“The Biden administration’s mail-order abortion policy poses a grave threat to the health and safety of American women,” Hawley wrote, citing studies that show one in 10 women who use mifepristone experience serious complications such as infection or hemorrhaging.

The Missouri senator also emphasized his home state’s litigation, which, alongside Idaho and Kansas, seeks to roll back federal rules enabling the distribution of abortion pills without in-person doctor visits or follow-up care.

DOJ lawyers revealed in a court filing Monday that the Trump administration’s DOJ is preparing to defend the FDA’s authority at least partially, arguing that the three GOP-led states lack standing to bring the lawsuit in Texas federal court.

The Justice Department has taken no position on the merits of mifepristone’s approval but contends that the states’ claims are procedurally flawed and should be dismissed.

This approach has drawn sharp criticism from prominent anti-abortion leaders, who warn the administration risks leaving in place dangerous Biden-era policies.

Kristen Waggoner, president and CEO of Alliance Defending Freedom, told the Washington Examiner that “the Trump admin should reverse the Biden FDA’s politically motivated decision to create a nationwide mail-order abortion drug regime. This reckless action has threatened women’s health, sending countless women to the emergency room for abortion drug complications.”

Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, similarly emphasized that the core issue is not merely legal standing but public safety.

“Real-world data proves common sense: these drugs are dangerous,” she said. “At a minimum, the Trump administration should reverse the Biden FDA’s reckless nationwide mail-order abortion drug policy. Women and girls deserve better than high-risk drugs with no in-person doctor, no follow-up, and no accountability. This isn’t health care, it’s harm.”

The legal battle comes as anti-abortion advocates have focused heavily on restricting mifepristone access following the Supreme Court’s 2022 Dobbs decision overturning Roe v. Wade.

Recent research from the Ethics and Public Policy Center found the real-world complication rate from mifepristone is roughly “22 times” higher than FDA estimates, with nearly 11% of women experiencing potentially life-threatening complications within 45 days of use.

Trump has sought to balance taking credit for overturning Roe v. Wade, with the help of his three appointees to the Supreme Court, while avoiding political backlash from suburban voters.

While Trump has framed abortion as a state issue since the 2024 race, during which he avoided calls for a national abortion ban and supported access to in vitro fertilization, his administration faces mounting demands from conservative allies to crack down on the Biden-era abortion pill policies through federal action.

Hawley’s letter to Bondi and recent statements from anti-abortion groups reflect intensifying pressure on the Trump administration to pivot from the DOJ’s current litigation strategy and actively work to undo Biden’s expanded access to the pills, including by increasing federal safety requirements on abortion drugs.

TRUMP DOJ TO DEFEND BIDEN ABORTION PILL RULES

“Missouri’s litigation aims to reverse that policy and protect women,” Hawley wrote. “I strongly urge you to reconsider the Justice Department’s defense of this policy in court.”

A spokesperson for the DOJ declined to comment.