Anti‑abortion conservatives are pressing the Trump administration to complete an FDA review of mifepristone, the medication used in many abortions, arguing delays are unacceptable. Major medical societies continue to defend the drug's decades‑long safety record. The dispute has prompted calls for the removal of senior officials and raised concerns among Republican strategists that aggressive federal action could harm the GOP in upcoming midterm contests.
Mifepristone Showdown: Anti‑Abortion Base Demands HHS Finish FDA Review as GOP Faces Midterm Risks
Anti‑abortion activists within the Republican base are intensifying pressure on the Trump administration to complete a Food and Drug Administration (FDA) review of the abortion pill mifepristone — a review that could affect the drug’s federal approval. Conservative leaders warn that any perceived delay is unacceptable, while medical societies, some Republican strategists and the White House urge caution to avoid political and public‑health fallout.
What Conservatives Are Calling For
A vocal segment of the conservative movement has urged the Department of Health and Human Services (HHS), led by Secretary Robert F. Kennedy Jr., to push the FDA to finish the review of mifepristone that was promised earlier this year. Reports that FDA Commissioner Marty Makary might pause the review have prompted calls for his removal from groups including Susan B. Anthony Pro‑Life America and organizations aligned with former Vice President Mike Pence.
“Enough is enough. [Makary] should be fired immediately. FDA is doing NOTHING while every day abortion drugs take the lives of children, put women & girls at serious risk, empower abusers, & trample state pro‑life laws,” said SBA Pro‑Life America President Marjorie Dannenfelser.
The Medical Community's Stance
Mifepristone has been FDA‑approved for medication abortion and miscarriage management since 2000. Leading reproductive medicine groups — including the American College of Obstetricians and Gynecologists and the American Society for Reproductive Medicine — continue to endorse the drug’s safety and efficacy.
“FDA approval of mifepristone must reflect the rigorous clinical evidence that has proven unequivocally that it is safe and effective,” a coalition of medical groups said earlier this year.
Political Stakes for the GOP
Republican strategists caution that aggressive federal action targeting mifepristone could alienate moderate voters and imperil the party’s already slim majorities in Congress ahead of the midterms. GOP consultant Liz Mair said the party cannot ignore voter responses seen in the 2022 elections and noted that moves that further imperil the GOP’s standing in midterms carry personal and political risks for Trump and other Republican leaders.
Administration Responses
The administration approved a second generic version of mifepristone in October, a decision that already heightened conservative frustration. The White House has defended FDA Commissioner Makary, saying he is working "diligently to ensure that Americans have the best possible, Gold Standard Science study of mifepristone." Meanwhile, Sen. Bill Cassidy and other GOP senators have formally requested updates on the status of the review and safety study.
What Happens Next
With pressure rising from conservative groups and some Republican lawmakers, HHS and the FDA face competing demands: complete a politically sensitive review that satisfies the party's anti‑abortion base, or prioritize established clinical guidance and the medical consensus that views mifepristone as safe. How the administration navigates that choice could influence GOP prospects in the midterms and shape internal debates about how aggressively to pursue federal abortion policy.
Key players: FDA Commissioner Marty Makary, HHS Secretary Robert F. Kennedy Jr., Susan B. Anthony Pro‑Life America, Sen. Bill Cassidy, former Vice President Mike Pence, and GOP consultant Liz Mair.
