A Once-a-Week Contraceptive Pill, Without Side Effects? Yes, Mifepristone.

Using mifepristone in this way “challenges the very difference between contraception and abortion,” said Dr. Rebecca Gomperts.

Rebecca Gomperts participates in the session “Women’s Rights are Human Rights: How to Provide Abortion Care in a Post-Dobbs World” during the Clinton Global Initiative on Sept. 19, 2023 in New York City. (Noam Galai / Getty Images for Clinton Global Initiative)

Research has for decades indicated that mifepristone may be a safe and effective contraceptive, but no one has conducted a large clinical trial to produce the proof that could form the basis for government approval of the drug for this use. Until now.

Pioneering reproductive health advocate Dr. Rebecca Gomperts is now leading a clinical trial of a low dose of the abortion medication mifepristone for use as a weekly contraceptive pill. Using mifepristone in this way “challenges the very difference between contraception and abortion,” said Gomperts, who was recently named one of 50 over 50 women in 2024 by Forbes magazine. 

“Roe is overturned and conservative Supreme Court judges will be there for another 30 years. So we need a new strategy to advance our reproductive freedom,” said Gomperts. 

Women on Waves, founded by Gomperts, has convened an international team of experienced medical, scientific and ethics professionals to work with the Stockholm-based medical university, Karolinska Institutet, and the Leiden University Medical Center (LUMC) in the Netherlands to conduct clinical trials in compliance with all the requirements of the U.S. Food and Drug Administration and the European Medicine Agency.

Gomperts hopes this large clinical trial will confirm the safety and efficacy of using a low dose of mifepristone to prevent pregnancy. 

“This method does not have the contraindications or side effects associated with the estrogens and progestins in hormonal contraceptives, such as weight gain, loss of libido or feelings of depression,” said Gomperts. “It also does not have the increased risk of breast cancer and thrombosis with use of hormonal contraceptives.”  

Whereas most traditional hormonal contraceptives must be taken daily, mifepristone would only need to be taken once a week.

Roe is overturned and conservative Supreme Court judges will be there for another 30 years. So we need a new strategy to advance our reproductive freedom.

Rebecca Gomperts

In May 2022, the Moldovan Department of Health gave approval for the clinical trial of mifepristone for contraception. More than 14 medical centers, including seven hospitals, have already committed to participate in the study. Researchers began enrolling patients in Moldova in August 2023 and hope to expand the study to the Netherlands soon, working with Leiden University Medical Centre. Researchers plan to include 949 women who will use mifepristone weekly for a year.

Approval of mifepristone for contraception would also make it available as a morning-after pill, for use within 120 hours after unprotected intercourse, and to end an early pregnancy. 

“It would allow us to move flexibly between the medicine’s different indications as weekly contraceptive, as an on-demand method used before or after sexual intercourse or as an early medical abortion method, depending on our life circumstances,” said Gomperts, who has worked to increase access to abortion healthcare in the United States by promoting telemedicine abortion across borders.

Rebecca Gomperts lands a ship in Valencia, Spain. In 2005, Gomperts founded the organization Women on Web to provide medication abortion via the internet and mail to people living in countries without access to safe abortion services. (Courtesy of Vessel press kit)

In 2018, Gomperts founded Aid Access, which began offering abortion pills to people in all 50 U.S. states by mailing medications from abroad, which took several weeks. Since June of 2023, Aid Access has been mailing medications from within the United States, with two to five-day delivery. They are able to do this by operating from within six states that have telemedicine abortion provider shield laws. These laws block prosecutors in anti-abortion states from investigating or extraditing telehealth abortion providers and also protect them from civil lawsuits by anti-abortion extremists.

Aid Access, which charges a sliding scale fee up to $150, provided abortion services to almost 85,000 people in all U.S. states in 2023. Approximately one-third were not able to pay the full fee, so Aid Access had to raise more than $2 million to make up the difference.

“Mifepristone can fundamentally change the way women all over the world will be able to control their fertility,” said Gomperts, who is raising funds to support the mifepristone clinical trials through GoFundMe.

You may also like: On a recent episode of On the Issues With Michele Goodwin, “Uncharted Waters: What’s Next for Abortion (with Rebecca Gomperts),” Gomperts and Goodwin unpack what it’s like to provide abortions to pregnant women in countries with restrictive abortion lawsthe victories and the horrors (including Gomperts’ boat being seized and chained, and her crew being held by gunpoint). They also unpack what comes next for abortion, including self-managed abortion and telehealth.

Up next:

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Carrie N. Baker, J.D., Ph.D., is the Sylvia Dlugasch Bauman professor of American Studies and the chair of the Program for the Study of Women and Gender at Smith College. She is a contributing editor at Ms. magazine. You can contact Dr. Baker at cbaker@msmagazine.com or follow her on Twitter @CarrieNBaker.