Abortion pills are a critical option for people seeking to end a pregnancy, especially those living in US states with abortion bans who cannot travel out of state for care. In 2023, medication abortion accounted for 63% of all clinician-provided abortions in states without total bans. Given the pivotal role of these medications in preserving abortion access, anti-abortion policymakers and advocates are resorting to increasingly unscientific, unconventional tactics to spread mis- and disinformation about medication abortion and about mifepristone, one of two drugs used in most medication abortions in the United States.
In a disturbing new strategy, anti-abortion policymakers are attempting to weaponize environmental laws and regulations, citing false claims that medication abortion pollutes US waterways and drinking water. Equitable access to clean and safe drinking water is a central component of community safety and sustainability—and a key priority for both the environmental and reproductive justice movements. But these efforts by anti-abortion policymakers do not target the known contaminants that make drinking water unsafe or their unequal burden on communities. They also fail to address the agricultural and industrial byproducts that are the leading polluters of water supplies, or the environmental impacts of other trace pharmaceuticals found in wastewater. Instead, this strategy is designed to stigmatize medication abortion and impose an exceptional level of regulation and surveillance on the use of mifepristone and misoprostol that is not applied to other pharmaceuticals. This analysis will explore state and federal efforts designed to restrict access to medication abortion through environmental policy and explain how these efforts are not grounded in science but rather in a broader anti-abortion agenda.
Environmental Attacks on Medication Abortion Are Not Grounded in Evidence or Expertise
The selective regulation of medication abortion through environmental law is a misleading and blatant ploy to stigmatize and restrict abortion access. This tactic relies on a series of baseless claims that range from allegations about dangerous levels of mifepristone contaminating the waterways and surrounding ecosystems to suggestions that the drug is present in drinking water—and even going so far as to claim that expelled tissue from abortion is a risk to the environment. In reality, all medications, including common over-the-counter medications like ibuprofen, can be found in trace amounts in wastewater after they are excreted from the human body. Medical waste tissue from an abortion is typically indistinguishable from that of a miscarriage or even a heavy period. While there is research indicating that other drugs present in wastewater, such as antibiotics and anti-inflammatories, may have a negative impact on aquatic and other ecosystems, there is no evidence to suggest that mifepristone is harming the environment or people’s health. These ideological attacks on mifepristone run counter to the expertise of scientists, advocates and civil servants who are actually working to improve the quality of our water and the environment.
Given the lack of evidence for these professed environmental concerns, the recent proliferation of regulatory bills can be best understood in the context of ongoing attacks on medication abortion and increased misinformation targeting mifepristone. Anti-abortion groups and policymakers have escalated these attacks in recent years, using junk science and false narratives to push for increased restrictions and ultimately a national ban on medication abortion. This includes miscategorizing routine follow-up care and known side effects of medication abortion as adverse events and using other scare tactics to stigmatize mifepristone—despite the broad scientific consensus regarding the drug’s safety and efficacy, based on decades of rigorous research.
Weaponizing State Environmental Policy Against Medication Abortion
In 2025, anti-abortion policymakers introduced nine bills in seven states that use environmental policies and deceptive claims about water pollution to target medication abortion. These bills employ a variety of tactics to restrict access to medication abortion, including selective and arbitrary testing of drinking water and public water systems, liability mandates for pharmaceutical manufacturers of medication abortion pills, bans on telehealth for the provision of medication abortion, and requirements that individuals dispose of embryonic and fetal tissue in medical waste kits. While these bills have not been passed into law, they pose serious threats to medication abortion access and some will likely be re-introduced during the 2026 state legislative sessions.
Requiring arbitrary water system tests
Legislation introduced in Texas, Wyoming and Wisconsin contained provisions that require testing for the presence of medication abortion in water systems, a selective and unsupported measure that would pose serious logistical and financial challenges. One of Texas’s bills would have required the state to conduct quarterly testing of their wastewater treatment plants for traces of mifepristone, along with other chemical components found in certain forms of contraception and treatments for gender-affirming care. Wyoming’s bill would have tasked the state’s Environmental Quality Council with testing community water systems and public water supplies for byproducts of medication abortion. To implement these provisions, Wyoming would need to divert budgetary resources from other areas, train or hire staff, and create new protocols and regulations. During a hearing on Wyoming’s bill, the water quality administrator for the state Department of Environmental Equality stated that her division lacked both the capability and the established protocols needed to test for mifepristone in public water systems. Wisconsin’s recently introduced legislation requires wastewater treatment plants to regularly test for the presence of endocrine disruptors, chemicals with potential hormonal impacts that come from a range of everyday products but which the bill attributes (without evidence) to mifepristone.
Imposing baseless liability on manufacturers of medication abortion pills
In a selective application of environmental accountability concepts to medication abortion, bills introduced in Wyoming, Montana, Maine, West Virginia, Pennsylvania and Wisconsin included arbitrary and unnecessary provisions that would have regulated how pharmaceutical manufacturers dispose of medication abortion pills and components. These measures would have made manufacturers legally and financially responsible for cleanup, remediation and preventative measures if components of medication abortion are found in wastewater and other water systems, despite a lack of evidence these components harm the environment or human health. The concept of producer liability is common in environmental law, especially in the regulation of hazardous products such as electronics and lithium batteries, and increasingly in the regulation of some pharmaceuticals. But the selective targeting of medication abortion pills for regulation without any evidence of harmful impact exposes these measures as arbitrary and covert efforts to restrict and stigmatize abortion access.
Banning telehealth provision of medication abortion
Framed as environmental protection and concern for public health, most of the bills discussed above (excluding Pennsylvania’s legislation) featured provisions that would undercut telehealth provision of medication abortion, harming patients who need or prefer this method of access. These provisions would have required providers to dispense medication abortion in person and mandated in-person follow-up visits. If providers did not comply with these in-person dispensing and follow-up provisions, they would have faced criminal charges as well as fines. Because many clinics have closed post-Dobbs due to the hostile political landscape, these provisions would exacerbate logistical and other barriers to care for patients. Those living in rural and other areas with shortages of abortion providers would likely need to travel even greater distances for care. The telehealth restrictions introduced in the Montana and Maine bills would have entirely eliminated access to medication abortion in these states, neither of which currently have restrictions in place that target medication abortion.
Requiring medical waste kits to shame patients and punish providers
Based on unsubstantiated claims that expelled tissue from medication abortion is contaminating drinking water, the purportedly environmental bills highlighted above would have imposed unnecessary waste-handling requirements on patients and providers. Many of these bills would have required providers to give patients medical waste kits to collect and return tissue for disposal by the clinic. Forcing patients to comply with these policies would not only impose logistical burdens with regard to collection, transportation and scheduling, but would also stigmatize these patients for seeking care. Providers would likely face serious administrative and financial challenges in implementing these provisions, and some bills would have imposed criminal penalties for providers who failed to do so.
Contributing to a culture of surveillance
Although logistically challenging, tracing and testing wastewater for tiny quantities of mifepristone and other byproducts of medication abortion could potentially increase the surveillance of individuals who self-manage their abortions—stoking fear and confusion for those seeking care. At the same time, the supposedly environmental bills discussed above subject both patients and providers to a new set of bureaucratic requirements that effectively surveil their behavior and threaten their criminalization.
Already, people seeking and providing abortion face threats to their privacy and security from the weaponization of digital tools, which often track location and activity data. Providers contend with state-mandated abortion reporting laws that can be used for legitimate public health purposes but are often misused by abortion opponents to threaten patient and provider safety. These proposed measures reveal how the anti-abortion movement is increasingly using tools of surveillance to deter individuals from seeking care and providers from offering care.
Using Federal Environmental Policy to Restrict Medication Abortion Access
Although the bulk of recent efforts to restrict mifepristone through environmental law have been pursued at the state level, many anti-abortion advocates see federal environmental policy under the Trump–Vance administration as a way to further restrict abortion access nationwide. Of course, federal environmental laws were enacted to protect US waterways and water supplies from pollutants: the Clean Water Act and the Safe Drinking Water Act, respectively, regulate the treatment and discharge of wastewater and guarantee the quality of peoples’ drinking water in the United States. These laws are implemented and enforced by the Environmental Protection Agency and state and municipal agencies.
Some anti-abortion groups, however, see these laws as potential weapons in their efforts to restrict medication abortion access and remove mifepristone from the market. They have also repeatedly attempted to use baseless claims of environmental contamination to question the FDA’s regulation of mifepristone. Such claims have been made despite the FDA’s assessment of mifepristone, in accordance with the National Environmental Policy Act, which found that the medication “can be manufactured, used and disposed of without any expected adverse environmental effects.”
One anti-abortion group first petitioned the FDA in 2022 demanding that prescribers of mifepristone give patients medical waste kits—claiming, without scientific evidence, that both products of conception and mifepristone were harmful to the environment. A second citizen petition filed the following year made further baseless claims about mifepristone as a danger to US waterways. The FDA denied these citizen petitions, noting that the petitioners provided “no evidence showing that bodily fluids from patients who have used mifepristone (a one-time, single-dose drug product) is causing harm to the nation’s aquatic environment or any endangered species.”
Despite this lack of evidence, opponents of abortion see opportunities for their environmental claims to gain traction within the anti-science and anti-abortion Trump administration, as well as with potential allies in Congress. This past June, 25 anti-abortion members of Congress submitted a letter to the EPA with a list of questions related to mifepristone—including whether the agency has a method of detecting the medication in the water supply. Although lawmakers have not yet received a formal response from the agency, recent reporting suggests that senior EPA officials directed scientists to assess whether such detection methods were available and were told they could be developed, though they do not currently exist.
Anti-abortion groups have ramped up these efforts in recent months, meeting with EPA staff as the agency carries out a routine update to its list of pollutants that must be tracked in drinking water. Although it is too late for mifepristone to be added to the list, anti-abortion groups are using the regulation's comment period as an opportunity to launch a renewed campaign against medication abortion.
Clean Water and the Health of Communities Are at Risk—But Not from Medication Abortion
While the anti-abortion opposition continues to use environmental laws to stoke confusion and fear about medication abortion, reproductive justice and environmental rights advocates have long fought for safe, clean water for their communities. The systematic and disproportionate placement of polluting sites in communities of color—commonly known as environmental racism—ensures that the health impacts of environmental pollutants are not felt equally. Advocates have highlighted the harms caused by contaminated drinking water and its impacts on Black communities, particularly for children and pregnant people. Residents of Flint, Michigan continue to battle illness and disability caused by lead poisoning—a direct result of decisions by state and local officials to replace the city’s water supply.
In the United States, agricultural practices are far and away the leading polluter of water supplies, due primarily to the use of fertilizers, pesticides and concentrated animal feeding operations. Farmworkers and their families, who are disproportionately Latino and immigrants, are at particular risk of exposure to these chemicals. Environmental justice advocates have raised concerns about the use of pesticides, such as atrazine, that are used in agricultural operations and their harmful impacts on humans, animals, ecosystems and drinking water. Atrazine is one of over a thousand known or suspected endocrine disruptors, which are associated with a number of health issues, in addition to impacting wildlife. Anti-abortion activists appear to be unconcerned with such well-established water-borne threats to human health and the environment and instead co-opt environmental legislation and regulation for the narrow goal of eliminating abortion access. Meanwhile, the infrastructure and regulation needed to protect public health and safe drinking water continue to be gutted by the judiciary and policymakers—putting communities, particularly communities of color, at even greater risk from legitimate environmental threats.
Communities Need Clean Water, Not Abortion Surveillance
Policymakers should push back on baseless environmental claims about medication abortion and instead advance evidence-based protections for our water and environment. It is also critical that experts and advocates denounce water policies focused on medication abortion for what they are: an effort to surveil, restrict and eventually ban abortion care. As we have seen in Texas, such pseudo-environmental tactics can also be easily extended to surveil and restrict access to gender-affirming care and contraception.
Despite anti-abortion groups’ attempts to weaponize environmental laws to restrict reproductive autonomy, the fight for environmental justice and reproductive justice are in fact inextricably linked, rooted in the recognition that communities need clean air and water to be able to raise children in a safe and healthy environment. Instead of singling out medication abortion for unscientific and ideological attacks, policymakers should advance a broad and equitable environmental agenda that ensures that everyone has access to safe drinking water and healthy, sustainable communities.