The Guttmacher Institute's Candace Gibson spoke with CG about how water policy — not based on evidence of environmental harm & proposed across the US — could impact abortion. That's not to say all enviro policy is bad for repro rights. In France, Belgium, even the US, it may still help protect them.
New analysis from the Guttmacher Institute suggests that anti-abortion groups and lawmakers have been working to leverage environmental regulations at the state and federal levels to monitor and potentially restrict abortion across the United States. The research and policy organization, which aims to advance sexual and reproductive health and rights, says that proposals to test wastewater for medications used in abortion care lack a basis in scientific evidence.
"Increasingly, the anti-abortion opposition is going after medication abortion," Candace Gibson, Guttmacher's director of state policy, told Climate, Gendered. "And we're seeing them engage in unconventional tactics, including subverting and weaponizing environmental policies."
According to the report, nine bills introduced this year in seven states — from Maine to Wyoming — used "environmental policies and deceptive claims about water pollution to target medication abortion."
Trace amounts of various medications may indeed be found in water supplies, as some pharmaceuticals are excreted by the human body and flushed down the toilet. Meanwhile, proposed legislation has called for wastewater testing that appears to single out medications like mifepristone and misoprostol — two drugs that can be used to end a pregnancy — despite no evidence they have any meaningful environmental impact.
"In terms of the sexual and reproductive health, rights, and justice movement here in the U.S., we're seeing these relentless attacks on abortion," Gibson said.
In their report — a draft of which was reviewed by the Center for Biological Diversity, an environmental nonprofit — Gibson and co-author Anna Bernstein also identified a Texas bill that "would have required the state to conduct quarterly testing of their wastewater treatment plants for traces of mifepristone, along with other chemical components found in certain forms of contraception and treatments for gender-affirming care."
Texas Senate Bill 1976 was introduced in March but did not advance. While not realized, Gibson noted that the bill could always be revived in Texas or pop up elsewhere.
Anti-abortion and anti-trans legislation has been circulated across state lines for years. In the U.S., the strategy to pursue water testing for mifepristone and misoprostol goes back to at least the fall of 2022, when the anti-abortion group Students for Life petitioned the Federal Drug Administration to mandate that prescribers of the medications be responsible for disposing of expelled fetal tissue as medical waste, preventing it from being flushed into septic and sewer systems.
The FDA previously found that mifepristone posed "no significant impact" in its 1996 environmental assessment, per MedPage Today. It approved another generic version of the drug just this year.
In 2022, Politico reported that SFL was working with lawmakers from at least five states in pursuit of the medical waste mandate. The outlet said it was "the culmination of years of brainstorming around how to restrict access to the pills," which many saw as the future of abortion access even before the Supreme Court's Dobbs decision that year and subsequent overturn of Roe v. Wade further fractured access across the country.
According to Gibson and Bernstein's report, "medication abortion accounted for 63% of all clinician-provided abortions in states without total bans" in 2023. The role mifepristone and misoprostol have played in sustaining access is fairly clear — anti-abortion groups, meanwhile, have seemingly sustained their attempts to use environmental regulation to restrict that access.
In October, the New York Times reported that SFL had helped organize a letter that was signed by 25 Republican members of Congress and addressed to the head of the Environmental Protection Agency on June 18. (One day prior, anti-abortion and anti-LGBTQ+ group Liberty Counsel Action announced a report entitled "Abortion in Our Water.")
The lawmakers' letter requested that the EPA respond to more than a dozen questions, including "Are there existing EPA-approved methods for detecting mifepristone and its active metabolites in water supplies? If not, what resources are needed to develop these testing methods?" Two anonymous sources told the Times that scientists directed by senior EPA officials to review at least the first of these questions told the officials "there are currently no EPA-approved methods for identifying mifepristone in wastewater — but that new methods could be developed."
The Times also spoke with legal experts concerned about the potential for such wastewater testing to be used to enforce abortion restrictions. SFL told the publication that the group's goal is not to prosecute people, but reproductive rights advocates are concerned this type of effort could have a chilling effect.
Gibson indicated that even baseless stigmatization of medication abortion could lead to further restrictions.
"If we start creating sort of this narrative, right, that medication abortion is unsafe, it's polluting the waterways, how many people will actually buy that?" Gibson posed. "If that concept becomes normalized, then you could push even more policies that further restrict care."
Politico reported this week that SFL met with the EPA's Office of Water in November, with the group saying agency representatives said SFL members could use an upcoming public comment period regarding a list of drinking water contaminants to submit thoughts about the drugs used in medication abortions. The group has since put out a call for comments on social media.
Politico indicated that mifepristone was unlikely to be added to the list — and that doing so could prompt a lawsuit against the agency.
“We have such a huge queue of emerging contaminants that we know are toxic, and we know are in our drinking water and in our fisheries,” former EPA scientist Betsy Southerland told Politico this week. “You would be replacing a known toxic chemical for a hypothetical one.”
This aligns with the Guttmacher report and with remarks from other scientists, including Jack Vanden Heuvel, who spoke with MedPage Today back in September.
"Most scientists would agree that there is no evidence that mifepristone pollution harms people, animals, or ecosystems," said Vanden Heuvel, a professor of molecular toxicology at Pennsylvania State University, adding that wastewater treatment plants are generally effective at removing the drug.
"Overall, the likelihood of appreciable mifepristone reaching surface or recycled water is considered low compared with many other pharmaceuticals," Vanden Heuvel said.
Southerland expressed a similar thought to Politico, noting that over-focusing on the unevidenced concern of medication abortions' impact on water systems could displace attention from managing known water contaminants, which might include lead, nitrates, and per- and polyfluoroalkyl substances, or PFAS.
"Even though these anti-abortion efforts are framed under environmental concern, they're not actually going after the known contaminants of water pollution, nor are they going after the harmful impacts of unsafe water that we've been seeing," Gibson told Climate, Gendered.
Already disproportionately impacted by restrictions to and surveillance of abortion pre- and post-Dobbs, communities of color, rural communities, and low-income communities also face disproportionate impacts of contaminants like PFAS.
Commonly known as "forever chemicals" for their persistence in the human body and the environment, these synthetic chemicals act as endocrine disruptors and can be found in everything from pesticides and fertilizers to household items like nonstick cookware and stain-resistant fabric. The second Trump administration has sought to roll back some PFAS drinking water limits, even though, according to the EPA, exposure to certain levels has been linked to serious health concerns, including certain cancers, reproductive issues, and low-birth weight.
It could be enough to provoke concern in anyone that environmental policies in the U.S. may be bent to harm reproductive health and rights. But, in addition to advocates fighting PFAS limit rollbacks, regulatory changes, and more, there may be another model to look to in Europe.
It was reported this summer that an estimated $9.7 million worth of European-stored contraceptives, originally purchased with American tax dollars by the U.S. Agency for International Development for distribution in low- and middle-income countries, were set for destruction. Having dismantled the agency, the U.S. government sought to incinerate the large quantity of medical supplies rather than sell them to nongovernmental organizations willing to purchase them, many of the items not set to expire for years.
With at least some of the stockpile warehoused in Belgium, reports emerged that it may be transported to France for burning. In response, members of the country's Green party wrote an open letter to Emanuel Macron in July, urging the French president to prevent the destruction and "intolerable waste." Signatory and Greens national secretary Marine Tondelier also reportedly wrote of the situation on social media, "We refuse to let France become the trash bin for American ultraconservatives." And the party, led by Mélissa Camara, called on European Commission President Ursula von der Leyen to review the legality of destroying the contraceptives, given the European Union's sustainability commitments.
Environmental and public health commitments were also at the heart of an op-ed published by legal experts in Le Monde this October, which argued that Belgium should seize and manage the stockpile.
"Under the European directive known as the Waste Framework Directive and its Flemish implementation — Materialendecreet — when a product is considered abandoned waste by its owner, in this case USAID and Chemonics, the holder, here Kuehne + Nagel [a transport and logistics company], has the legal obligation to manage and process it, to avoid any risk to human health or the environment," they wrote. "Since destruction is prohibited in Flanders for still-usable medicines, the only legal and compliant management would be to direct this stock toward humanitarian redistribution."
In early December, a spokesperson for the Flemish Minister for the Environment told Euronews that the stockpile had not been incinerated.
The fate of the highly-valued contraceptives may yet be unresolved (some reportedly now lost to improper storage) — but so are the fates of numerous environmental and climate-related policies, many of which could be used to protect sexual and reproductive health and rights.
In addition to more effective PFAS policies, legally limiting extreme heat exposure could help protect pregnant workers in the U.S. and around the world. Gender-responsive climate adaptation could help mitigate the effects of saltwater incursion on menstrual and reproductive health in coastal communities.
And as for the EPA's public comment period ahead of finalizing the agency's Sixth Unregulated Contaminant Monitoring Rule to collect data on pollutants in drinking water, that is also anticipated and should be open to anyone, though the agency seemed to miss its initial deadline for sharing the list of contaminants.
"Companies that fail to adapt … will lose market share," Emily Carey Perez de Alejo, executive director of the Maine-based watchdog group Defend Our Health, told CG.
"We are effectively trading the health of our planet and communities for misogyny," Brionté McCorkle, executive director of Georgia Conservation Voters, told CG.
"There are still questions around what causes endometriosis [...]," Julia Froese told CG. "Researching the mechanisms through which microplastics act to influence fertility can help us determine if they could have a combinatory effect when paired with other risk factors."
“ Women are the ones who understand the needs of their families and how much water is needed to manage their households," Nik Kowsar told CG. "They can teach how to manage the water to their own children."
