Abortion Opponents Have A New Weapon In Their Fight For Pill Bans: Wastewater Data

Anti-abortion activists are launching the next phase of their years-long effort to use environmental protection laws to cut off access to the abortion drug mifepristone, which they see as the main impediment to eliminating abortions after the fall of Roe v. Wade.

The group Students for Life of America spent the last two years collecting and analyzing water samples in different American cities, searching for evidence to support their claim that women having at-home abortions using the drugs and flushing fetal remains poses a threat to the environment.

That work culminated in the release this week of a controversial study purporting to show “significant levels of mifepristone” contaminating the waterways of Austin, Texas; Blacksburg, Virginia; and Carbondale, Illinois. Despite acknowledging there is no proof the mifepristone detected impacts human health, livestock or the environment, the paper warns of potential “deleterious effects on human and animal biology,” including everything from autism to infertility.

Environmental activism is rare for conservatives. But more in the anti-abortion movement are turning to it as federal rules adopted by the Biden administration allowing telehealth prescription and mail delivery of the drug enable a growing number of patients to circumvent state bans on the procedure that Students for Life and others spent half a century fighting for.

Furious that the number of people terminating pregnancies has increased since the fall of Roe, cutting off access to mifepristone, which is used more than two-thirds of abortions, has become the movement’s top priority. As other groups sued doctors, drafted state and federal legislation, petitioned for regulatory action and mounted consumer boycotts, tapping into environmental law became a key tactic in Students For Life’s efforts to put restrictions on the pill without having to go through a gridlocked Congress.

“We developed a strategy of throwing everything we possibly can against chemical abortion, because we have far too many years of experience in the pro-life movement of hanging our hope on one specific strategy, one specific piece of legislation, to only be disappointed,” Kristan Hawkins, the president of Students for Life of America, said in an interview. "It’s time to press go and pull all the levers.”

Publishing a single study, in a journal run by anti-abortion physicians, isn’t going to realign the science around the medication. But other anti-abortion groups or elected officials may pick up the study and embrace its findings, or commission their own follow-up research. And as abortion pill use continues to surge despite state attempts to ban them, activists are betting the paper proves compelling to an administration that has embraced and acted on theories shunned by mainstream academia and the medical field on Tylenol, peptides and vaccines.

Several environmental experts flagged flaws in the study’s methodology, telling POLITICO its conclusions are “misleading,” “poor quality” and “should not be considered in environmental or public health decision-making.”

Still, over the last few years, the group’s theory that the rise in at-home abortions with mifepristone could be contaminating the water supply has gained traction on the right — cited in congressional hearings, referenced in state legislation and lawsuits and endorsed by most Republican state attorneys general. Yet it has also been met with skepticism even within the anti-abortion movement, which the activists are now hoping to overcome with the new data.

“One study isn't going to make or break the case, but it can change the conversation,” said Patrick Brown, a fellow with the anti-abortion think tank Ethics and Public Policy Center.

He pointed to scientific advancements around fetal development in the 1980s as ultrasounds became more common as a catalyst for the movement’s success banning a commonly used surgical method for abortions later in pregnancy.

“Rigorously done science can have an impact,” he said.

A preprint of the wastewater study the activists have hinged their hopes on was posted online by the journal Issues in Law and Medicine, which is run by the anti-abortion physicians who failed to convince the Supreme Court to ban abortion pills in 2024, and was coauthored by a researcher who has been “working for the prolife cause since 1968.”

Though preprints are typically drafts of studies posted online prior to peer review, the journal’s editor said it went through a peer review process and will be published in the forthcoming edition of Issues in Law and Medicine.

In the meantime, anti-abortion activists are forging ahead with a blitz of actions to pressure regulators to impose restrictions on the pills.

“This paper is going to be a tremendous help,” said Hawkins.

They sent the study on Wednesday to Environmental Protection Agency staff, who are currently reviewing and updating the nation’s water contamination rules, and who met with them earlier this year about including abortion pills in the list of pharmaceuticals monitored in U.S. waterways.

EPA spokesperson Brigit Hirsch confirmed receiving the new data from Students for Life, and said in a statement that the agency is still going through months of public comments from anti-abortion activists and others on the issue.

“EPA takes the issue of pharmaceuticals in our water systems seriously and employs a rigorous, science-based approach to protect human health and the environment,” she said.

Students for Life is also using the study in its petitions to the FDA — which is in the middle of a review of the pills’ safety prompted in part by data gathered by another anti-abortion group — to ban telehealth prescription and mail delivery of the drug or pull them from the market entirely. The agency’s acting leader Kyle Diamantas, on a call with Students for Life earlier this year, promised to be “the most pro-life head of FDA we've ever had.”

The FDA did not respond to questions about its interactions with anti-abortion activists and whether it will consider the new paper as it reviews regulations on mifepristone.

At the same time, the group is making overtures to activists across Health Secretary Robert F. Kennedy Jr.’s Make America Healthy Again movement and producing commercials set to air after the midterms that will pressure state attorneys general to use environmental laws to bring charges against abortion pill providers.

Students for Life is also briefing GOP members of Congress and state legislatures — several of whom have signed letters to the Trump administration and co-sponsored bills to roll back access to abortion pills because of their alleged environmental impact.

Even if the new wastewater study doesn’t immediately “tip the scales,” Brown, the fellow at the Ethics and Public Policy Center, said, it’s part of the broader movement’s willingness to experiment and try a variety of tactics until one succeeds — the same strategy that ultimately toppled Roe.

“There is some strength in letting a thousand flowers bloom."

‘Unsubstantiated claims’

Environmental experts disputed the new study’s assertion that it proved the existence of detectable levels of mifepristone in the U.S. water supply.

Jack Vanden Heuvel, a molecular toxicologist at Pennsylvania State University whose lab frequently examines pharmaceutical contamination in waterways, noted that while the report describes measuring the “mifepristone concentration" in water samples, the testing method described in the study actually measures a reaction in the water samples that could be caused either by the drug or equivalent chemicals that block the hormone progesterone.

A number of compounds besides mifepristone can do that, he said, including certain contraceptives and endocrine-distrupting chemicals, like BPA, which is found in many plastic products and some polychlorinated biphenyls, which were once used in electrical equipment. The study didn’t test for those other progesterone-blocking compounds, so it’s not clear whether they or mifepristone caused the detected activity.

“What they did is a big ‘no-no,’” said Vanden Heuvel. “This would not have been published if I had been a peer reviewer.”

The study also does not describe using any analytical chemistry testing techniques that could specifically identify mifepristone in the water samples, said Betsy Southerland, a former career scientist who left EPA’s Office of Water during the first Trump administration after more than three decades at the agency.

It’s also unclear, she said, whether what the group detected could be harmful, despite the researchers making “unsubstantiated claims … that mifepristone poses a grave threat to ecological and human health.” The study cites another paper examining changes to uterine tissue prompted by patients undergoing long-term treatments involving low-doses of mifepristone.

The study’s author, Elise Rose, disputed these critiques in an interview.

The lab they contracted with in the Netherlands tested specifically for mifepristone, she said, and any other chemical detected would have to be genetically “identical or nearly identical” to the abortion medication, and “the odds against that would be very great.”

“This is a bio assay that's based on enzymes and antibodies are like a lock and key,” said Rose, who holds a doctorate in agronomy and environmental plant physiology from Kansas State University. “In order for something else to fit in there, it has to be very similar. And mifepristone is not a simple molecule.”

She acknowledged, however, that some of what was detected “could be a metabolite of mifepristone that's very close in structure” and that the group did not deploy any of the other analytical chemistry techniques Southerland says are necessary.

Vanden Heuvel and Southerland’s criticisms were echoed by other environmental health experts, including Kim Garrett, an environmental health scientist at City University of New York’s School of Public Health and Health Policy, who called the study’s methods "inappropriate and misrepresented.”

“The test used for analyses is not specific for mifepristone. Rather, it can pick up anything that interacts with progesterone receptors,” she wrote in an email.

Students for Life Executive Vice President Tina Whittington acknowledged that the paper “probably could have been worded better” to clarify that the tests conducted for the study were measuring “metabolites of mifepristone” meaning traces of components of the drug, rather than the drug itself.

But she and Rose defended the paper’s conclusion.

“Everyone should be concerned that we are possibly being exposed to an endocrine-disrupting compound without our consent," Rose said.

‘Turned a lot of heads’

Though the Trump administration has angered Students for Life and other anti-abortion groups with its inaction on abortion pills and other movement priorities, the new study lands in a ripe environment.

When President Donald Trump cautioned women late last year against taking Tylenol during their pregnancies — advice that runs counter to guidance from doctors — he cited a single study. Kennedy has also lifted up and changed policies based on research papers on vaccines, autism, anti-depressants, Covid-19 and other areas of health that break with the scientific consensus.

And when Brown’s colleagues at the Ethics and Public Policy Center published a report last year that claimed to show a far higher rate of medical complications among women who took mifepristone than previously known, conservatives in positions of power were quick to embrace its findings even as academic experts and fact checkers blasted its methodology.

Criticisms of that analysis — which didn’t undergo peer review and was released directly by the think tank rather than published in a medical journal — did not limit its political impact. It's since been cited by Cabinet secretaries and lawmakers as cause for government action and held up as evidence in legal filings.

Sen. Josh Hawley (R-Mo.), one of Congress’ leading abortion opponents whose wife, a conservative attorney, has argued multiple lawsuits that could restrict the pills’ use nationwide, told POLITICO the EPPC motivated many lawmakers who were previously noncommittal on the issue to support legislation or regulation to restrict abortion pills.

“I know that report opened a lot of eyes here and turned a lot of heads, especially among my Republican colleagues,” he said. “Some of them previously were kind of like, ‘Well, I don't know.’ But when they heard about that data they're like, ‘Whoa, that's shocking.’ So I hope this new data will have a similar effect.”