Defending the post-Roe lifeline

It took 50 years for anti-abortion extremists to reverse Roe v. Wade but they did not achieve their goal of ending abortion in the U.S. because people still—and always will—need abortion care. Millions of Americans now access this critical healthcare by taking abortion pills, also known as medication abortion, and now extremists have set their sights on taking away this last lifeline. 

Across the U.S. people rely on abortion pills to access the care they need.

Abortion pills by the numbers The post-Roe lifeline

Why is medication abortion a lifeline in post-Roe America?

Requests for abortion pills via telemedicine doubled after Roe v. Wade was overturned—making it a lifeline for millions of people, particularly people living in rural areas or where abortion access has been restricted. In the U.S., a standard medication abortion is made up of two pills, mifepristone and misoprostol. It is an accessible and effective way to end a pregnancy that affords patients privacy and safety.

Medication abortion 101 Medication abortion is the new target

Why are abortion pills the new target?

Medication abortion is the new anti-abortion target because it is the most common form of abortion care in the U.S., and the last remaining lifeline for millions of pregnant people across the country. Anti-abortion extremists know that a national policy limiting or banning abortion pills would push abortion entirely out of reach for many people, even in states that have recognized the right to abortion in their state constitutions or through legislation.

Attacks on abortion pills

How are extremists trying to restrict access to abortion pills nationwide?

Extremists are trying to ban medication abortion by attacking it from every direction—through federal administrative actions, antiquated laws, decisions by anti-abortion activist judges, and state legislation. At the federal level, the Trump FDA announced it will “reexamine” the safety of abortion pills—which could lead to new, medically unnecessary restrictions on mifepristone.  The Trump DOJ has also signaled willingness to misuse an 1800s anti-sex law (the Comstock Act) to restrict abortion access nationwide, even in states where it is legal.

National-level threats State-level threats

How are states trying to ban abortion pills?

These actions don’t end at the federal level; state governments with anti-abortion agendas are vying to see which state can undermine access the most. Abortion is now illegal or severely restricted in 20 states, with 13 states completely banning the provision of abortion care by imposing criminal penalties. In recent years, the Center has tracked legislation that aims to designate medication abortion as a controlled substance, ban the mailing of medication abortion, and allows bounty hunters to file civil lawsuits against anyone who mails, intends to mail, or helps someone in mailing these medications.

Stop attacks on medication abortion

How can we stop attacks on medication abortion?  

Undaunted by these attacks on medication abortion, the Center and our partners are fighting back in courts, state legislatures, and the halls of Congress. Here is how the Center is fighting back:

Defend abortion pills in the courts

1. Defend abortion pills in the courts

Two courts have ruled that restrictions on medication abortion are unjustified and unlawful in two major cases. In the Center’s case, Whole Woman’s Health Alliance v. FDA, a federal judge ruled that the FDA disregarded the scientific record demonstrating that mifepristone could be safely prescribed without restrictions and ordered the agency to reconsider the current regulations. In October 2025, a federal judge in Hawaii ruled in Purcell v. Kennedy that the FDA’s imposition of medically unnecessary restrictions on mifepristone violated federal law, affirming the medication’s safety and the importance of unburdened access.

Advance protective shield laws

2. Advance protective shield laws

Shield laws are designed to prevent politically motivated out-of-state legal actions that persecute abortion providers and are a tool to safeguard access to medication abortion. Since 2022, 19 states and D.C. have codified a range of shield law protections. An additional four states have protected access through executive orders, bringing the total number of states with shield law protections to 23.  Nonetheless, multiple ban state Attorneys General are attacking healthcare providers outside their borders, hoping to give courts in states that ban abortion a chance to strike down shield laws that protect doctors who mail abortion pills.    

Hold the Trump administration accountable

3. Hold the Trump administration accountable

The Center is holding the Trump administration accountable for undermining abortion access through administrative legal tools, like FOIA (Freedom of Information Act) requests. FOIA is a law that allows anybody—including organizations—to request access to federal agency records to ensure government transparency. Through our FOIA requests, the Center is conducting oversight, identifying and exposing wrongdoing, and holding the Trump administration accountable. The Center also researches Trump administration appointees and nominees to identify those who are likely to threaten reproductive rights.

Battle in the courts