A study published in the New England Journal of Medicine on Jan. 23 proposed an alternative to common abortion pills. The study showed a high rate of effectiveness. Its success sparked questions about the future of reproductive healthcare in the United States. 

The paper focused on ulipristal acetate, more commonly known as Ella because of the medication’s similarity in chemical makeup  to current abortion pills. Ella is used as an emergency contraceptive, but the study concluded that it may be a viable alternative for those who cannot access mifepristone, the most commonly used agent that induces abortion. The study’s authors found that the combination of a 60 milligram oral dosage of ulipristal with 800 micrograms of buccal misoprostol successfully terminated 97% of women’s pregnancies.

Following the June 2024 overturning of Roe v. Wade, 14 states have near-total bans on mifepristone, posing a barrier to many women who need access to abortions. 

The study’s goal was to find an alternative to mifepristone to make abortion pills more accessible. “[We] did this study because not everybody has access to mifepristone,” the study’s lead co-author, Beverly Winikoff, M.D., M.P.H. said in an interview with The Urban Legend. “[Ulipristal] is very similar to mifepristone in almost every way. … It is another choice, so people who can’t get mifepristone can get [ulipristal].”

Currently, mifepristone is used in about 98% of medication abortions, with an efficacy of 99%. It works by blocking progesterone, a hormone necessary for pregnancy, causing the lining of the uterus to break down, leading to termination of the pregnancy. 

Since the 2024 U.S. general election, the Republican party has controlled both houses of Congress and has six out of nine Supreme Court seats. While President Donald Trump himself has held ambiguous positions on abortion, much of his party and staff have worked on anti-abortion projects in the past. 

Students expressed anger and fear about current and future restrictions.“I’m just scared that we are backpedaling with women’s rights in general, and we will be able to see these impacts in the near future,” Sofia Gitelman ’26 said.

Kai Maufe ’26 shared similar concerns. “I think it’s really scary that women are losing the right to have autonomy over their own bodies,” he said.

Ulipristal is an option that could challenge state and federal authorities that regulate reproductive healthcare. “If there are two kinds of pills, people [can share] or mail them. So [having] another source is a little bit better than just one pill you have to use in a certain way,” Winikoff said. “At least there’s a chance of another way of getting a good, safe [solution] to a patient.”

It also provides an additional safeguard against possible future legal regulations. “A new abortion pill can give women more freedom with their bodies,” Olivia Prime ’27 said. “If a pill helps support that, then it should be passed, especially to resist legal regulations that Trump has made.”

However, ulipristal may face complications. “That would be a commercial decision of the people who own this. … It has to come from the company to make it a real thing. Then they would have to give the FDA data to show that it can be used in this way,” Winikoff said. “[And] given the people who are going to be running the country in the [next] few years, it may be very hard to get a label for this as an abortion [pill].”

A New York Times article highlighted concerns that marketing ulipristal as an abortion pill could create a backlash against its use as an emergency contraceptive or against contraceptives in general. “It’s going to put wind in the sails of abortion opponents who have been saying things like contraceptives can be abortifacients,” said Mary Ziegler, an abortion expert and law professor at the University of California, Davis, in an NYT interview.

If medicines like ulipristal are not approved outright, it could lead people to riskier and potentially illegal alternatives, according to pro-abortion activists. “People have [reproductive healthcare] needs, and those needs need to be filled,” Winikoff said. “And if you don’t fill them in a good way, people will go around anyway and find something else.”