serious complications are uncommon: ACOG and other summaries put major adverse events at well under 1% in clinical practice. (eppc.org)
Amid the debate, Health and Human Services Secretary Robert F. Kennedy Jr. has told Congress that the prior administration “twisted the data” to bury an “approximately 11%” safety signal and said HHS, through the FDA, is reviewing real‑world outcomes for mifepristone. The comment—disputed by abortion‑rights advocates—came during a Sept. 4, 2025 hearing; a subsequent communication referenced the ongoing review. (news.bloomberglaw.com)
On Oct. 2, 2025, the FDA approved a second generic 200‑mg mifepristone tablet (Evita Solutions), joining the brand‑name Mifeprex and an earlier generic. The agency said its discretion on bioequivalent generics is limited, but the timing triggered criticism from anti‑abortion groups and some Republicans; the company has said it aims to launch in early 2026. (apnews.com)
Advocacy groups have urged the agencies to reverse course. Live Action organized a coalition letter with groups including Students for Life and AAPLOG seeking to rescind the new generic approval and, ultimately, withdraw mifepristone. Separately, 22 state attorneys general, led by Alabama’s Steve Marshall, had earlier called the 2023 rollback of in‑person rules “illegal and dangerous,” and in July 2025 a different coalition of 15 Republican attorneys general asked Congress to preempt state “shield laws” that protect cross‑state, telehealth prescribing and mailing of abortion pills. (liveaction.org)
On Capitol Hill, Sen. Lindsey Graham (R‑S.C.) led a letter signed by 51 Senate Republicans urging HHS and the FDA to reevaluate or halt the generic rollout and restore safeguards while the safety review proceeds. HELP Committee Chair Bill Cassidy (R‑La.) followed with an oversight letter pressing FDA Commissioner Martin (Marty) Makary for details on the review and arguing the decision “fails to mitigate the risks to women … and fails to protect women from the coercive use of the drug.” (britt.senate.gov)
Supporters of broader access, including ACOG and many medical societies, maintain that medication abortion is safe and effective when used as directed, and note that state laws continue to govern availability regardless of federal policy. With legal fights over mail‑order access and cross‑state enforcement intensifying, federal regulators’ review—and how they weigh conflicting datasets—will shape the next phase of the mifepristone debate. (acog.org)
