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“ Protecting Women: Exposing the Dangers of Chemical Abortion Drugs”

Senate HELP Committee

January 14th, 2026 (recording linked here)

WITNESS & TESTIMONY

• The Honorable Elizabeth Murrill: Attorney General of Louisiana

• Monique Chireau Wubbenhorst, M.D., M.P.H., FACOG, FAHA: Senior Fellow, de Nicola Center for Ethics and Culture, University of Notre Dame and Adjunct Professor, Indiana University School of Medicine

• Nisha Verma, M.D., M.P.H., FACOG: Fellow Physicians for Reproductive Health

HEARING HIGHLIGHTS

MEMBER OPENING STATEMENTS

• Chair Cassidy (R-LA) opened the hearing by framing pregnancy as involving “two patients” and argued that life began at conception and abortion ended that life. He said the committee would examine the dangers of mifepristone, citing studies and personal accounts to argue that chemical abortion could cause severe pain and serious complications, including hemorrhage and sepsis. He criticized FDA policy changes under the Obama and Biden administrations for reducing reporting requirements and removing in-person dispensing safeguards, arguing that this enabled coercion, abuse, and trafficking-related exploitation. He urged Secretary Kennedy and Commissioner McCarry to complete a safety review and called for reinstating in-person requirements.

• Ranking Member Sanders (I-VT) argued the hearing was not truly about drug safety or women’s health but was instead an effort to restrict women’s reproductive rights. He asserted that overwhelming scientific and medical evidence showed mifepristone was safe and effective, citing major medical organizations and decades of research. He said Republican efforts intensified after the Supreme Court overturned Roe v. Wade, leading to state bans and restrictions on medication abortion. He framed the central issue as whether women in 2026 would retain the right to control their own bodies or have that control shifted to politicians.

• Sen. Murray (D-WA) stated that medication abortion was safe and effective, emphasizing that FDA approved mifepristone 25 years ago and reaffirmed its safety when it approved a generic version recently. She cited extensive global research and argued mifepristone was among the most studied medications, with complication rates lower than many common drugs. She said heavy regulation of mifepristone reflected politics rather than science and accused Republicans of using debunked studies to justify imposing burdensome restrictions and ultimately eliminating access. She also criticized the committee for prioritizing this hearing over oversight of RFK Jr’s vaccine-related actions.

WITNESS OPENING STATEMENTS

• Hon. Murrill argued that Dobbs returned abortion policymaking to elected state officials and said Louisiana reaffirmed protections for unborn life, including prohibitions involving abortion-inducing drugs. She contended that the Biden administration intentionally sought to circumvent state pro-life laws by removing the in-person dispensing requirement and facilitating distribution of abortion pills by mail. She described mail-based dispensing as medically dangerous, unethical, and illegal under Louisiana law, and she cited reported increases in illegal abortions along with cases involving coercion, late-gestation pill use, and medical emergencies. She urged vacating the 2023 REMS changes and criticized shield laws for protecting out-of-state distributors and undermining enforcement against abortion pill trafficking.

• Dr. Wubbenhorst argued that chemical abortion carried significant physical and psychological risks and said policymakers should evaluate its harms alongside its purported benefits. She stated that medication abortion had become the predominant method and cited bleeding, infection, hemorrhage, and emergency room treatment as evidence of serious complications, adding that some women required surgical intervention after chemical abortion. She asserted that abortion was associated with mental health harms and exploitation risks, including trafficking and abuse, and argued that remote prescribing should not be legitimized as standard telemedicine. She emphasized that elective abortion was not equivalent to miscarriage, stillbirth, or ectopic pregnancy care and concluded by calling for stronger REMS safeguards and enforcement of existing regulations.

• Dr. Verma described her full-spectrum OB-GYN practice and said complexity around abortion care should not be used to distort medical facts. She testified that evidence on mifepristone’s safety and effectiveness was long-standing and settled, including strong evidence supporting telehealth as equally safe and effective. She explained that the medication was also widely used to manage miscarriage and shared her personal experience using it after a pregnancy loss, emphasizing privacy and safety when access was available. She argued the real threats to patients came from abortion restrictions and broader healthcare risks, and she urged the committee to focus on evidence-based solutions rather than restricting access to established care.

QUESTION AND ANSWER SUMMARY

• Chair Cassidy (R-LA) asked whether prescribing mifepristone at 20 weeks was appropriate given FDA approval only through 10 weeks. Dr. Verma said she would not prescribe it at 20 weeks as described.

  Chair Cassidy asked whether Louisiana cases showed abortion pills being used around 20 weeks without clinical supervision. Hon. Murrill said emergency-room clinicians assessed the pregnancies at approximately 20 weeks and that the pills were obtained through an online process with no human provider contact.

  Chair Cassidy asked whether prescribing abortion medication with no live clinical interaction met medical standards. Dr. Wubbenhorst said it was irresponsible and inconsistent with standard-of-care prescribing.

  Chair Cassidy asked whether in-person evaluation reduced coercion risk. Dr. Wubbenhorst said in-person visits allowed private screening for abuse or trafficking and could identify coercion that telehealth or mail-order models might miss.

• Ranking Member Sanders (I-VT) asked whether mifepristone safety should be determined by medical science and professional organizations rather than legislatures. Dr. Verma said patients and clinicians should rely on evidence and individualized decision-making rather than politician-driven restrictions.

  Ranking Member Sanders asked what restricting access to mifepristone meant for overall healthcare access and outcomes. Dr. Verma said restrictions affected not only abortion access but also evidence-based miscarriage management and emergency obstetric care, including rapid access to misoprostol for postpartum hemorrhage.

  Ranking Member Sanders asked whether Louisiana’s abortion policy effectively displaced decision-making from patients to the state. Hon. Murrill said Louisiana law reflected state policy choices after Dobbs and that cross-border pill distribution undermined enforcement while increasing medically unsupervised use.

• Sen. Marshall (R-KS) argued that telehealth prescribing without reliable gestational dating increased medical risk and asked whether ultrasound dating was important for safety. Dr. Wubbenhorst said ultrasound dating was clinically important and that later-gestation medication abortion carried elevated hemorrhage risk.

  Sen. Marshall asked whether ultrasound was standard practice in evaluating threatened miscarriage and pregnancy dating uncertainty. Dr. Verma said ultrasound was used when dating was uncertain and that restrictions could make timely follow-up and access more difficult.

• Sen. Murray (D-WA) asked whether coercion concerns were best addressed by restricting medication abortion access or by focusing on abuse prevention and patient protections. Dr. Verma said coercion was wrong but restricting care did not solve abuse and could worsen safety by removing clinical options and support pathways.

  Sen. Murray asked whether there was scientific support for claims that medication abortion contaminated water supplies. Dr. Wubbenhorst rejected that claim and said she was not qualified to opine on wastewater impacts.

• Sen. Banks (R-IN) asked how weakening FDA adverse-event reporting and loosening REMS affected safety monitoring. Dr. Wubbenhorst said reduced reporting likely undercounted harms and degraded the quality of real-world safety surveillance.

  Sen. Banks asked what a black box warning signaled and whether drugs with such warnings should be prescribed online. Dr. Wubbenhorst said black box warnings reflected serious risks and argued such drugs should not be prescribed online or without in-person safeguards.

  Sen. Banks asked how frequent serious complications were relative to the FDA label’s “very rare” language. Dr. Wubbenhorst cited international data suggesting complications like infection occurred at non-trivial rates at population scale.

• Sen. Baldwin (D-WI) asked how broader Republican health policy actions that reduced coverage and clinic capacity affected women’s access to comprehensive care, including prenatal care, cancer screening, and reproductive health services. Dr. Verma said these policies worsened maternity care deserts and access barriers, leaving more patients without prenatal care and making both safe pregnancy and safe abortion care harder to obtain.

  Sen. Baldwin asked why the weight of evidence on mifepristone safety differed from a small set of studies cited by opponents. Dr. Verma said the evidence base consisted of over 100 high-quality, peer-reviewed studies supporting safety and effectiveness, while a handful of frequently cited contrary papers were methodologically flawed, sometimes retracted, and in at least one prominent case functioned more like a self-published policy document that misclassified routine care as serious adverse events.

• Sen. Husted (R-OH) asked how policy could prevent nonconsensual or coercive use of abortion pills obtained online or by mail, including by partners using the drugs surreptitiously. Hon. Murrill said restoring in-person dispensing and tracking through state controlled-substance frameworks would increase accountability and reduce misuse, while emphasizing enforcement against illegal distribution.

  Sen. Husted asked what additional measures could curb illicit distribution and coercion. Dr. Wubbenhorst said strengthening REMS and enforcing existing federal shipping restrictions such as the Comstock Act would be key levers to limit mail distribution and remote prescribing pathways.

  Sen. Husted asked what approach would reduce unsafe outcomes without cutting off legitimate care. Dr. Verma said reducing harms required ensuring patients could access timely, local, supervised care and broader support options, rather than forcing care into more precarious channels.

• Sen. Hassan (D-NH) asked what health impacts could result from reduced access to Planned Parenthood and similar safety-net providers for preventive reproductive healthcare. Dr. Verma said decreased access would delay or prevent cervical cancer screening and STI testing and treatment, reduce contraception access, and generally undermine preventive care that avoided downstream complications.

  Sen. Hassan asked what happened clinically when states restricted mifepristone for miscarriage management. Dr. Verma said restrictions reduced access to a standard-of-care regimen that could speed resolution, reduce pain, and lower the need for procedural intervention for patients who preferred medication management.

  Sen. Hassan asked how telehealth affected access to reproductive care in rural areas and maternal care deserts. Dr. Verma said telehealth expanded access through regulated screening pathways but warned safety broke down when patients could not obtain follow-up care locally due to fear of criminalization and limited local capacity.

• Sen. Moody (R-FL) asked whether abortion pills were easily obtained across state lines and whether that enabled misuse by men or others to coerce or harm pregnant women. Hon. Murrill said the drugs were readily obtainable through low-verification channels designed to minimize accountability, which facilitated misuse and impeded enforcement across jurisdictions.

  Sen. Moody asked what enforcement obstacles prevented state prosecutors from stopping illicit distribution and coercion. Hon. Murrill said shield laws and interstate friction limited prosecution tools, and she argued that restoring in-person safeguards would improve traceability and deterrence.

• Sen. Kim (D-NJ) asked for an explanation of maternal care deserts and what was driving them. Dr. Verma said clinic and hospital closures were increasing travel distances for obstetric care, with Medicaid cuts and financial pressures contributing to reduced capacity, leaving some patients more than 100 miles from an OB-GYN.

  Sen. Kim asked which populations were most affected within maternal care deserts. Dr. Verma said patients already facing access barriers—those with limited transportation, limited insurance coverage, Medicaid reliance, and marginalized communities—were disproportionately harmed.

  Sen. Kim asked what broader consequences followed if political pressure eroded public trust in FDA science-based approvals. Dr. Verma said undermining FDA credibility could spill over beyond abortion drugs to other therapeutic areas and public health domains, including contraception and vaccines, by substituting politics for evidence in clinical decision-making.

• Sen. Hawley (R-MO) asked whether “men can get pregnant” as a test of scientific clarity in reproductive health discussions. Dr. Verma said she treated patients with varied identities and argued the framing was being used as a political tool rather than a clinical inquiry, emphasizing patient complexity over a binary premise.

  Sen. Hawley argued that clarity about biological sex was essential to protecting women’s health and to maintaining public trust in science-based testimony. Dr. Verma said she was representing patients’ lived complexity and warned that polarized questioning distracted from evidence-based care and patient outcomes.

• Sen. Alsobrooks (D-MD) asked whether the Ethics and Public Policy Center’s mifepristone paper was peer reviewed and medically rigorous. Dr. Verma said it was not a peer-reviewed medical journal study and characterized it as a policy paper.

  Sen. Alsobrooks asked whether the EPPC paper mixed unrelated clinical encounters into its complication counts and how that would affect reported outcomes. Dr. Verma said the methods were not transparent and that inclusion of unrelated conditions and routine care inflated complication rates and overstated risk.

  Sen. Alsobrooks asked what the credible evidence base showed about mifepristone safety and efficacy. Dr. Verma said there was a large body of high-quality, peer-reviewed research supporting safety and effectiveness and noted that the FDA label stated no causal relationship had been established between the drug regimen and listed complications.

• Sen. Markey (D-MA) asked how abortion bans affected the timing of care and the pathway to obtaining services even in states with protections. Dr. Verma said restrictions delayed care by forcing patients to travel and assemble resources, which pushed abortions later into pregnancy compared with timely local access.

  Sen. Markey asked what harms followed from long-distance travel for care. Dr. Verma said the burdens fell heaviest on patients already facing access barriers and added delays in receiving needed care.

• Sen. Kaine (D-VA) said the policy focus was shifting from state bans to restricting medication abortion nationally and asked whether emphasizing coercion logically conflicted with restricting choice. Chair Cassidy said Louisiana law included an exception for the health of the mother and argued that some high-profile adverse stories did not reflect the scope of those legal exceptions.

• Sen. Hickenlooper (D-CO) asked whether ongoing attacks on mifepristone would reduce options for patients managing miscarriage and early pregnancy loss. Dr. Verma said the mifepristone–misoprostol regimen was a highly effective standard option that many patients could not access due to restrictions, including policies that made dispensing more difficult in some states.

  Sen. Hickenlooper asked how expanding comprehensive reproductive healthcare and contraception access affected outcomes and system costs. Dr. Verma said broader access to contraception and reproductive health services improved health, reduced downstream harms, and supported patient safety, including for people facing reproductive coercion or unstable home situations.

• Sen. Murray (D-WA) said the hearing reflected a strategy to restrict abortion access incrementally rather than a science-driven review of women’s health. Chair Cassidy said he supported conducting a formal safety review, emphasized the importance of genuine clinician–patient interaction rather than automated online ordering, and said standard clinical practices like ultrasound dating and accurate medical histories were important for safe care.