Advocacy Group Threatens FDA Lawsuit, Alleging Mifepristone Contaminates Water Supply

Students For Life, a pro-life advocacy organization, has threatened to sue the FDA for violating the Endangered Species Act if the agency doesn’t take action within 60 days on the Mifepristone abortion pill. The organization filed an intent to sue while alleging “tons of mifepristone-poisoned waste” is being dumped into the water supply and risking harm to endangered aquatic species in every state.

“The Endangered Species Act requires federal agencies to consult with fish and wildlife services before taking any action that may affect a listed or threatened species,” said Attorney Lincoln Wilson. “And the scientific literature shows that mifepristone in water has adverse effects on wildlife, but the FDA never consulted on the matter. That means FDA’s actions for mifepristone, including approving abortion by mail, are void.”

The organization cited a peer-reviewed study published on July 20, 2026 in Issues in Law & Medicine. The researchers evaluated water samples collected from Austin, Texas; Blacksburg, Virginia; and Carbondale, Illinois upstream and downstream from wastewater treatment facilities.

“There were significant levels of anti-progesterone activity (up to 0.041 μgram/l) in the water of all but one of the nine sampling classes,” the authors concluded. “Given progesterone’s numerous effects, this contaminant could affect the physiology of aquatic animals and human health, including fertility, pregnancy, and fetal development. The findings indicate the significant need for additional investigation into the levels of various hormones and EDCs, including mifepristone, in water sources.”

Students For Life is asking the FDA to conduct environmental testing and pull mifepristone from the market during the investigation. The group is also asking for the FDA to commit to not approving labels for mifepristone that would allow the drug to be used for miscarriage care.

The study evaluating water in three American cities didn’t specifically test for Mifepristone, but anti-progesterone activity. Most sample-class means were about 1–26 ppt, with the highest reading 41 ppt. Lab studies show when zebrafish are exposed to Mifepristone at rates of 5 to 77 ppt, they have increased egg production and ovarian changes. African clawed frogs had hormone-gene changes at roughly 9 to 215 ppt. The animals in these studies were exposed to Mifepristone specifically while the 2026 water test only evaluated “anti-progesterone activity which could be a result of Mifepristone as well as other endocrine-disrupting plastics, pesticides, and pharmaceutical chemicals.

EPA is conducting a novel study to look at 1,400 contaminants, which includes more than 1,000 pesticides and pesticide metabolites, more than 250 pharmaceuticals and personal care products, and more than 70 PFAS. Mifepristone is included on the list. The agency is finalizing a contaminant candidate list that includes 75 chemical candidates plus four contaminant groups and nine microbes for regular tracking. The list does not contain Mifepristone. The agency is reportedly considering adding the chemical after receiving feedback from the public comment period, but the list isn’t expected to be finalized until November 17, 2026. If it is added to the list, the agency would conduct more research and treat it as a chemical that may be in public drinking water. The CCL listing is usually the first step before a tap-water safety standard could be established, but it doesn’t mean a safety standard would be set by the agency.

Mifepristone was used in 642,700 medication abortions in the United States formal health-care system in 2023, according to the Guttmacher Institute. The overall percentage of abortions conducted with Mifepristone has increased continually since 2000 when the drug was first approved by the FDA. 2020 was the first year in which the majority of abortions were conducted with Mifepristone, typically as part of a two-drug regimen along with Misoprostol.

In April 2021, the Biden administration announced it would not enforce a rule requiring Mifepristone to be handed out in a clinic and in December announced it would permanently revoke the in-person dispensing requirement. The FDA finalized the Risk Evaluation Mitigation Strategy (REMS) in 2023 that allowed the drug to be mailed around the country.

Dobbs v Jackson Supreme Court decision in 2022 reversed Roe v Wade and led to several states implementing restrictions or bans on abortion. Individuals in states with abortion bans have been able to obtain Mifepristone and Misoprostol by mail from clinics in other states as a result of the Biden administration rule. The Trump administration is considering reversing that REMS and there is ongoing litigation by the state of Louisiana to try to halt the practice of sending Mifepristone prescriptions by mail after short telehealth visits.

The Supreme Court in May blocked an order by a federal appeals court in Louisiana court that prohibited the mailing of Mifepristone until the case is resolved in court. Justice Clarence Thomas dissented and said the drug companies “cannot, in any legally relevant sense, be irreparably harmed by a court order that makes it more difficult for them to commit crimes.” Justice Samuel Alito also dissented and said the ruling enables the perpetration of a scheme to undermine the court’s decision in Dobbs v Jackson.

The FDA has tracked a total of 4252 adverse event reactions from Mifepristone from 2000 through the end of 2024, including 36 deaths, 1056 hospitalizations, and 606 cases of blood loss that required a blood transfusion. Those figures are not proven causation and are associated with approximately 7.5 million uses during the same time frame.

Missed ectopic pregnancies are another risk associated with the drug. Mifepristone is not effective for ectopic pregnancies, which are non-viable pregnancies that require a different standard of care. A ruptured ectopic pregnancy carries the same symptoms as Mifepristone, including abdominal pain and uterine bleeding. If the ectopic pregnancy is not identified and a patient takes Mifepristone, they may not receive the required medical care in a timely manner.

The FDA has 97 reports of ectopic pregnancy with Mifepristone from 2000 through 2024. The increase of telehealth services following the Biden administration’s REMS makes it more likely that an ectopic pregnancy will not be caught. Mifepristone’s label says providers should “assess the pregnancy by ultrasonographic scan if the duration of the pregnancy is uncertain or if ectopic pregnancy is suspected.” An ultrasonographic scan cannot be conducted during a telehealth appointment. Patients would need to get that scan conducted elsewhere.