From weekly birth control to emergency contraception, mifepristone’s future reveals who truly controls women’s bodies.
This is the final installment in the series, “The Moral Property of Women: How Antiabortion Politics Are Withholding Medical Care,” a serialized version of the Winter 2026 print feature article. Part 1 examined how politics stalled mifepristone research for fibroids, forcing millions of women toward invasive surgery. Part 2 explored how those same forces delayed treatments for endometriosis, cancer, depression and other chronic illnesses. This final installment looks at why mifepristone’s promise as contraception may be the most politically threatening use of all.
From the moment government approval for the drug was granted, RU-486 became the moral property of women, not just the property of a drug company.
Claude Évin, French health minister
After decades of evidence showing mifepristone’s safety and versatility, the question is no longer what the drug can do, but whether women will be allowed to decide how it is used. As a treatment for disease, mifepristone has already challenged antiabortion politics. As a form of contraception, it poses an even greater threat.
Since the 1990s, studies have demonstrated mifepristone’s promise as a form of birth control. Pioneering reproductive-health advocate Dr. Rebecca Gomperts is now running a large clinical trial in the Netherlands measuring the effectiveness of a 50-milligram dose of mifepristone as a weekly contraceptive pill. The research is being conducted at 14 centers across the Netherlands and hopes to enroll 1,000 participants. They have already recruited 225 participants, and the results so far are positive, according to Gomperts: 286 menstrual cycles with no pregnancies and few side effects.
Women on Waves, which was founded by Gomperts, convened an international team of experienced medical, scientific and ethics professionals to run the trials with the Karolinska Institute, a Stockholm-based medical university, and the Leiden University Medical Center in the Netherlands. The study is being conducted in compliance with the European Medicines Agency and the FDA.
“What we know from earlier studies, we are very confident that it will be a very effective and safe contraceptive … with very few side effects,” Gomperts says, “that can also be used by people that have genetic predisposition for breast cancer, for example, who cannot use hormonal contraceptives. … People with a higher risk for thrombosis [blood clots], they can also use this.”
Gomperts adds that most women do not menstruate while they are taking mifepristone, and use it as a contraceptive. She says, “The feedback is that they actually prefer that.”
[Mifepristone] doesn’t have the mood changes that are linked to the hormonal contraceptives.
Dr. Rebecca Gomperts
Gomperts explains that hormonal contraception prevents ovulation, whereas mifepristone works through a combination of reducing the ovulation rate and preventing buildup of the endometrium—the tissue that grows in the uterus each menstrual cycle and sheds monthly as menstrual blood. This means mifepristone “doesn’t have the mood changes that are linked to the hormonal contraceptives,” Gomperts notes.
Gomperts plans to seek European Medicines Agency approval and market authorization of 50 milligrams of mifepristone as a weekly contraceptive, opening the door to use throughout the European Union. “We hope we will have [the study results] within three years,” she says. “It can go pretty quick [after that] because we already asked for advice from the European Medicines Agency … so we know what they require.”
Gomperts adds that approval for contraception would also allow mifepristone to be offered as a morning-after pill for use up to 120 hours (five days) after unprotected intercourse. “Mifepristone can also be used as a morning-after pill so that you have an on-demand contraceptive. If you have sex once every two, three weeks,” she says, “this is more a pre-or morning-after pill. … If you have a lot of sex, you use it once a week [as a contraceptive].”
Barriers to New Uses
Despite the potential of mifepristone to deliver life- and health-saving treatments across multiple conditions, the FDA has approved mifepristone for only two indications: termination of early pregnancy, in 2000; and control of high blood sugar in diabetic patients or those who have glucose intolerance with Cushing’s syndrome, in 2012.
After research showed that mifepristone was effective in treating some brain tumors and providing palliative care for several forms of cancer, including breast and ovarian cancer, the FDA also agreed to allow use of the drug under a highly restrictive and hard-to-access “compassionate use” program.
For all other purposes, mifepristone access has been blocked by anti-abortion threats of boycotts and harassment of anyone promoting the medication for any use, leaving hundreds of thousands of women to live in chronic pain—or die.
Currently, the resources required to win FDA approval for new uses of an existing product are substantial. They include costly testing and clinical trials, an application fee of more than $4 million, investments in a new manufacturing facility and implementing rigorous FDA compliance systems specific to the medication. Layer on the risk of antiabortion backlash, and most drug companies have judged the gamble too great. And women pay the price.
Even so, the work has not stopped as researchers continue to build evidence showing the many uses of mifepristone. And advocates are pressing forward to develop the full potential of the medication.
Let’s not forget it took a massive, 12-year campaign led by the Feminist Majority Foundation (publisher of Ms.) to win FDA approval of mifepristone for abortion. The campaign persuaded the drug developer to donate the right to distribute mifepristone in the U.S. to the non-profit Population Council, which in turn raised the money for clinical trials, created a company to distribute the medication and fought governmental red tape and antiabortion pressure. Then feminists had to fight for years to make the drug widely available, which has only happened with the advent of telehealth abortion during the pandemic.
To win FDA approval for fibroids and other conditions, feminists must once again organize and pressure drug companies to conduct clinical trials of mifepristone for these purposes, apply to the FDA for approval and overcome anti-abortion disinformation and obstruction efforts.
In 1988, after the French government approved mifepristone (also called RU-486), the drugmaker Roussel Uclaf withdrew the medication from the market because of anti-abortion threats of boycotts and violence. In response, the government, which owned 36 percent of Roussel Uclaf stock, threatened to transfer the drug patent to another company in the interest of public health. French Health Minister Claude Évin famously explained why: “From the moment government approval for the drug was granted, RU-486 became the moral property of women, not just the property of a drug company.” He ordered Roussel Uclaf to place the drug back on the market.
Mifepristone is still the moral property of women, and women must demand access to the drug.
Lacking other options, when the FDA began allowing compassionate use of mifepristone, the Feminist Majority Foundation stepped in to facilitate. In the first two years, the organization provided mifepristone to 71 patients—53 women and 18 men. “We thought that if people could see it was used for other illnesses, they would start understanding that you can’t politicize the drug,” the foundation’s president, Eleanor Smeal, explains. “This pill can treat other diseases. We need breakthroughs in the treatment of cancer. For us not to recognize that and not to encourage research, that’s politicization.”
Gomperts, of Women on Waves, sees urgency in this moment. “It works against endometriosis. It works against myoma [fibroids]. We are now involved in a study group that looks at whether it can prevent breast cancer,” she says. “It has so many potential uses, and it hasn’t been [developed].
“If we as women don’t make sure that it becomes available to meet our needs … then it won’t happen.”
