Anti-abortion advocates first began calling for a comprehensive safety study for mifepristone following a report using insurance claims data from the Ethics and Public Policy Center last spring that found roughly 11% of women suffered serious adverse events following at-home abortions.

Republicans in Congress and anti-abortion advocates grew increasingly frustrated over the past year with Makary and the Trump administration, with multiple delays to the promised study, going as far as to say that they were intentionally delaying it until after the midterm elections for political reasons.

Since Makary was replaced by Acting Commissioner Kyle Diamantas last month, the agency has taken a renewed interest in the study and the interests of the anti-abortion base, including phone calls from Diamantas to anti-abortion leaders to reassure them of his personal commitment to the issue.

But anti-abortion advocates say they are disappointed that agency officials say the study will take at least another six months to complete, placing any action by the FDA to restrict online abortion pill sales after the elections.

David Bereit, president of the anti-abortion advocacy coalition Life Leadership Conference, told the Washington Examiner he hopes the FDA follows the evidence instead of political interests. 

“After far too much political delay, the FDA’s safety review of mifepristone is finally underway, and it must follow the science, not the election calendar,” Bereit said.

The FDA’s study does not go far enough

Several anti-abortion leaders told the Washington Examiner that the FDA’s study is not enough to satisfy the GOP base ahead of the 2026 election, saying that there are other things the administration can do in the meantime to restrict access to abortion pills.

Marjorie Dannenfelser, president of the anti-abortion group Susan B. Anthony Pro-Life America, told the Washington Examiner that advocates “should be very happy that real women’s lives are being considered now,” but she said advocates should also be pushing for the Department of Justice to reverse course in its legal dispute with the state of Louisiana over online abortion pill access.

The DOJ has supported the FDA in a lawsuit filed late last year by Louisiana against the Biden administration decision to remove in-person screening requirements.

Louisiana and other states that have prohibited elective abortion throughout pregnancy argue that abortion pill sales online effectively nullify their laws, as residents in anti-abortion states are still able to obtain mifepristone via telehealth.

Dannefelser says the DOJ ought to settle its lawsuit with Louisiana and allow for a block on abortion pill sales in states with anti-abortion laws while the FDA’s safety study is ongoing.

“The most important aspect of the pro-life movement to the administration right now is that DOJ settle with the state of Louisiana and give the states relief from the effects of the change in the in-person dispensing requirement,” Dannenfelser said.

Bereit said, in addition to the risk of adverse consequences, law enforcement agencies should take particular notice of several documented cases of abortion coercion, in which women were forced to take mifepristone against their will by abusive partners or family members. 

“Mifepristone is designed to end the life of a child, and the evidence now shows it is harming mothers too,” Bereit said. “It has also become a weapon for abusers, fueling a growing abortion-pill coercion crisis that demands immediate scrutiny.”

The DOJ did not respond to the Washington Examiner’s request for comment.

The hardline group Students for Life of America is pushing the Trump administration to curtail abortion pill access on the grounds that the drug may poison the water supply.

Kristi Hamrick, the group’s vice president, told the Washington Examiner that her organization is concerned that the FDA’s safety study will not take into account concerns regarding the potential effects of residual chemicals and human remains that make their way into the water supply from at-home abortions.

Students for Life has filed four citizens’ petitions with the FDA in the past several years, arguing that the agency did not complete environmental hazard reviews for mifepristone when it was initially approved in 2000 and has not done retrospective reviews in the more than 25 years the product has been on the market.

“They have never done the right environmental assessment,” Hamrick said. “That needs to happen too.”

Midterm election effects

Anti-abortion advocates have been increasingly sounding the alarm that the Trump administration’s abortion pill policy will likely affect voter turnout in November. 

Dannefelser said she believes the administration taking swift action on mifepristone would be “the most strategic thing and the right thing to do.” 

Whether through the DOJ settling with Louisiana or the FDA unilaterally reinstating safety requirements, Dannefelser said any action from the Trump administration to rein in mifepristone would reaffirm to anti-abortion voters the GOP’s commitment to their values ahead of the election.

“It will increase the intensity at a moment where intensity is needed for battleground candidates,” Dannefelser said. “You take just a couple of degrees of intensity away because of something so deep and so important for strong pro-life voters, and you potentially lose the handful of votes that you need to win.” 

A public opinion poll from February commissioned by SBA and conducted by the firm Cygnal of likely Republican primary voters found that 80% support in–person dispensing requirements for abortion pills. 

Nearly a third, 32%, of GOP voters reported being less enthusiastic about voting in the general election in November if party leadership abandons core anti-abortion policies. 

NEW FDA CHIEF’S PLANNED PARENTHOOD PAST PROMPTS CONCERNS FROM ANTI-ABORTION LOBBY

Another third, 34%, said they would be less likely to volunteer for Republican candidates during the thick of election season this summer if the party backs away from its anti-abortion commitments. 

Dannefelser said that the administration restricting mifepristone is “a politically smart thing to do in a moment where the polls are not looking so hot.”