Mifepristone reached an important milestone in the US on Sunday, but its future is uncertain.Jose Luis Magana/AP

Twenty-five years ago today, the Food and Drug Administration approved the use of mifepristone for abortions. Now, the drug is more under threat than ever as anti-abortion Republicans seek to revoke FDA approval of the drug in a bid to further curtail abortion access nationwide.

The first of two drugs used in the standard abortion pill regimen, mifepristone blocks the pregnancy hormone progesterone; the second drug, misoprostol, causes the uterus to contract, expelling the pregnancy. Mifepristone’s FDA approval on Sept. 28, 2000, came more than a decade after the drug was first approved in France, where it was invented.

After it finally was approved in the US, its impact was revolutionary, allowing pregnant people to have abortions in the quiet of their homes, rather than in a clinic, thereby avoiding anti-abortion protesters and opening up access to the procedure as never before.

While mifepristone was originally approved for use up to seven weeks of pregnancy, in 2016, the Obama-era FDA permitted its use through ten weeks’ gestation—although abortion rights activists arguing it is safe later in pregnancy, with the World Health Organization saying it can be used anytime in the first trimester. In December 2021, the Biden administration began allowing abortion drugs to be prescribed remotely rather than in person, a development that has made them even more accessible and less expensive.

Today, despite the Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade, mifepristone’s reach has only grown, thanks to telehealth and shield laws that protect providers in blue states from mailing pills into red states. Medication abortion now accounts for more than 60 percent of all abortions nationwide, according to the abortion rights research and advocacy........

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