Attorney General Hanaway Files New Challenge To Stop Dangerous Mail-Order Abortion Drug From Flooding The Market

JEFFERSON CITY, Mo. – Today, Missouri Attorney General Catherine Hanaway announced that her Office has filed a new challenge to stop dangerous, high-risk chemical abortion drugs from flooding the country through mail-order distribution, and to block the latest approval of an additional generic mifepristone product.

This suit bolsters Missouri’s existing multi-state challenge to the ongoing dismantling of critical safety protections surrounding mifepristone, protections Congress required, and that drug manufacturers are obligated to meet before placing these products into the marketplace.

“Mifepristone is sending women to the hospital with life-threatening complications, and yet drug companies continue pushing new versions of it into the market without basic medical safeguards,” said Attorney General Hanaway. “Mail-order abortion drugs are dangerous when taken without in-person care, and Missouri will not stand by while manufacturers gamble with women’s lives.”

The lawsuit challenges the latest approval, issued on September 30, 2025, that authorizes an additional generic version of mifepristone, even though the drug’s risks are well-documented and worsening with further study.

According to the drug’s own labeling information, roughly 1 in 25 women who take chemical abortion drugs end up in the emergency room. Many suffer severe hemorrhaging, infection, or require surgery. These complications are far more common when women receive abortion pills through the mail without personalized care from a medical professional.

Despite this evidence, manufacturers have continued relying on weakened safety standards, standards originally designed to catch dangerous conditions such as ectopic pregnancies, which can only be identified through an in-person medical exam. Reporting of non-fatal complications has also been eliminated nationwide, leaving regulators and physicians without a full picture of harm.

“No caring physician would call mifepristone ‘as safe as Tylenol,’” Attorney General Hanaway added. “That claim was always false. Women are ending up in emergency rooms, and manufacturers know it. If the FDA is reevaluating the brand-name drug’s safety, then it needs to stop rubber-stamping new mail-order generic versions before more women are hurt.”

Federal law has long prohibited sending abortion drugs through the mail. But instead of following that law, abortion-pill distributors and national telehealth networks have built a nationwide mail-order abortion economy, shipping these drugs to women in all 50 states without ensuring they receive in-person screening, follow-up care, or emergency medical support.

For Missouri and other states with strong protections for unborn life and maternal health, the widespread mail-order distribution of mifepristone directly undermines state law and burdens state hospitals, emergency rooms, and taxpayers.

This new lawsuit focuses specifically on the 2025 approval of a new generic mifepristone product manufactured by Evita Solutions, even though the drug is chemically identical to earlier versions already linked to severe complications. The product was approved without requiring any new safety studies and relies on unsafe changes made in previous years.

Those earlier changes:

• Rolled back nearly all original safety precautions,
• Removed the in-person medical evaluation requirement,
• Removed follow-up visit requirements,
• Allowed pharmacies to dispense mifepristone, and
• Enabled pills to be prescribed remotely and mailed directly to

As a result, Missouri hospitals continue to report growing numbers of women suffering complications from chemical abortions performed out of state or through mail-order providers.

Missouri, joined by Kansas and Idaho, is asking the Court to:

• Block the new generic mifepristone approval,
• Restore pre-2016 safety standards,
• Enjoin the mail-order distribution of abortion drugs, and
• Stop drug manufacturers and distributors from enabling violations of state

“Every woman deserves real medical care, not a dangerous pill in a mailbox,” said Attorney General Hanaway. “Our lawsuit demands accountability from manufacturers and distributors and places women’s health above political pressure.”

The new challenge can be read here.