A Call to Action for Women's Health
Women across the nation are caught in a struggle for basic healthcare rights. Mifepristone, a medication with a 25-year record of safety, remains shackled by federal restrictions that serve no medical purpose. On June 5, 2025, California Attorney General Rob Bonta, alongside leaders from Massachusetts, New York, and New Jersey, took a bold step. They petitioned the FDA to tear down these barriers, demanding a system that puts women's health first.
Mifepristone provides a pathway to safe, timely care for abortions and miscarriage treatment. Yet, the FDA's Risk Evaluation and Mitigation Strategy program creates obstacles that hit hardest in rural and underserved communities. Why does a medication safer than common painkillers face rules stricter than those for far riskier drugs?
Since the 2022 Dobbs decision upended abortion protections, access to care has splintered. Medication abortion, now 63 percent of all U.S. abortions, offers hope in this fractured system. But the REMS program undercuts that hope, burdening women with unnecessary certifications and forms that add no safety value.
This fight touches real lives. A rural California woman, juggling work and family, is forced to drive hours for care. A patient facing a miscarriage is forced to sign a form implying an abortion. These rules erode trust in healthcare, and Bonta's coalition is demanding change.
The petition lays out a clear choice: dismantle the REMS program entirely or stop enforcing it in states with strong healthcare laws, like California. This is about ensuring every woman can access care with dignity and respect.
Science Over Politics
Mifepristone's safety is beyond dispute. Since 2000, 7.5 million Americans have used it, with serious complications in extremely rare cases, according to the FDA. The World Health Organization calls it essential. So why does it face restrictions designed for dangerous medications?
The REMS program forces prescribers to certify, risking harassment. Pharmacies are required to meet complex tracking rules, discouraging them from carrying the drug. Patients, even for miscarriage care, are required to sign forms that misrepresent their needs. These requirements create fear and limit access, offering no enhancement to safety.
Other drugs face no such scrutiny. Opioids, tied to thousands of deaths yearly, have fewer restrictions. Medications for cosmetic procedures or erectile dysfunction, despite risks, don't require certifications. This inconsistency suggests political meddling, overriding medical reasoning.
Groups like Susan B. Anthony Pro-Life America, behind the 'Rolling Thunder' campaign, push claims of mifepristone's dangers, ignoring over 100 studies proving its safety. Their efforts to ban mail-order access or reclassify the drug prioritize ideology over evidence.
The Toll of Unfair Barriers
The REMS program burdens patients and the entire healthcare system. In rural areas, where 66 percent of primary care shortages occur, mifepristone is often out of reach. With 90 percent of U.S. counties lacking an abortion provider, certification rules keep the drug out of primary care, where only one percent of medication abortions occur.
Pharmacies face relentless pressure. When Walgreens tried to certify, intimidation campaigns forced it to abandon dispensing in 20 states. Emergency rooms, vital for miscarriage care, struggle with certification hurdles. These barriers undermine equitable care, offering no protection to patients.
The impact is starkest for underserved communities. Women in rural areas, already facing long travel distances and limited resources, bear the brunt. Telehealth, now 20 percent of abortions, offers a lifeline, but 28 states restrict it. Why let red tape deny care to those who need it most?
A Vision for Change
The FDA can fix this. Bonta's petition, grounded in decades of data and growing public support, demands action. A January 2025 JAMA Network Open study shows rising backing for easier access, including over-the-counter options. The Biden administration's 2021 rule changes, removing in-person dispensing, show progress is possible.
Yet, opponents like Senator Josh Hawley and Project 2025 advocates push for tighter restrictions, from banning telemedicine to auditing state programs. Their approach ignores women's realities, favoring control over compassion. Science and fairness point to a better way.
Removing the REMS program would let providers focus on care, not bureaucracy. It would allow pharmacies to stock mifepristone without fear. It would ensure women receive care with respect, not stigma. If the FDA won't act nationwide, it can honor states like California, where healthcare is robustly regulated.
This fight is about trust—trust in women to make their own choices and in healthcare to deliver equitable care. The FDA must act now, siding with evidence and justice over political pressure, to ensure every woman's right to health and dignity.