For more than 20 years, medication abortion has been a safe, effective, FDA-approved method for people to end a pregnancy in the comfort of their own homes. In states where abortion remains legal, medication abortion is an essential and widely used option for care; and due to its accessibility via telehealth and mail delivery, it plays a critical role in ensuring safe and timely access to care for people who live far away from the nearest abortion provider or face long wait-times for an in-person appointment.

While the Biden administration has taken recent action to improve access to medication abortion, anti-abortion politicians and extremist groups are using every trick in the book to outlaw mifepristone — one of two drugs used in medication abortion — as part of their larger, concerted campaign to end abortion access entirely nationwide.

Here are some of the key facts you need to know about mifepristone and why it’s a critical part of our fight for abortion access going into the new year:

The Food and Drug Administration (FDA) approved mifepristone in 2000 as a safe and effective way to end a pregnancy. Today, based on high-quality evidence, mifepristone is also endorsed by leading medical authorities like the American College of Obstetricians and Gynecologists as part of the superior medication treatment regimen for miscarriage care.

Study after study has shown the exceeding safety and efficacy of mifepristone for use in abortion and miscarriage care. In fact, mifepristone is safer than Tylenol and Viagra when it comes to serious medical complications.

Since being approved, mifepristone has increasingly become an essential part of abortion access across the country. Even before Roe was overturned, medication abortion accounted for more than half of abortions across the country.

“It’s just so much easier to feel safe and supported and loved when you’re having a medication abortion, because there’s more of a level of control that you have over the process than if you’re using another method.”

— Maleeha Aziz, abortion storyteller and activist

Despite its approval and long safety track-record, the FDA has continued to impose a set of medically unnecessary restrictions on mifepristone, known as a Risk Evaluation and Mitigation Strategy (REMS), which has made it needlessly difficult for women and other people who need abortion care to access the medication. Medication abortion has also faced targeted attacks by state politicians in their effort to push abortion out of reach bit by bit; and since Roe was overturned, abortion bans in several states have outlawed medication abortion entirely, along with procedural abortion care.

Credit: Allison Shelley

Following the science, the FDA has repealed several medically unnecessary restrictions on mifepristone in recent years. Most significantly, ACLU lawsuits prompted the agency to eliminate its illogical in-person pill pick-up requirement and finally permit people to get the medication by mail or from a pharmacy by prescription, rather than having to travel to an abortion provider which could be hours away. Though this is meaningful progress, the FDA still imposes needless restrictions on mifepristone that are not applied to similarly safe medications. Notably, mifepristone’s safety record remains just as strong in countries that have eliminated medically unnecessary restrictions like those that the FDA continues to impose.

Mifepristone is one of two drugs used in abortion and miscarriage care, which is different from medications used to prevent pregnancy in the first place — like birth control or emergency contraceptives, also known as the morning-after pill. According to leading medical organizations, these medications prevent pregnancy by impeding ovulation and preventing fertilization, and remain legal in every state. Despite this clear distinction, which the FDA further endorsed recently, misinformation conflating contraceptives and abortion have continued to spread.

As we navigate the first year without the protections of Roe v. Wade, attacks by anti-abortion extremists and politicians on medication abortion care will only increase. Already, state politicians have introduced bills to curtail the use of medication abortion care and dark-money groups are devising ways to push care out of reach entirely. That means it’s all the more important to understand this vital medication and spread the word.

“The conundrum of color is the inheritance of every American, be he/she legally or actually Black or White. It is a fearful inheritance, for which untold multitudes, long ago, sold their birthright…

It is not pleasant to be forced to recognize, more than thirty years later, that neither this dynamic nor this necessity have changed. There have been superficial changes, with results at best ambiguous and, at worst, disastrous. Morally, there has been no change at all and a moral change is the only real one…

The only real change vividly discernible in this present, unspeakably dangerous chaos is a panic-stricken apprehension on the part of those who have maligned and subjugated others for so long that the tables have been turned.”
–James Baldwin, Preface to the 1984 edition of “Notes of a Native Son”

Thirty years after publishing his “Notes of a Native Son,” James Baldwin revisited his influential essays. It is interesting to see the 60 year old reflect on the words of a younger version of himself entering the height of the Civil Rights Movement.

Growing up in Broward County schools, we learned about the Civil Rights Movement like we do American Revolution: Years of mistreatment create a conflict. The freedom fighters are heroes, the oppressors, villains. Bloody battles are fought, the war is eventually won, and a new, fairer system overhauls the old.

That was a lie.

Baldwin observed near the end of his life that the conclusion of the Civil Rights Movement and the important victories its heroes secured did not mark the end of racism in America. Americans were subject and doomed to repeat a vicious cycle of racial subjugation for generations thereafter. White supremacy continued to rear its ugly head in new forms in American life.

Around the time of Baldwin’s secondary observation, just thirty years after the brutal fight for civil rights, policymakers in Washington used aggressive city planning to decimate Black communities and destroy generations of wealth in the process. And while communities were still reeling from this devastation, Congressional power brokers gave the criminal justice system and police more power to disproportionately incarcerate Black and Hispanic Americans compared to white Americans for drug crimes, even with similar drug use rates. Families and loved ones to this day live with the repercussions of our country's failed drug war.  

A predecessor of Baldwin, Frederick Douglass, also challenged white supremacy for most of his life. And while many white Americans claim to hold him in high regard today, he too documented the shameful unwillingness of America's political establishment to pursue meaningful reconciliation with Black Americans, even after the Civil War ended and the 13th Amendment was ratified. Racism also did not end with Reconstruction, as Douglass woefully witnessed.  He challenged America’s commitment to equality in one of his most famous speeches, delivered in 1890:

“The United States Government made the negro a citizen, will it protect him as a citizen? This is the problem. It made him a soldier, will it honor him as a patriot? This is the problem. It made him a voter, will it defend his right to vote? This is the problem. This, I say, is more a problem for the nation than for the negro, and this is the side of the question far more than the other which should be kept in view by the American people.”

Douglass’ questions are ones many of us are still asking, more than a century after they were spoken.

It is difficult to use the word “unprecedented” as 2023 begins replete with the hyper-focused scrubbing of Black history in Florida schools. Gerrymandering and voter suppression tactics in Florida, stalled debates about police accountability, the continued call to protect and honor Black lives, and, now, callbacks to Jim Crow-era sentencing guides add to these harmful tactics to silence Black Americans and obstruct the pursuit of true equity.

Black history is American history.

Black history is American history. Black Americans helped engineer the Space Race, earned gold medals in our country’s name at the Olympics for generations, birthed rock and roll music (Robert Johnson and Chuck Berry), and were present at the very moment that begat the country’s founding. The Black experience is uniquely American. Still, the history and contributions of the Black people who helped build this country is devalued in American history. 

This Black History Month, we encourage all Floridians to learn of the foundational contributions Black Americans have made to our state and country.

All Floridians must challenge attempts to cull Black history to marginal interpretations, and efforts to chill our voices, and our freedom. We cannot be silent observers of the vicious cycles of subjugation that are as old as this country. Instead, we must remind each other that mere scraps of progress do not equate to the necessary moral shift needed to achieve true equality. We must challenge each other to reevaluate our own values and commitments to democracy, not just for ourselves, but for everyone.

As we honor leaders in Black history this month, the battles they lead for civil rights may seem like relics of a past era. But there is more progress to be made to achieve systemic equality for Black people, particularly in the realm of voting rights, economic justice, housing, and education; as well as ending police brutality and eradicating racism and discrimination in the criminal legal system. Those battles continue under the leadership of Black activists, lawmakers, athletes, actors, and others — many working side by side with the ACLU — who are pursuing true equality to this day. This year, we’re recognizing both.

Yoichi Okamoto

As one of the foremost leaders of the civil rights movement, Thurgood Marshall was the architect of a brilliant legal strategy to end segregation and fight racial injustice nationwide. He’s best known for Brown v. Board of Education, a landmark 1954 Supreme Court case that dismantled the “separate but equal” precedent, initiating integration in schools and other parts of society. Before becoming the first Black Supreme Court Justice in 1967, he worked with the NAACP, founded the Legal Defense Fund, and served on the ACLU board for eight years.

“Where you see wrong or inequality or injustice, speak out, because this is your country. This is your democracy. Make it. Protect it. Pass it on.” — Thurgood Marshall, commencement address at the University of Virginia in 1978

Associated Press

One of the greatest legal minds of the 20th century, Pauli Murray was among the first to theorize that the 14th Amendment’s guarantee of equal protection under law could be used to challenge laws that discriminated based not only on race, but also on sex. This work formed the basis for arguments in Brown and laid the framework for Ruth Bader Ginsburg’s mission when she founded the ACLU’s Women’s Rights Project in 1972.

Murray also co-founded the National Organization for Women 1966, but eventually left the organization in protest of its exclusionary racial politics that she believed did not address the barriers faced by Black women.

“Since, as a human being, I cannot allow myself to be fragmented into Negro at one time, woman at another, or worker at another, I must find a unifying principle in all of these movements to which I can adhere … This, it seems to me, is not only good politics, but also may be the price of survival.” — Pauli Murray in a letter to the National Organization for Women

In addition to Murray’s foundational work in women’s and civil rights, Murray also served the ACLU on its national board of directors and as part of an advisory committee guiding its women’s rights work. This past fall, we launched the Pauli Murray Fellowship in Murray’s honor — a program that will foster the next generation of leaders.

Duke University / Broadsides and Ephemera Collection

When Black landscape gardener Winfred Lynn received his draft notice in 1942, he responded by defiantly stating that he was “ready to serve in any unit of the armed forces of my country which is not segregated by race.” The ACLU took up his case challenging the racially segregated draft in World War II. While the lawsuit itself ultimately failed, the controversy surrounding it highlighted the hypocrisy of segregating the armed forces of a country espousing ideals of equality during its fight against the Nazis. This case was a contributing factor in President Truman’s July 26, 1948 executive order ending racial segregation in the military.

Associated Press

On the launch of his groundbreaking 1903 treatise “The Souls of Black Folk,” W.E.B. Du Bois remarked that “the problem of the twentieth century is the problem of the color-line.” In describing the Black American experience as a form of “double consciousness,” he created a theoretical framework still widely used in sociology today. Du Bois went on to found the NAACP in 1909, and became one of the most influential figures in Black history.

“One ever feels his twoness — an American, a Negro; two souls, two thoughts, two unreconciled strivings; two warring ideals in one dark body, who dogged strength alone keeps it from being torn asunder.” — W.E.B Dubois

Andy Kropa /Invision/AP

As the first openly trans Emmy nominee, Laverne Cox has used her rising fame to advocate for trans rights, awareness, and visibility, particularly for Black trans women, who face criminalization and disproportionate violence and harassment. A frequent partner, she’s fought side-by-side with the ACLU against anti-trans legislation and at the Supreme Court, where she was instrumental in raising awareness for the Aimee Stephens case, in which the court ruled that Title VII of the Civil Rights Act of 1964’s protections against sex discrimination in the workplace also apply to LGBTQ people — a major victory for the rights of trans people across the country.

“I think part of this is a backlash against the unprecedented visibility we have in the media now. Trans people are coming forward and saying, ‘This is who I am. I have a right to exist.’ We’ve always existed, and now we’re coming out of the shadows. And as we come out of the shadows, people want to force us back into the dark and to back pages. And we are saying, ‘No, we deserve a right to live in the light.’ And that’s all we want.” — Laverne Cox in Democracy Now!

When Colin Kaepernick knelt during the national anthem before a NFL game in 2016, the “take the knee” movement was born as a widespread, powerful form of protest against police brutality and racial inequality, raising awareness on a national stage. While this act cost Kaepernick his NFL career, it made an indelible impact on the national conversation about race and policing, and the ways we protest.

“There are bodies in the street and cops are getting paid leave and getting away with murder … I am not looking for approval. I have to stand up for people that are oppressed. If they take football away, my endorsements from me — I know that what I stood up for is right.”— Colin Kaepernick

More recently, Kaepernick has worked on a docuseries on police brutality, “Killing County;” wrote a children’s book, “I Color Myself Different;” and appeared in a Netflix series about his life, “Colin in Black and White.”

NDZ/STAR MAX/IPx

As a young activist fighting against racial segregation, Eleanor Holmes Norton took her passion for the First Amendment to the ACLU, where she worked as an attorney fresh out of law school, and later, to Congress, where she has represented the District of Columbia since 1991. Her work as a Congresswoman centers on full voting representation and economic justice for the people of D.C., and includes fighting for D.C. statehood, lowering college tuition, and housing reforms. In January, she announced the Senate introduction of her D.C. statehood bill, bringing it one step closer to passage.

“Growing up in the District of Columbia was ample preparation for the civil rights movement, not only because of racial segregation in the nation’s capital, but also considering that D.C. was directly controlled by the federal government until the 1973 Home Rule Act and had no mayor or city council, and no member of Congress. Deprived of the basics of democracy, compelled to abide by racial segregation, and denied representation in Congress, my hometown prepared me to look to the First Amendment for change.” — Eleanor Holmes Norton

Dr. Yashica Robinson has been on the front lines of the fight for abortion rights as an obstetrician-gynecologist serving her community in Alabama. With representation from the ACLU, she fought for years to keep Alabama’s near-total abortion ban from taking effect and to keep abortion available in the state. Even though that ban finally took effect last year after the fall of Roe, she continues working tirelessly for reproductive freedom.

“Black women in Alabama are nearly five times more likely to die from pregnancy-related causes than white women. We know that racial disparities in health care are exacerbated by policies that make accessing health care more challenging. Without access to abortion, maternal mortality rates will rise even more — in Alabama, and across the country.” — Yashica Robinson

Associated Press

As a Black trans woman and leader in the trans rights movement, Lala Zannell has fought discrimination, criminalization, and violence against trans people with the ACLU and as a community organizer. Protecting Black trans lives is a priority of her work, which includes helping to end unconstitutional searches by the NYPD, advocating for the decriminalization of sex work, and testifying at the first Congressional forum on violence against transgender people, among other initiatives. In 2017, she made history as the first trans woman to speak at the White House for Women’s History Month.

“I was not all the way 100 percent, a publicly out visible trans woman … It was not until after Islan Nettles died — who was a Black trans woman out of Harlem who was in school, she just got her apartment, was on her way to FIT university for fashion, was trying to go home. And a guy cat-called her. She told her truth and he beat her to her death. … to just see so many Black trans women, Black queer people mourning the life and death of a Black trans woman was just so powerful for me. So in that moment, I just said I don’t care anymore.” — LaLa Zannell