A new legislative push in Washington is reigniting the national debate over abortion policy and drug safety after Josh Hawley unveiled a bill seeking to strip federal approval for the abortion medication Mifepristone.
The Missouri Republican announced the proposal Wednesday, arguing that Congress should intervene to remove the drug’s certification granted more than two decades ago by the U.S. Food and Drug Administration. His plan would prohibit the medication’s use in abortions while still allowing prescriptions for certain medical conditions, including Cushing’s syndrome, a rare hormonal disorder.
If enacted, the measure would mark one of the most significant congressional efforts yet to restrict medication-based abortion in the United States. The drug has become central to abortion care nationwide, particularly after the U.S. Supreme Court overturned federal abortion protections in Dobbs v. Jackson Women’s Health Organization.
Since the FDA first approved mifepristone in 2000, an estimated 7.5 million women in the United States have used the medication to terminate pregnancies. When paired with Misoprostol, the treatment can end pregnancies during the first 70 days of gestation.
Medication abortion has grown increasingly common. Federal data shows the drug accounted for roughly 63 percent of all abortions nationwide in 2023.
The medication’s expanded role has drawn intense scrutiny from anti-abortion advocates. In response to growing pressure, Donald Trump directed federal regulators to review the drug’s safety profile, though that evaluation has not yet been finalized.
Hawley argues the medication presents higher health risks than federal regulators acknowledge and says easier access to the drug — including prescriptions across state lines — has opened the door to misuse.
“We’ve known for years that mifepristone is risky but it’s really just in the last few years that we’ve learned that this drug is inherently dangerous and it is inherently prone to abuse,” he said.
The senator cited a study analyzing roughly 875,000 prescriptions that found “serious adverse health” complications occurred in about 11 percent of cases.
“What it means in practice is internal infections, sepsis, a trip to the emergency room, a life-threatening condition — in 11 percent of cases,” he said.
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The senator cited a study analyzing roughly 875,000 prescriptions that found “serious adverse health” complications occurred in about 11 percent of cases.
“What it means in practice is internal infections, sepsis, a trip to the emergency room, a life-threatening condition — in 11 percent of cases,” he said.
However, that research, conducted by the Ethics and Public Policy Center, has faced significant criticism from fact-checkers and medical experts. The U.S. Food and Drug Administration estimates serious complications occur in about 0.5 percent of cases. Analysts at Kaiser Family Foundation say other peer-reviewed studies report similar safety rates.
Still, Hawley contends those figures underestimate the true scale of injuries linked to the medication.
“This is a drug that is incredibly widespread and is inherently dangerous, it is also inherently prone to abuse,” he said.
Under Hawley’s proposal, the federal government would revoke the drug’s approval for abortion use while maintaining access for other medical treatments. The bill also seeks to create new legal pathways allowing patients to sue drug manufacturers if they believe the medication caused harm.
Supporters of the proposal say it would strengthen patient protections. Critics, meanwhile, argue the measure would dramatically restrict access to reproductive health care.
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During a press conference held in a Senate Judiciary Committee hearing room, Hawley appeared alongside several women who said they experienced severe complications after using the medication.
One of them, nursing student Shanyce Thomas, described the medical crisis she said followed her use of the drug.
“I developed a severe infection behind my uterus that went undetected until it became life-threatening. My condition deteriorated so rapidly that I was rushed into the ICU,” she said. “I was [in a] medically induced coma for a month. During this time, I required several blood transfusions.”
Thomas said the infection ultimately resulted in a partial hysterectomy.
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Hawley is urging fellow Republicans to rally behind the legislation, but the proposal may face resistance even within his own party. Senators such as Susan Collins of Maine and Lisa Murkowski of Alaska have previously taken more moderate positions on abortion policy.
Despite the uncertainty, Hawley says Congress must take action.
“This is something for Congress to do. Congress needs to act,” he said. “Only Congress at this stage can withdraw the certification for abortion for mifepristone in an effective way. Only Congress can do it and make it permanent.”
“I’m going to make that case to my colleagues,” he added.
