As physicians, we pride ourselves on following the evidence. We weigh risks and benefits, assess data, and trust science to guide decisions about patient care. Yet, when it comes to reproductive health, lawmakers and courts too often override scientific consensus. Nowhere is that clearer than in the debate over mifepristone.
Patients deserve care rooted in evidence and science, not ideology. To provide safe and best-practice medical care, physicians need the ability to practice medicine guided by science, not politics. And all of us deserve a health care system where safety standards are applied consistently, not selectively.
The safety profile
Mifepristone, a medication used safely for more than two decades for early abortion and miscarriage care, is one of the most rigorously researched reproductive health drugs in the world. More than 5 million people in the United States have used it since the FDA approved it in 2000. Serious complications occur in fewer than 0.5 percent of cases, and the risk of death is less than one in 100,000, making mifepristone safer than ibuprofen, penicillin, and Viagra.
By comparison, sildenafil (the generic version of Viagra), approved in 1998, has been linked to higher rates of serious adverse events, including heart attack, stroke, and sudden death, especially among patients with cardiovascular disease. Yet it is prescribed freely and advertised on primetime TV. No lawsuits. No state bans. No hearings in Congress.
Politics versus science
Although the FDA recently approved a new generic version of mifepristone, there are two cases filed against the FDA by Missouri and Louisiana asking for restrictions on mifepristone access based on “safety concerns” reflecting political pressure, not science. If there is concern for the safety of mifepristone, then the same should be done for other medications with higher rates of adverse events such as Viagra, penicillin, and ibuprofen.
There is nothing to suggest that mifepristone is unsafe. Though mostly known for its use in safely ending an early intrauterine pregnancy, it is a medication used for other OB-GYN indications as well as in endocrine disease like Cushing’s. It does what it is designed to do. The attempts to mischaracterize the issue as a safety issue seem largely motivated by an attempt to prevent access to a women’s health medication.
With a proven safety profile for its intended use, this medication allows doctors to provide the best care for the FDA-approved indications. Unfortunately, access to mifepristone has been targeted by misinformation, restrictions, and lawsuits that have nothing to do with health and safety and everything to do with control.
Trusting the evidence
Mifepristone has already been proven safe and its use by millions of patients proves the reliability of the safety profile. There has been no new peer-reviewed research to suggest that further research or evaluation is needed. The fact that there are again calls for further reviews on the safety of mifepristone says more about political pressure than medical necessity.
Mifepristone represents something powerful: women’s autonomy, evidence-based care, and the right to make personal decisions with compassion and dignity. It stands for the belief that medical care belongs in the hands of patients and their physicians, guided by science, not politics.
It is time to trust the data, trust the science, and most importantly, trust patients and the clinicians who care for them.
Theresa Rohr-Kirchgraber is an internal medicine-pediatrics physician. Sophia Yen is a physician executive.
