Amid an ongoing legal battle over the widely used abortion medication mifepristone, anti-choice activists are doubling down on their scare campaign on misoprostol-only abortions, which physicians are likely to use as an alternative should the mifepristone ban succeed. Anti-abortion media are escalating their attacks on misoprostol abortions, with some activists explicitly stating that misoprostol “is next” in their crusade to eradicate abortion in any form. 

On April 7, a ruling by staunchly conservative Texas federal Judge Matthew Kacsmaryk struck down the Food and Drug Administration’s 23-year approval of mifepristone, one medication in the two-pill medication abortion regimen used in the first 10 weeks of pregnancy, in a decision meant to apply nationwide. That same day, a conflicting ruling from a federal judge in Washington state ordered the FDA not to restrict mifepristone in 17 states and Washington D.C. — a directive in direct conflict with Kacsmaryk’s ruling. On April 12, the 5th Circuit Court of Appeals ruled to keep the FDA approval of mifepristone in place but restricted its use to the first seven weeks of pregnancy and forbade prescribing the drug via telehealth appointments and mailing the drug. 

Most recently, on April 14, Supreme Court Justice Samuel Alito temporarily paused restrictions on mifepristone until midnight on April 19. The full Supreme Court is expected to soon weigh in on the case.

While medication abortion in the United States typically involves both mifepristone and misoprostol, a misoprostol-only process is an acceptable alternative endorsed by both the American College of Obstetricians and Gynecologists and the World Health Organization. Misoprostol-only regimens are safe and effective, but they have a slightly higher failure rate than the two-medication approach and may result in a higher incidence of side effects. Because misoprostol is currently approved by the FDA to treat ulcers, health care providers prescribing the drug for abortions do so off-label. 

Even before Kacsmaryk’s ruling, however, right-wing media have pivoted their efforts to disseminate misinformation about the safety of misoprostol. Now appearing to take advantage of the murky legal landscape regarding mifepristone access, anti-abortion outlets are continuing to flood conservative media with false and misleading statements about misoprostol-only abortions as they rise in prominence.

• Anti-abortion group Progressive Anti-Abortion Uprising tweeted, “Any effort to dimmish the power and scope of the Abortion Industrial Complex is good. Mifepristone has a 2 year shelf life so good luck stockpiling & more importantly miso is next 💅.” 
• Extremist group Alliance Defending Freedom tweeted, “The FDA chose politics over science when it pushed to legalize chemical abortion drugs mifepristone + misoprostol in 2000,” claiming that “the FDA approved the drugs only by characterizing pregnancy as an ‘illness’ and arguing that they provide a ‘meaningful therapeutic benefit.’” 
• On Facebook, anti-abortion activist Abby Johnson posted that “Misoprostol only abortions are significantly more dangerous and it completely removes the ability to utilize the abortion pill reversal process” (an unproven and unscientific process). Johnson pushed back on the notion that Kacsmaryk’s ruling was a win for the anti-abortion movement, writing, “These sort of regulations don’t stop abortions. It changes the way they kill the babies. Is that really what we are trying to do?”
• Pregnancy Help News published a piece criticizing media coverage of the case, claiming that “Misoprostol (the second drug in a chemical abortion) is not FDA-approved for use in abortion.” The piece also claims that reporters are “oblivious to their own hypocrisy” and “do not care if a woman ends up in the hospital – or worse – due to their lack of morals.”
• On One America News, anti-abortion activist Karen Garnett called Kacsmaryk’s ruling on mifepristone a “partial victory” and underscored the goal of the anti-abortion movement to make misoprostol illegal, falsely claiming that it’s “even more harmful.” During the interview, Garnett also stressed that “we have to keep working all the way to … constitutional personhood” and said Roe v. Wade’s reversal was just the first “domino” in that effort.
• National Right to Life’s online blog published an article about renewed attention to misoprostol, stressing the negative side effects of misoprostol-only abortions and suggesting that abortion providers are nefariously pushing misoprostol.   
• Another article from Pregnancy Help News lamented that Planned Parenthood locations across the country will continue to provide medication abortions with misoprostol regimens. The piece claimed misoprostol is used in “expelling the developing child” and unnecessarily fearmongered about the safety of the drug. 
• In a recent piece, LifeNews criticized “abortion businesses” expecting to pivot to misoprostol for medication abortions, falsely saying they were choosing to switch “to the more dangerous abortion drug” rather than “redirecting their resources to support pregnant mothers and their babies.”