When recent U.S. cases come into focus, the argument for restoring stronger safeguards around the abortion pill is no longer abstract — it becomes urgent and practical. There have been at least three disturbing incidents in 2024 alone — a Toledo doctor accused of secretly administering mifepristone and misoprostol to his girlfriend, a North Texas man charged with allegedly slipping “Plan C” into a partner’s drink, and a Massachusetts man accused of misleading a woman into taking pills that ended her pregnancy— show how easy it can be for a third party to obtain abortion pills and give to a woman unknowingly or by force. The Toledo matter, because it happened in our state and involves a physician alleged to have misused medical access and personal data, is particularly stark.
These cases share a common and avoidable mechanism: someone other than the pregnant woman obtains abortion pills — most likely online or through mail-order channels — and then administers it to her without informed consent or by force. Easy access and anonymity can combine to make such wrongdoing feasible: online teleprescribing, shipment by mail, and the removal of in-person requirements that once guaranteed a direct patient–provider encounter.
Policy choices have made a difference. Mifepristone was first approved with a REMS (Risk Evaluation and Mitigation Strategy) that included strict dispensing controls. Over the last decade, however, those safeguards were relaxed (most notably the in-person follow-up in 2016 and the in-person dispensing requirement in 2021) — changes the FDA said were based on safety data and access concerns. Those same policy shifts expanded the pathways by which medication can be obtained remotely and delivered, creating more opportunities for misuse. In 2025, the FDA no longer recommends the ability to access mifepristone online, but that has not yet changed the laws.
Beyond the criminal episodes, there is evidence that pressure and coercion in abortion decisions are common. Large surveys and analyses — including work compiled by the Lozier Institute — report that nearly 70% of women who have abortions felt pressured or coerced, and that such pressure correlates with worse emotional and mental-health outcomes later on. That research does not prove causation in any given case, but it does show that coercion is not rare and must be taken seriously when designing safeguards.
From a Catholic moral perspective, abortion is a grave wrong because it ends an innocent human life. Even leaving that conviction aside, any policy must at least prioritize the safety of women. Restoring key elements of the original REMS — including an in-person clinician assessment or other robust verification that the patient is consenting and informed, and tighter controls on who may obtain and dispense mifepristone — would reduce the practical ability of bad actors to weaponize the abortion pill against women and their unborn children. It is the least we can do to protect the vulnerable, to limit opportunities for abuse, and to ensure that every woman’s choice is truly hers.
We cannot know how many cases were never reported and presumed to be miscarriages, but it seems likely there were many. Still, the known incidents alone should be enough to prompt a cautious public-health posture: when a drug can be used covertly to end a pregnancy, it makes sense to require clearer verification, closer clinician contact, and more careful tracking of dispensing. Restoring sensible REMS protections is not an attack on women’s rights; it is a sensible step to ensure safety, consent, and the protection of life.