Since the Food and Drug Administration (FDA) approved the use of the drug mifepristone for chemical abortions in 2000, the landscape of abortion in America has shifted dramatically. With this shift, the health and safety of women has taken a back seat to profit margins and the increased availability of a way to end an unplanned or unwanted pregnancy.
Following the initial approval of mifepristone, formally known as RU-486, the FDA has continued to loosen and eliminate safeguards that were originally in place to protect women who chose chemical abortions to end their pregnancies. The relaxing of these safety protocols has led to a dramatic increase in the use of the drug and serious health concerns for women—including maternal death. But, the impact of the FDA’s safety rollbacks has other serious consequences too—some outcomes that affect us all.
The FDA’s Dereliction of Duty
Pro-abortion activists promote chemical abortion as a safe and convenient way to end an unwanted pregnancy. Their efforts to convince the general public of this fallacy have been shockingly successful. According to the Guttmacher Institute’s 2023 abortion data, chemical abortion has become the leading way to end a pregnancy in this country. In fact, the statistics for
that year indicate that 63% of all abortions in America were chemically induced.
Unlike surgical abortion, chemical abortion can be performed at home, and now can often be prescribed without an in-office visit with a physician. Originally, the FDA required that mifepristone (the first of a two-drug regimen) must have been prescribed and administered by a doctor in a medical clinic, and they required an in office follow-up visit. While some states, including North Carolina, still require many of these steps, other states do not. Since 2016, the FDA has permitted non-physician practitioners to prescribe chemical abortion drugs – and since 2021 via the Internet through telehealth. They also expanded the 7-week gestational limit to 10-weeks gestation. Then, after the Covid outbreak, the FDA approved the shipment of mifepristone through the mail. This permits women who live in states with more restrictive abortion laws to acquire the abortion pill and circumvent the precautionary safeguards of their respective states. Put plainly, women can now utilize mail-order abortion without medical oversite.
One of the more alarming changes the FDA made in 2016 regarding mifepristone was to cease the reporting of non-fatal adverse events. Currently, the FDA only requires the reporting of maternal deaths resulting from chemical abortion. Other life-threatening dangers such as hemorrhage, retained pregnancy tissue, sepsis, ruptured ectopic pregnancy, and continued pregnancy are no longer required reporting events. Going back to Guttmacher’s 2023 data, that means that approximately 642,700 women in our country were tasked with overseeing their own abortion that year, and an unknown number of serious complications went unreported and possibly untreated. Ultimately, we don’t really know the full scope of the dangers associated with this drug—a task blundered by our FDA—and women cannot truly give informed consent to its use without having this important information.
Sadly, the abortion numbers are likely much worse than reported. As with other societal ills, the demand for abortion pills has created a black market and the unregulated sale of the drug. A brief internet search will quickly offer many ways for women, including those who are underage or living in states with comprehensive safeguards, to obtain the drugs from out of state, or from out of country suppliers. Plan C, which describes itself as “a public health creative campaign on abortion pill access, started in 2015 by a small team of veteran public health advocates, researchers, [and] social justice activists,” is a likely result of a search engine query. Plan C boasts on its home page, “Abortion pills by mail in every state.” Notably, abortions originating through these sources are not included in Guttmacher’s national numbers.
Report Unveils the Substantial Risks of Mifepristone
Fortunately, in April of 2025, the Ethics and Public Policy Center (EPPC) released a comprehensive study of the harms of mifepristone use. Their findings are extremely concerning. According to the data they analyzed from an all-payer insurance claims database, 10.93% of the prescribed mifepristone abortions between 2017-2023 resulted in serious adverse events like infection, sepsis, and hemorrhage within the 45 days following a mifepristone abortion. In fact, the report states, “the real-world rate of serious adverse events following mifepristone abortions is at least 22 times as high as the summary figure of ‘less than 0.5 percent’ in clinical trials reported on the drug label.” If we were to extrapolate this out using Guttmacher’s chemical abortion statistic of approximately 642,700 for the year 2023, approximately 70,240 women had serious adverse events following their mifepristone abortion—and this number does not include all mifepristone users, as stated above.
An Open Door to Crimes Against Women
Aside from the health risks associated with chemical abortion, the FDA’s deregulation of some of mifepristone’s safeguards has also ushered in the opportunity for criminal activity, fraud, and abuse. In particular, removing the need to be seen in a medical office and allowing for telehealth visits puts the onus of truth and health standards on the patient and removes the rightful responsibility from the medical provider. In short, it allows patients to lie about their pregnancy in order to obtain the dangerous abortion drug.
It was recently reported that a woman suffered a miscarriage after her married boyfriend spiked her drink and cookies with abortion drugs that he bought online. Another story out of Louisiana tells of a mother who coerced her underage pregnant daughter to take the pills that the mother purchased from out of state. These are not isolated incidents, and they raise concerns about women being forced to take the abortion pill, knowingly or otherwise. The ease of their procurement leaves pregnant women of all ages vulnerable to bad actors who are forcing these drugs upon them.
Pregnancy Care Centers See Drop in Activity
The ability to obtain chemical abortion drugs without seeing a medical practitioner leaves women—while engaged in one of the most emotional moments of their life—alone. Mail-order abortions have also decreased the foot traffic of pregnant women through Pregnancy Care Centers (PCCs), where women find support, information, and alternatives to abortion. PCCs are commonly located near abortion clinics, and women experiencing an unexpected pregnancy often visit them while seeking an abortion provider. The FDA’s original policy, requiring in-person appointments before mifepristone could be administered, resulted in women looking for resources and information—often finding what they needed via PCCs. Women who are seeking abortion commonly state a lack of finances, a lack of support, or a desire to continue their education/career as reasons they seek out abortion services. PCCs offer hope, assistance, and information about alternatives to abortion to women who desperately need all of these. Many PCCs provide ultrasounds, clothing, jobs, continued education, and supplies. They are the helping hands that so many mothers-to-be need when they experience an unplanned pregnancy of a child they truly want to keep. Sadly, less traffic through PCCs means fewer mothers helped and fewer babies saved.
What’s in the Water?
Another concern, which has not received great attention to-date, is the effects of mifepristone-tainted water in our environment. According to Liberty Counsel Action, 30 to 40 tons of “medical waste” is flushed into our water systems yearly as a result of at-home abortions. “Medical waste” includes blood, placenta, and human tissue passed during chemical abortions. The waste contains still-active metabolites from mifepristone which block progesterone and starve
the unborn child to death during the chemical abortion.
Many are now starting to question the potential health risks of having these metabolites in our water supply and their effects on our nation’s dropping fertility rate. In June of this year, members of the US Congress sent a letter requesting the Environmental Protection Agency (EPA) to “study the impact of the ‘byproducts’ of mifepristone, such as the active metabolites that are entering our nation’s water system and threatening access to safe drinking water.” They continued, “We believe it is reckless to allow a known progesterone blocker to be flushed into America’s drinking water without knowing definitively if it impacts fertility rates. The American people deserve to know what contaminants might be present in their drinking water and their potential impacts on public health.” The letter, authored by US Senator James Lankford (R-OK) and Congressman Josh Brecheen
(R-OK), was joined by over 20 other members including North Carolina’s own Rep. Richard Hudson and Rep. Mark Harris.
Lower US Fertility Rate: Culture Changed and Systems Stretched
The decrease in the U.S. fertility rate may have major impacts on our American culture. Currently, our birthrate is below the population replacement rate. When this occurs, the population begins to decline because fewer people are being born than are dying. According to the U.S. Center for Disease Control and Prevention, in 2024 our total fertilility rate (TFR) dropped to a record low of 1.599 births per woman. To replace our population, the rate needs to be 2.1. This means our culture could be facing great challenges in the future.
One example is that a decrease in the American population could have national economic implications. A decrease in our labor market could lead to lower productivity and eventually decreased national income. This impacts our systems like Social Security and Medicare—systems most Americans rely on in their later years. Some economists are concerned that the needs of our older populations cannot be sustained with our decreasing birthrates.
For over six decades our birth rate has been in decline. In 1957, there were 122.9 births per 1,000 women aged 15-44 (TFR of 3.77). That statistic shrank to 54.5 by 2023 (TFR of 1.621). Through eras of economic boom, technologic innovations, and life-saving health advances, our birthrates have still continued to decline. This has happened in part because our birthrate profoundly parallels America’s sexual revolution. Margaret Sanger’s radical eugenics agenda that ushered in birth control and abortion has had an overwhelming and negative effect on our population. And worse, our current culture of death does not appear to be slowing down.
Jesus is the Solution
As Christians, we know that each and every child is created in God’s image (Gen 1:27). Every life is precious to God and should, likewise, be precious to us and protected. We have been instructed to “be fruitful and multiply and fill the earth,” (Gen. 1:28). We have also been instructed to care for God’s creation (Gen. 1:28 and 2:15).
The truth is that abortion is not simply limited to the invaluable life of a baby. While the destruction of a life should rightly appall everyone, the harms of abortion extend even further. The destruction of God’s creation affects us all.
Christians must rise to the occasion and be people of courage to speak for the vulnerable and the voiceless in a culture that widely embraces abortion. Christians also should be the ones that women in crisis turn to for the care and protection they need.
We cannot remain complacent. We must let God work through us as He reaches the hearts and minds of the people in this world. We need to pray that He would shine His light on the overwhelming destruction abortion causes, and that He would cause people to turn from their sin and turn to Him.
Sharon Sullivan, is a Registered Nurse and a former Staff Member at NC Family