Among Project 2025’s 900 pages, a significant amount of ink is dedicated to abortion pills. The document describes the medication as “the single greatest threat to unborn children in a post-Roe world,” and targets one particular brand of prescription-only emergency contraception, EllaOne. Project 2025 claims Ella should be excluded from the Affordable Care Act’s contraceptive coverage mandate because it’s an “abortifacient.” Unfortunately, this is part of a broader effort among anti-abortion activists to conflate emergency contraception (which prevents a pregnancy) from medication abortion (which ends a pregnancy).
Now, new reporting by journalist (and Jezebel contributor) Susan Rinkunas in The New Republic breaks down a recent study that, overall, should be good news for abortion access, but instead may arm anti-abortion activists in their crusade against both abortion and contraception.
The study found that the active ingredient in Ella, ulipristal acetate, can be used in place of mifepristone, which could be helpful if the mifepristone winds up banned in certain states. (Medication abortion typically involves a patient taking mifepristone to block progesterone, then misoprostol to induce a miscarriage.) For the study, 133 women up to nine weeks pregnant took 60 milligrams of ulipristal, then 800 micrograms of misoprostol 24 hours later. Of those 133 women, 129 completed abortions—a 97% success rate comparable to that of mifepristone.
Clearly, this is a small study, and whether or not a patient uses ulipristal or mifepristone, misoprostol is the crucial piece to complete the abortion; misoprostol-only medication abortions can be 93% effective. EllaOne itself is only a 30-milligram dose, while study participants took twice that amount along with misoprostol.
On the one hand, this is an encouraging development amid increasing attacks on mifepristone. But on the other, anti-abortion activists may misleadingly wield the study as “proof” that birth control and contraceptives like Plan B should be banned just like abortion pills.
Rinkunas writes in The New Republic:
As you might expect, anti-abortion groups were practically giddy about the news. Students for Life told The New York Times in response: “The pro-life movement should be vindicated. We’ve been arguing for years that Ella acts as an abortifacient.” The American Association of Pro-Life Obstetricians and Gynecologists gave a similarly misleading comment to The Atlantic: “Abortion advocates have long denied Ella’s potential to end an embryo’s life, but this study contradicts that narrative.”
But don’t be fooled by their narrow focus on one form of Plan B: Birth control broadly is under increasing political threats, and all anti-abortion activists and lawmakers need is an entryway like this.
“It’s been frustrating to see that this study has been reduced to a talking point against emergency contraception when, critically, the study used misoprostol alongside a higher dose of an active ingredient in Ella,” Shireen Shakouri, executive vice president at Reproaction, told Jezebel. “Anti-abortion leaders are inflating the scientific findings so they can make a case to end birth control access, just like they’re trying to do with abortion.”
When Senate Republicans blocked the Right to Contraception Act in June, Sen. Joni Ernst (R-Iowa) baselessly claimed it would “mandate access to abortion drugs for women and girls of all ages,” referring to the bill’s protections for Plan B. She introduced her own bill claiming to protect contraception, which she stated “does not include [protections for] Plan B, which many folks on the right would consider abortive services. Big distinction. We want to prevent a pregnancy, not end a pregnancy.” That is entirely false.
The anti-abortion movement has also previously targeted some IUDs that can be used as emergency contraception when inserted within five days after having sex by making it harder for sperm to fertilize an egg. In Jessica Valenti’s book Abortion, she traces a history of insurers and employers wielding “conscience” exemptions put in place to allow them to not cover abortion to also not cover contraception. Hot mic audio from November 2022 showed top anti-abortion organization Susan B. Anthony Pro-Life America counseling Tennessee Republicans to wait before eventually going after birth control and IVF.
“What’s important for people to know is that this one study will change nothing about the way emergency contraception is used or prescribed, and won’t alter any prescribed or recommended methods for medication abortion,” Shakouri said. “Emergency contraception and abortion are just not the same thing, and anti-abortion groups want to muddy the waters between the two because it will make it easier for them to ban both.”
GET JEZEBEL RIGHT IN YOUR INBOX
Still here. Still without airbrushing. Still with teeth.
