Elizabeth sat huddled on her bathroom floor, covered in blood and living a nightmare. She had taken mifepristone and misoprostol, the drugs in the two-part chemical abortion regimen, and she had no idea that she’d experience the worst pain she’d ever experienced. “I was not prepared for how severe and devastating those drugs were going to be,” she shared in a 2024 testimony. “It was so incredibly traumatic.”
Unfortunately, Elizabeth’s tragic experience isn’t an outlier. A new analysis of abortion pill data, the largest known of its kind, released by the Ethics and Public Policy Center, reveals that the abortion drug mifepristone may be causing serious adverse events at a rate 22 times higher than the Food and Drug Administration’s official claim. Specifically, the study found that more than 10 percent of women who take mifepristone suffer hemorrhaging, infection, sepsis, and more — while the FDA’s mifepristone drug label claims that serious adverse events occur in “less than 0.5 percent” of instances.
The latest data on the dangers of the abortion pill doesn’t just expose a national health crisis that must be addressed by lawmakers and the policymakers at the FDA, which under the Biden administration eliminated the requirement that mifepristone be dispensed in person. It also underscores the necessity of vigorously defending the life-saving option of Abortion Pill Reversal, or APR, for women who regret their decision, mid-chemical abortion.
APR is a protocol that floods the body with the natural pregnancy-sustaining hormone, progesterone — offering a lifeline to women in a literal life-or-death moment. When the protocol is begun within 72 hours of first taking mifepristone, APR has a 64-68 percent success rate, without any safety risks, according to peer-reviewed studies recognized by the American Association of Pro-Life Obstetricians and Gynecologists.
The success of APR is consistent with natural progesterone’s long history of use as a safe and effective treatment for sustaining pregnancies. Indeed, APR has saved the lives of approximately 6,000 babies according to Heartbeat International, the global pregnancy center network that operates the Abortion Pill Rescue© Network. So, it’s no surprise that pro-abortion politicians are now making it a policy priority to silence pro-life pregnancy centers that promote this life-saving option for women.
Most forcefully, New York Attorney General Letitia James and California Attorney General Rob Bonta have launched frenzied lawfare campaigns, targeting Heartbeat International and scores of affiliated pro-life pregnancy centers in their states simply for informing women about the availability of APR. With lawsuits alleging “false advertising,” they are threatening Heartbeat International and their network partners with ruinous fines and investigations.
These attacks blatantly violate the First Amendment for numerous reasons — not least of which is that speech promoting APR’s efficacy and safety is true. Even the pro-abortion director of Yale Medical School’s reproductive health clinic told The New York Times that APR “makes biological sense” and is “totally feasible.”
Pro-abortion attorneys general contend that peer-reviewed studies confirming APR’s validity are “discredited” because they rely on “case studies” rather than “clinical trials.” But randomly assigning a placebo to a mom who wants to save her baby is obviously unethical. And even the prestigious Journal of the American Medical Association recognizes that use of such case series is preferable when clinical randomization would be unethical.
Moreover, the First Amendment prohibits biased government officials from silencing a perspective they disfavor on matters of public concern related to abortion, especially when abortion facilities remain free to promote the confirmed falsity that the abortion pill is “safe.” In striking down a prior California speech restriction on pro-life pregnancy centers, the U.S. Supreme Court “stressed the danger of content-based regulations ‘in the fields of medicine and public health,’” which pose the risk of governments seeking to “suppress unpopular ideas or information.”
Our legal team at the Thomas More Society, the public interest law firm where I work, is helping the targeted pro-life ministries fight back in state and federal courts against James and Bonta — by defending Heartbeat International in the litigation that aims to censor information about APR, while also going on the offensive to protect the rights of other pregnancy centers.
In New York and California, we’ve filed hundreds of pages of legal papers defending Heartbeat International against state-court enforcement actions by James and Bonta attempting to censor speech about APR. And in New York we’ve already secured a federal court injunction protecting the same speech on behalf of a group of pregnancy centers.
If the pro-abortion lawfare against APR succeeds, pregnancy centers that serve countless women in need — providing free ultrasounds, counseling, diapers, parenting classes, and more — could be fined, investigated, and sued into oblivion. Women will lose life-affirming options and be forced to go through with abortions they no longer want. The First Amendment will be left frayed, empowering the state to silence disfavored speech and suppress the truth about APR.
No woman should be forced to complete an abortion she no longer wants. The latest data on the dangers of the abortion pill underscores the need to protect APR and stop the ideological lawfare that seeks to deprive mothers and their babies of a second chance at life.
Michael McHale is senior counsel at Thomas More Society, a national nonprofit public interest law firm. Prior to joining TMS, he served as general counsel for the Nebraska Catholic Conference and as a clerk for the U.S. Court of Appeals for the Eighth Circuit.
