In August, the U.S. Food and Drug Administration warned about noncompliant foam sunscreens, recalled potentially radioactive Indonesian shrimp, and proposed an update to the amount of sugar allowed in orange juice. But when it comes to abortion drugs, the FDA seems slow to protect women’s health.
Since the early 1900s, the FDA has taken on diluted, doctored drugs and fake foods. While the agency’s reach has certainly expanded, its core mission remains the same: safeguarding American citizens from powerful corporate interests.
The FDA has often faced — or created — political conflict, but few agency policies remain more contentious than the regulation of mifepristone, the medication primarily used in combination with misoprostol for medical abortions. That’s unsurprising for a drug that treats healthy pregnancy like a disease and, when successful, ends a human life. But even leaving the ethics of these challenges to the side, the FDA must grapple with the question: Will it continue to allow the enormously lucrative mifepristone industry to run roughshod over the health and well-being of the women who use it?
The industry is, indeed, lucrative. In 2023, Mother Jones published a damning exposé on the financial shenanigans of the private equity investors behind Mifeprex, the commercial name for a leading mifepristone pill. While the “secret money men” seem to view widespread chemical abortions as a social good, they also admit — when deposed in litigation — that “investments have been ‘extremely profitable.’”
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This isn’t just about ideology — it’s about money.
According to a 2024 industry report, the entire abortion drugs market is estimated at 29.16 billion in 2025 and is forecasted to reach 43.85 billion by 2030. The industry is clearly fighting for deregulation in an effort to maintain dominance. GenBioPro, a pharmaceutical company that supplies about two-thirds of the mifepristone distributed in the country, is currently fighting a West Virginia law that protects the health of its citizens, but inconveniently threatens the company’s bottom line. The manufacturer has also petitioned the FDA to “take no action that would reduce or inhibit patient access” to its drug.
But since approving the drug in 2000, the FDA has — under the leadership of Presidents Barack Obama and Joe Biden — relaxed the safeguards to extend approval of the drug to 10 weeks, eliminated in-person dispensing, and limited reporting requirements to deaths only. The abortion drug’s funders, pharmacists, and fans rarely face the implications and fallout of their lucrative project or their deregulatory efforts. The front-line consultants and nurses at our pregnancy help organizations do.
An April report from the Ethics and Public Policy Center suggested that mifepristone is 22 times more dangerous than the FDA itself reports. While abortion backers contest these numbers, our counselors, advocates, and medical professionals see indications that the EPPC estimates are far more accurate than the FDA’s rosy picture.
Our Option Line nurses help women understand more about the drugs they’re considering, but even their medically precise, compassionate conversations can’t replace an ultrasound that detects how far along a woman is in her pregnancy and whether her pregnancy is ectopic or not. Our peer counselors have helped women who are literally picking up the pieces of their abortion — unaware that the drug would “deliver” a baby with tiny, recognizable features. And our Abortion Pill Rescue Network has helped thousands of women who instantly regret taking mifepristone to quickly and safely reverse its effects and, months later, welcome the birth of a healthy child.
But, while pregnancy help organizations help a woman pick up the pieces of her decision, abortion drug providers continue to profit from the pain. When a young woman “successfully” ends her pregnancy alone in her bathroom, abortion drug providers profit and women lose. When a disgruntled boyfriend stockpiles abortion pills and tricks his partner into ingesting them, the drug providers profit and women lose. When women face medical complications — including hemorrhage, incomplete abortion, and infection — abortion drug providers still profit and women lose.
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The FDA has the opportunity — and the responsibility — to reestablish safeguards, including mandated adverse events reporting, in-person dispensing, and ultrasounds. Thankfully, the Trump administration has shown an appetite for disrupting some entrenched special interests. Now the FDA must stand up to the lucrative abortion drug industry.
The FDA has a long list of priorities, and personally, I’m glad it keeps an eye on the sunscreen, shrimp, and orange juice I might put on or into my body. But protecting America’s women from feckless abortion drug providers should be at the very top of that list.
Jessica Prol Smith is director of government relations for Heartbeat International, the world’s largest network of pregnancy help organizations.
