Mifepristone Has Been Proven Safe for 25 Years. It’s Under Attack Again. 

Safeguarding mifepristone is not just about abortion care—it’s about defending the role of science in medicine itself.

Twenty-five years ago, the Food and Drug Administration made a decision that changed the course of reproductive health in America. By approving mifepristone (the first pill in the two-step medication abortion regimen), the agency gave people access to one of the safest, most effective and most studied medications in modern medicine.

Since then, more than 7.5 million Americans have relied on it to end pregnancies safely and with dignity. Its safety record is stronger than many drugs we take without question, including penicillin. What was once a breakthrough is now a cornerstone of healthcare. And at a moment when vaccines, Tylenol and even basic public health guidance are being questioned, that kind of evidence-based decision-making feels more fragile—and more essential—than ever.

The impact of the FDA’s approval of mifepristone on Sept. 28, 2000 is hard to overstate. Mifepristone has expanded access to early pregnancy abortion, giving patients more flexibility in how they receive care, and providing them with greater privacy and control. In fact, the majority of all abortions in the U.S. are now done via medication. And it was this very medication that helped lay the foundation for innovations that reshaped healthcare delivery itself: Today, one in four abortions in the United States happens through telehealth—a model that exists only because mifepristone (alongside misoprostol, the second medication taken in the medication abortion process) made this mode of abortion care possible in the first place.

The through line is the same: Ignore the evidence, stir up doubt and leave patients to bear the consequences.

Yet despite overwhelming evidence and broad public support, there are relentless attempts to restrict access to mifepristone. In 2023, a coalition led by extremist antiabortion groups filed a lawsuit seeking to roll back the FDA’s approval of the drug (which the Supreme Court ultimately dismissed). But the attacks have continued, fueled by a dangerous belief that science is optional.

As recently as this week, HHS secretary Robert F. Kennedy Jr. and FDA commissioner Marty Makary sent a letter to Republican-led states threatening to put mifepristone back under “review”—a move that disregards decades of research and millions of real-world patients.

And they’re not alone: Throughout this year, prominent political figures have repeated baseless claims that mifepristone is “unsafe” or “untested,” directly contradicting the scientific consensus and real-world evidence. These kinds of baseless claims, whether from fringe groups or government officials, don’t just mislead the public, they reinforce a broader wave of anti-science decision-making that undermines trust in the very institutions designed to protect our health.

We’ve seen it with COVID vaccines. We’ve seen it with birth control. We’ve seen it in lawsuits claiming Tylenol causes autism. We’ve even seen people question milk pasteurization and folic acid in prenatal vitamins—two of the most basic public health measures we have. The through line is the same: Ignore the evidence, stir up doubt and leave patients to bear the consequences.

If a drug that is safer than penicillin can be called “dangerous,” what does that mean for vaccines? For contraception? For prenatal care? For the next life saving innovation we haven’t discovered yet? The cost isn’t abstract, it’s borne by patients who lose access, delay care or are forced to navigate a collapsing health system.

Look no further than abortion access to understand the ways that science-driven innovation matters. As brick-and-mortar clinics across the country (including in states where abortion is still legal) continue to close, communities are left without local providers, forcing people to travel hundreds of miles or go without care altogether. Because mifepristone made telemedicine abortion possible, patients with early pregnancies can still access safe, effective treatment even when in-person clinics are out of reach. Telehealth is not a cure-all—people later in pregnancy or those who prefer in-person care still need local providers—but it has softened the blow of a worsening healthcare landscape, giving people a way to take care of themselves when systems fail around them.

That’s what’s at stake here. Not just a pill, but a philosophy of reason. Telemedicine is living proof that when science is trusted, patients benefit. It has allowed people to avoid unnecessary travel, take less time off work and preserve more privacy in deeply personal circumstances.

Just this month, the virtual clinic I co-founded in 2021, Hey Jane, served our 100,000th patient. That milestone is not about us, it’s about the undeniable demand for care that is safe, evidence-based, and designed for the realities of people’s lives.

That’s why protecting mifepristone matters now. Because once ideology and viral misinformation drown out science, it’s almost impossible to claw the truth back.

The people who rely on medication abortion are not abstractions. They’re our neighbors and coworkers, young people and parents, conservatives and progressives, people in cities and in rural towns. Mifepristone has given them a safe and effective way to make one of life’s most personal choices on their own terms. The FDA’s decision in 2000 did not just open a door. It was a declaration that evidence matters more than ideology. And every time public figures repeat falsehoods about mifepristone’s safety, they’re not just attacking abortion care—they’re chipping away at the very idea that science should guide medicine.

This anniversary is both a celebration and a warning. For 25 years, mifepristone has expanded access, strengthened patient autonomy, fueled the rise of telehealth and transformed lives. But now it stands at the same crossroads as vaccines, birth control, prenatal vitamins and even Tylenol—all essential, lifesaving health measures suddenly cast into doubt.

That’s why protecting mifepristone matters now. Because once ideology and viral misinformation drown out science, it’s almost impossible to claw the truth back. Safeguarding this medication is not just about abortion care—it’s about defending the role of science in medicine itself.

If we fail to do that, none of us—not patients, not providers, not families—will be safe.