RFK Jr. could restrict NC women’s access to abortion and miscarriage care

The newly confirmed Secretary of Health and Human Services has expressed support for a review of federal approval of mifepristone, which could ultimately revoke access to the drug used in abortion and miscarriage care.

Reproductive rights advocates in North Carolina are sounding the alarm about the possibility that the Trump administration will revoke access to a key medication used in abortions and to treat miscarriages. 

Trump, who during his presidential campaign sought to downplay the possibility that he would impose national restrictions on abortion, recently ordered newly-confirmed Secretary of Health and Human Services Robert F. Kennedy Jr. to “study the safety of mifepristone,” Kennedy Jr. said in January during his Senate confirmation hearing.

Kennedy said Trump had “not yet taken a stand on how to regulate” mifepristone, but told senators that he would back Trump’s policies on the medication, whatever they may be.

Mifepristone was approved by the US Food and Drug Administration (FDA) nearly 25 years ago and has repeatedly been shown to be safe. The medication is used in more than half of all abortions in the country, and is also used to treat miscarriages.  

In 2021, medication abortions — a two-drug regimen involving mifepristone and another drug, misoprostol — made up around two-thirds of abortions in North Carolina. Therefore, any restrictions to mifepristone could be devastating to North Carolina women needing access to reproductive healthcare, advocates say.

“We’ve seen in states with abortion bans where care is out of reach that the consequences are deadly,” Sophie Vaughan, Planned Parenthood Action Fund’s Manager of Federal Advocacy Communications, told Cardinal & Pine. 

“The most severe consequence of RFK potentially attempting to make mifepristone out of reach is that people will die. It is that people will suffer complications from pregnancy that could harm their reproductive future, that could harm their current health, future health,” she said.

Kennedy has stated that it is important for people to know the “adverse affects” of the drug, even though a significant body of research shows its safety.

Dr. Ushma Upadhyay, an OB-GYN and professor who specializes in epidemiology and demography at the University of California, San Francisco, emphasized the safety of medication abortion during a virtual press conference last week.

“Research has consistently found that medication abortion is safe and effective. Mifepristone’s safety record is backed by over 100 peer-reviewed journal articles, and now, 25 years of use,” she said.

Federal approval of the drug was also previously reviewed in 2008 and 2018 by the Government Accountability Office, which affirmed the drug’s safety and found that the FDA followed protocol in the approval process each time. 

Kennedy also falsely claimed that under the Biden Administration, the National Institute of Health (NIH) prevented doctors and patients from reporting injuries from mifepristone. In reality, anyone can report incidents to a publicly accessible database.

Kennedy’s hearing further raised questions as to whether or not his agency would enforce the Emergency Medical Treatment & Labor Act (EMTALA) when it comes to abortion care.

Passed in 1986, EMTALA was created to “…ensure public access to emergency services regardless of ability to pay.” Under the Biden administration, then-Secretary of Health and Human Services Xavier Becerra instructed hospitals participating in Medicare to provide emergency abortion care to all patients who needed it.

During his confirmation process, Senator Catherine Cortez-Masto (D-NV) asked Kennedy if a woman who was experiencing life-threatening bleeding in a state with an abortion ban had a legal right abortion to save her life.

“I don’t know,” he said in response.

What does it mean for North Carolina?

Attempts to potentially restrict access to mifepristone are not new. In April 2023, a federal Judge in Texas issued a ruling that sought to essentially nullify the FDA’s approval of mifepristone. 

While mifepristone never became unavailable in states where abortion is legal, the ruling created uncertainty across the country, and resulted in a group of 24 state attorneys general, including then-North Carolina Attorney General Josh Stein, filing a lawsuit to keep mifepristone available.

Since then, Stein has been succeeded by fellow Democrat Jeff Jackson, who, in an interview with Cardinal & Pine last year, signaled his support for Stein’s lawsuit and committed to supporting access to mifepristone for women in North Carolina.

“I think restricting access in that manner is a violation of both due process and the First Amendment,” Jackson said at the time. Given Jackson’s prior position, any attempts to limit or ban access to mifepristone from the federal government could be met with a lawsuit from the attorney general’s office.

In the nearly three years since Roe v. Wade was overturned, 19 states have implemented some form of abortion bans, including North Carolina. The General Assembly passed a 12-week ban into law in May 2023, with certain exceptions. In cases of rape or incest, abortion is allowed up to 20 weeks, and up to 24 weeks if a fetal anomaly is found. There are no limitations if the life of the mother is at risk.

As of Feb. 27, Jackson has filed four lawsuits against the Trump administration since the president took office last month. In response, Republicans in the North Carolina General Assembly filed a bill that, if it became law, would prevent Jackson from challenging Trump’s executive orders. 

The bill would not retroactively impact suits that the attorney general has already joined.

Impact on women’s health

Restrictions on  reproductive healthcare and threats to mifepristone access present a threat to North Carolina women’s futures, advocates argue. 

Vaughan worries that Kennedy’s confirmation hearing shows he doesn’t value the right of women to make decisions about their own bodies. 

“In the hearings, he kind of repeatedly said, especially on that first day that ‘…every abortion is a tragedy,’ so I think it was pretty clear there that he does not believe that people have the right to control their bodies,” she said.