Opinion: FDA commissioner nominee Heidi Overton is ignoring the science on abortion drug

OpinionFirst Opinion FDA commissioner nominee Heidi Overton is ignoring the science on abortion drug Mifepristone has passed every safety review. But Overton doesn’t seem to care Manage alerts for this article Save this story for later Share this article By Julie F. KaySept.

25, 2026 Kay, a human rights attorney, is the founder and CEO of Reproductive Futures. On Thursday, the Senate health committee met with Heidi Overton, nominee for commissioner of the Food and Drug Administration. When asked about her views on mifepristone, a key abortion medication, Overton danced around the issue.

As the CEO of Reproductive Futures, a legal organization advocating for reproductive rights, I am deeply concerned. Overton’s anti-abortion views are crystal clear. As FDA commissioner, she would have a chance to implement them and do serious harm.Advertisement When her nomination was first announced, anti-abortion groups cheered it as an opportunity to remove access to mifepristone.

The head of Americans United for Life said he had spoken with Overton five or six times and predicted that she would “expose this drug.” With this latest appointment, mifepristone has a new boss but an old problem. Few medications have been sued, petitioned against, and unnecessarily hauled before Congress as often as this one has. For the past two decades the U.S.

has probed, cross-examined, and disparaged mifepristone, despite the medication’s well-documented safety. Even under this unprecedented scrutiny, mifepristone’s impressive safety and efficacy record stands strong in the U.S. and globally.

As a human rights lawyer, I spent more than a decade working with women in Ireland to challenge the country’s complete ban on abortion. Back then, those who needed an abortion made “the Irish journey,” traveling by ferry or flight to England, sometimes using borrowed money, often in isolation and always with unnecessary hardship. That work inspired me to launch Reproductive Futures, an organization that brings legal firepower to the fight for patients to have the option to access abortion through telemedicine and avoid “the American journey.”Advertisement The vast majority of all abortion now relies on mifepristone, and patients should not have to travel to a clinic to receive the same safe, effective medications they could receive at home.

So you can see why mifepristone makes abortion opponents lose their minds. Paired with a second drug, misoprostol, mifepristone is standard care around the world. An estimated 7.5 million Americans have used it.

The American College of Obstetricians and Gynecologists recommends it for early pregnancy loss too. Yet the FDA has never added miscarriage management to mifepristone’s label. Patients experiencing miscarriage get tangled in the same medically unnecessary red tape — and Thursday’s hearing indicated that birth control is next.

The red tape wrapped around mifepristone is thick. FDA regulations require clinicians to be specially certified to prescribe mifepristone. Because pharmacies must join a unique registration system in order to dispense mifepristone, very few do, even in abortion-friendly states.

Patients must sign a special agreement form that creates another layer of exposure and bureaucracy for them. All this unneeded rigamarole for a safe drug, with a comparatively very low rate of reported deaths across its decades of use in the U.S., none of which the FDA can attribute to the drug with certainty. Meanwhile acetaminophen, sold next to the gum at the local gas station, is far less safe and directly linked to an estimated 458 deaths a year.

Birth control pills went over the counter in 2023. Emergency contraception has safely sat on drugstore shelves for years. Mifepristone still needs a permission slip.

None of that caution is driven by the data. Abortion opponents see red when they see mifepristone because it makes abortion simple and safe, affordable and accessible. Opponents are willing to undermine the FDA’s reputation and the drug approval process itself just to take mifepristone away from women.

They repeatedly have challenged mifepristone in courts. In 2024, the Supreme Court unanimously threw out a nationwide challenge to the FDA’s approval and regulation of mifepristone in FDA v. Alliance for Hippocratic Medicine, because the doctors who sued lacked standing.Advertisement Louisiana then filed its own suit to stop remote prescribing of mifepristone and end telemedicine nationwide.

This spring, a 5th Circuit order briefly reinstated in-person dispensing nationwide, but thankfully the Supreme Court stepped in to pause that order and preserve access while the case continues. But just weeks ago, Louisiana was back at the 5th Circuit seeking the same restrictions again, and the FDA’s own review of mifepristone has been conveniently scheduled to finish after the midterms. Overton acknowledged that the FDA’s internal research safety study of mifepristone would “immediately be on [her] desk,” and said she is eager to get to work to respond to Louisiana’s anti-mifepristone litigation — presumably to support it.

In response to that case, a biotech CEO recently warned in these pages that letting courts and politicians second-guess the FDA’s scientific judgment endangers the whole drug pipeline. Overton inherits an agency that has fired more than 3,000 staff in the past year, whose last commissioner resigned after clashing with the White House. During Thursday’s Senate hearing, she continuously sidestepped questions about renouncing or correcting the White House’s misinformation about vaccines schedules, food safety, and tobacco use, frustrating both Republican and Democratic Senators alike.

Her inability to prioritize science over the White House’s political agenda was so obvious that Sen. Maggie Hassan (D-N.H.) outright asked Overton to name one thing she thought the president had ever been wrong about, but she received no answer. Overton will now be the fox guarding the hen house.

Public trust in the FDA approval process took decades to earn. It will not survive a commissioner who treats settled scientific evidence as negotiable to appease the Trump administration. For more than 30 years, abortion opponents have harassed patients outside clinics, threatened providers, and attacked facilities with arson and bombings.

Clinics were targets because they were visible. Telemedicine took that target away. With mifepristone, a patient can consult a clinician by video, receive pills by mail, and end a first trimester pregnancy at home.

No hassle or expense of a journey across state lines and past protesters needed. About 30% of U.S. abortion patients now choose to receive care via telehealth, many prescribed by clinicians working from states where telemedicine shield laws offer them protections from anti-abortion elected officials.Advertisement That is what truly alarms abortion opponents: safe, affordable abortion on a patient’s own terms.

During Overton’s hearing, anti-abortion Sen. Josh Hawley (R-Mo.) noted his distress that telemedicine has allowed greater access to abortion despite the overturn of Roe v. Wade, and reiterated his desire to halt it in its tracks.

But make no mistake: The horse has left the stable. Messing with mifepristone will not make abortion disappear. Care will continue, including through clinicians who prescribe misoprostol alone, an effective regimen with more side effects or new medications being developed.

And some patients will access pills through other channels, without the guidance of a licensed medical professional. While they can’t eliminate access to abortion medications, what we all stand to lose is abortion care from doctors in the US offering the best possible care, a government that respects scientific rigor and a country that embraces reproductive rights as human rights. Let’s stand strong for our rights, and circle up to protect mife, and science.

Julie F. Kay, a human rights attorney, is the founder and CEO of Reproductive Futures and co-author of “Controlling Women: What We Must Do Now to Save Reproductive Freedom.” Letter to the editor Have an opinion on this essay? Submit a letter to the editor.

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