Opinion piece penned by Case Dixon and published by 1819 News
President Donald Trump’s first administration was repeatedly described by allies and supporters as “the most pro-life administration in history.” That claim helped mobilize millions of voters in 2024 who believed his second presidency would continue a decisive break from decades of federal indifference, or outright hostility, toward unborn life.
Words, however, are not policy. Today, on one of the most consequential pro-life issues in modern America, the record tells a far more complicated story.
Mifepristone, the abortion drug used in more than half of abortions nationwide, remains widely available, increasingly detached from in-person medical oversight, and protected by regulatory decisions that could be revisited but have not been. If this administration intends to meet the expectations of the pro-life voters who put their trust in it, far greater urgency and clarity are needed.
First, the uncomfortable truth: the FDA approved the first generic version of mifepristone in 2019 under the Trump administration, followed by another generic approval in late September.
Supporters will argue, correctly, that generic approvals are often routine FDA actions governed by statute. But routine does not mean neutral. Any decision that increases access to an abortion drug is not pro-life in effect, regardless of how bureaucratic the justification may be. Resisting regulatory momentum is always on the table.
Second, the Biden administration’s removal of the in-person doctor-visit requirement for Mifepristone remains in place.
Under President Joe Biden, the FDA eliminated the long-standing rule requiring women to receive the drug in person from a physician, opening the door to telehealth prescribing and mail-order abortion pills. That shift fundamentally altered the abortion landscape, reducing medical safeguards, severing the doctor-patient relationship, and making enforcement of state abortion laws significantly more difficult.
That decision was not made by Congress. It was made by regulators. And what regulators do, regulators have the authority to undo.
A Trump administration could reinstate in-person dispensing requirements through lawful administrative processes. Doing so would require political will, regulatory discipline, and the willingness to withstand inevitable legal challenges. What it does not require is new legislation or constitutional amendments.
At a minimum, mifepristone should not be available through the mail in ways that deliberately circumvent state law. Ideally, it should be removed from the market entirely. But if federal regulators refuse to take that step, restoring in-person requirements is the least they can do to ensure basic oversight and respect for laws enacted by the states.
Yet so far, those levers have gone largely untouched.
Third, and perhaps most troubling, is the widespread perception that the administration’s review of Mifepristone is being slow-walked.
Multiple reports indicate that a long-promised FDA safety review has been delayed, with critics alleging it has been postponed for political convenience rather than scientific necessity. The administration denies this, insisting the review must be thorough and methodical.
I believe the delay is intentional. Whether acknowledged publicly or not, it appears to be designed to push off any meaningful action until after the midterm elections, avoiding a political fight that could complicate Republican electoral prospects.
Waiting until after the midterms may make political sense. But it does not make moral sense. And it certainly does not save lives.
Every moment of delay means more unborn lives lost through chemical abortion. Choosing to wait may be safer politically, but it is not neutral. It is a decision that allows preventable deaths to continue in the meantime.
No serious person disputes that science takes time. But when delay becomes a strategy rather than a necessity, it is no longer caution. A review that never concludes is functionally indistinguishable from a decision not to act.
This matters because mifepristone is not an abstract policy question. It is the centerpiece of a post-Roe abortion regime where pills, not clinics, are the front line. It is how abortion access is expanding even in states like Alabama that have enacted strong pro-life laws. And it is where federal regulators still wield immense power.
Despite all of this, we cannot ignore that Trump did appoint judges who ultimately overturned Roe v. Wade. That achievement reshaped constitutional law and deserves recognition.
But while Dobbs returned abortion policy to the people and their elected representatives, it did not absolve the executive branch of responsibility. A pro-life administration cannot outsource its moral obligations entirely to the courts.
If the White House wants to claim the mantle of the most pro-life administration in history, it must be willing to act like it. That means confronting mifepristone directly, not regulating around it. An administration serious about protecting unborn life would seek to pull the drug from the market entirely. At the very least, it must immediately require in-person dispensing so federal policy is no longer used to circumvent state abortion bans. Continuing to delay while unborn lives are lost is a choice.
History will not judge this administration by its slogans. It will judge it by whether, when given the chance to act, it chose conviction over convenience.
Case Dixon is a Licensed Physical Therapist Assistant and Republican candidate for U.S. Congress in Alabama’s 6th District.
