The newly confirmed Secretary of Health and Human Services has expressed support for reviewing the federal approval of mifepristone, a move that could ultimately restrict access to the drug used for abortion and miscarriage care.
Reproductive rights advocates in North Carolina are raising concerns over the possibility that the Trump administration could revoke access to this key medication. Although Trump downplayed the likelihood of national abortion restrictions during his campaign, he recently directed Health and Human Services Secretary Robert F. Kennedy Jr. to “study the safety of mifepristone,” according to Kennedy’s Senate confirmation hearing in January.
Kennedy stated that Trump has “not yet taken a stand on how to regulate” but assured senators he would support the administration’s policies on the matter.
Mifepristone, approved by the FDA nearly 25 years ago, has been repeatedly shown to be safe. The drug is used in over half of all abortions in the U.S. and is also a critical treatment for miscarriages. In 2021, medication abortions—utilizing a two-drug regimen of mifepristone and misoprostol—accounted for around two-thirds of abortions in North Carolina. Advocates warn that restricting mifepristone could have devastating consequences for reproductive healthcare access in the state.
“We’ve seen in states with abortion bans where care is out of reach that the consequences are deadly,” said Sophie Vaughan, Manager of Federal Advocacy Communications for Planned Parenthood Action Fund.
“The most severe consequence of RFK Jr. potentially attempting to make mifepristone out of reach is that people will die. It is that people will suffer complications from pregnancy that could harm their reproductive future, that could harm their current health, future health,” Vaughan said.
Despite strong scientific consensus on its safety, Kennedy has emphasized the need to examine the drug’s “adverse effects.” However, Dr. Ushma Upadhyay, an OB-GYN and epidemiology professor at the University of California, San Francisco, reaffirmed mifepristone’s safety, citing over 100 peer-reviewed studies and 25 years of data.
The FDA’s approval of mifepristone has already been reviewed twice—by the Government Accountability Office in 2008 and 2018—both times affirming its safety and the FDA’s adherence to proper protocols.
Kennedy also falsely claimed that the Biden administration’s National Institutes of Health (NIH) prevented doctors and patients from reporting injuries related to mifepristone. In reality, anyone can report adverse events through a publicly accessible database.
His confirmation hearing further raised concerns about whether his agency would enforce the Emergency Medical Treatment & Labor Act (EMTALA) in cases involving abortion care. EMTALA, passed in 1986, mandates emergency medical services regardless of a patient’s ability to pay. Under the Biden administration, then-Health Secretary Xavier Becerra required hospitals participating in Medicare to provide emergency abortion care when necessary. However, when asked by Sen. Catherine Cortez Masto (D-NV) whether a woman experiencing life-threatening bleeding in a state with an abortion ban had the legal right to an abortion to save her life, Kennedy responded, “I don’t know”.
What This Means for North Carolina
Efforts to restrict access to mifepristone are not new. In April 2023, a federal judge in Texas ruled to nullify the FDA’s approval of the drug, creating national uncertainty. Although mifepristone remained available in states where abortion is legal, the ruling prompted a coalition of 24 state attorneys general—including then-North Carolina Attorney General Josh Stein—to file a lawsuit defending access to the medication.
Stein’s successor, Democrat Jeff Jackson, has signaled his commitment to protecting mifepristone access in North Carolina. In a 2023 interview, Jackson stated, “I think restricting access in that manner is a violation of both due process and the First Amendment.” His position suggests any federal efforts to limit access could be met with legal challenges from his office.
Since Roe v. Wade was overturned nearly three years ago, 19 states have enacted abortion bans, including North Carolina. In May 2023, the state passed a 12-week abortion ban with exceptions of up to 20 weeks for rape or incest and 24 weeks for fetal anomalies. There are no restrictions if the mother’s life is at risk.
As of February 27, Jackson has filed four lawsuits against the Trump administration. In response, North Carolina Republicans introduced legislation that would prevent Jackson from challenging Trump’s executive orders.
Impact on Women’s Health
Threats to mifepristone access jeopardize reproductive healthcare for North Carolina women. Vaughan expressed concern that Kennedy Jr.’s confirmation hearing revealed a lack of respect for bodily autonomy.
“In the hearings, he kind of repeatedly said, especially on that first day that ‘…every abortion is a tragedy,’ so I think it was pretty clear there that he does not believe that people have the right to control their bodies,” she said.
If federal restrictions on mifepristone move forward, North Carolina’s legal and political landscape could become a battleground for reproductive rights, with significant consequences for women’s health, safety, and autonomy.
