Pro-Life AG Suggests a Reason Why the Trump Admin Hasn’t Cracked Down on the Abortion Pill

Alabama Attorney General Steve Marshall, a Republican, faulted the Food and Drug Administration for failing to quickly restrict access to mifepristone, the key drug in the abortion pill regimen.

“There’s obviously a political calculus that has gone on in the administration for pro-life issues,” Marshall told the Daily Signal in an interview Wednesday. He acknowledged the political headwinds on the issue, but argued that protecting women’s health should outweigh political concerns.

“I think calling on them to see it beyond the political lens, but about being able to protect women across the country from a drug that has obviously had adverse consequences,” the attorney general said.

The Trump White House countered Marshall’s claim, noting that the agency under Trump has launched an investigation into the drug over safety concerns.

“The Trump administration is pursuing a rigorous review of mifepristone in response to widespread safety concerns,” White House spokeswoman Allison Schuster told the Daily Signal. “This ongoing Gold Standard Science-based safety review by the FDA is just one example of President Trump’s total commitment to thoroughly evaluating emerging drugs to ensure the health and safety of all Americans.”

The Abortion Pill

In making his case about the harms of the abortion pill, Marshall cited a study from the Ethics and Public Policy Center, which analyzed insurance claims data from 865,727 mifepristone abortions from 2017 to 2023. The study identified a serious adverse event rate of 10.93%, even when excluding a majority of emergency room visits to avoid overstating risks.

“The emergency room visits included in the report are only those related to the chemical abortion, based on the diagnosis and procedure codes in the insurance records, and are counted only if treatment for a serious complication related to the chemical abortion took place,” the report explains. “Thus, if a woman took the chemical abortion pill and then got into a car accident or broke a bone, that did not count.” Yet the report also excluded adverse effects such as mild cramping from the abortion pill.

While President Donald Trump’s second administration has reversed many acts of the administration of President Joe Biden, the FDA has not reversed the Biden-era rules on mifepristone. The agency under Biden had allowed companies to distribute abortion pills to women via telehealth prescriptions and mail-order distribution. While the FDA has launched its safety review of the drug, the agency has yet to take action to reverse the Biden rule.

“The FDA has been actively working on a science-based safety review of the mifepristone REMS for months, as the agency has stated publicly and in court filings,” an FDA spokesperson told the Daily Signal. The spokesperson also highlighted an information page about the drug, noting that the FDA first approved it for this use in 2000.

The Trump administration has championed pro-life policy in many arenas, from reinstituting the Mexico City Policy (which bars federal funding to promote abortion overseas), to pardoning pro-life protesters who had been prosecuted under President Joe Biden, to reinstating conscience protections for physicians opposed to abortion, to attempting to defund abortion providers such as Planned Parenthood.

According to the pro-abortion Guttmacher Institute, abortion pills—which Guttmacher terms “medication abortion”—accounted for 63% of clinician-provided abortions in the U.S. in 2023, up from 53% in 2020.

Marshall’s Acts on the Abortion Pill

Attorney General Marshall has taken many steps to oppose the abortion pill.

He signed an amicus brief supporting Louisiana’s case against the FDA. Louisiana Attorney General Liz Murrill sued the FDA in October, challenging Biden-era mifepristone rules from 2023. While a three-judge panel on the U.S. Court of Appeals for the 5th Circuit granted in May Louisiana’s request to prevent the dispensing of the abortion pill by mail or telehealth prescription while the case continued, the Supreme Court reversed about two weeks later, allowing the Biden-era rule to stand.

The Louisiana case remains active.

Last month, Marshall joined a 14-state coalition urging the Environmental Protection Agency to add mifepristone to its Containment Candidate List for environmental concerns. The list includes “contaminants that are known or anticipated to occur in public water systems and are not currently subject to EPA drinking water regulations.”

“EPA takes the issue of pharmaceuticals in our water systems seriously and employs a rigorous, science-based approach to protect human health and the environment,” an EPA spokesperson told the Daily Signal in a statement Monday. “EPA is currently reviewing comments submitted on its draft contaminant candidate list 6, which lists pharmaceuticals as a group, and human health benchmarks for 374 individual pharmaceuticals that are approved by the FDA and may occur in surface and groundwaters and/or treated drinking water.”

This public comment period represents a step in the rulemaking process under the Safe Drinking Water Act of 1974.

“EPA’s mission and the intent of the Safe Drinking Water Act is ensuring safe drinking water for the American public,” the spokesperson added.

Also last month, the Alabama AG sent cease-and-desist letters to six companies he accused of illegally advertising, facilitating, and enabling the sale and procurement of abortion-inducing drugs to Alabama consumers.

“It’s an illegal activity for it to come into the state,” the attorney general told the Daily Signal.

He suggested that the FDA could prevent this state of affairs by preventing mail-order mifepristone.

“You would eliminate this ability for mail-order prescriptions to be able to come in in a clandestine way, if you got back to the requirement that the dispensing has to occur inside a physician’s office,” Marshall said. “That way there is no lawful ability of a mail-order pharmacy to be able to send drugs anywhere.”