Are abortion pills harming the environment?

by Monica Snyder

Note: In this post I talk a lot about miscarriage and what happens to miscarried remains. If your history or heart aren’t up for that, you may want to skip this one.

Background

In March 2025 a bill to require abortion pill providers to provide “catch kits” and medical waste bags to patients failed in Montana on a tied vote. The bill is one of a series proposed across multiple states claiming to address the potential harm of mifepristone (part of the standard abortion pill regimen) going into wastewater.

In the last few years, the proportion of abortions done via pills and via telemedicine has risen dramatically. Some pro-lifers argue that the FDA and other standard-setting bodies have not properly examined the environmental impacts of unprecedented amounts of mifepristone going into our water systems. Some further argue that potential harmful environmental impacts are reasons to legislate changes in how abortion pills are distributed, specifically including collecting and returning embryonic and fetal remains from at-home abortions to facilities that will handle them as medical waste. I’m going to call arguments like this the “environmental hazard” approach to abortion pills.

I’ve heard proponents of the environmental hazard approach make one of two arguments: at-home abortions via pills are dangerous to the environment because either

1. human remains, or

2. mifepristone

are going into our wastewater and the environment.

Human remains in our wastewater

In this form, environmental hazard proponents argue that it’s dangerous for women to expel embryos, placenta, and related pregnancy tissues into the sewer system.

The proponents of this idea I’ve spoken with have not argued narrowly that the remains of more developed children at later gestational ages are a hazard. Their assertions have been broader: that even embryonic remains at earlier gestational ages can pose an environmental threat. (As an example, see the section “Wastewater Treatment Plants Do Not Remove All Pharmaceutical Contaminants and Are Not Meant to Process Fetal Remains” here.)

Is this argument true?

It’s a strange claim to make, because millions of women have miscarried embryos and related tissue into toilets for decades. From the perspective of wastewater treatment and management, these are biodegradable liquids and tissues, similar to feces, urine, and menstrual blood and tissue. And they are removed from treated water to the same extent and in the same ways. As far as I can tell, proponents of the environmental hazard approach have offered no evidence to the contrary.

Is the framing appropriate?

Some proponents of the environmental hazard approach explain what happens to flushed embryonic remains with graphic descriptions, and politicians proposing related legislation use condemning language. For example, in a statement to Politico, Virginia Rep. Bob Good called the flushing of fetal remains “reckless” and a “disgusting practice.”

As is often an issue in the abortion debate, the people making these statements are thinking about abortion specifically. But their statements also apply to miscarriage, and I wish they’d think about that a little bit more.

There continues to be a cultural silence around miscarriage, which means, among other problems, that many people experiencing miscarriage have no idea what to expect. Losing your prenatal child in a toilet is often a shocking, confusing, and traumatic experience, but unfortunately it’s not at all an uncommon one. Pregnancy loss groups sometimes address this, trying to help people heal and forgive themselves if they “flushed.” Comments under this post illustrate the heartbreak:

I had 2 miscarriages that I had to flush the toilet! It was the hardest decision I had to make. I sat next to the toilet until I was ready. Thank you for posting this!

Thank you for this. I was a confused and scared 18 year old the first time this happened and I recall that moment clearly. I didn’t know what I should do.

Thank you for saying this. This was one of the most difficult things I’ve ever done. I replayed that moment for a long time afterwards. Took me a long time to be okay.

If I thought it were true that embryonic remains were harming our wastewater or environment, I’d understand the necessity of speaking hard truths even though they cause emotional distress. (I’d note, though, even then there are better and worse ways to communicate hard truths.) But there appears to be no evidence that embryonic remains are a threat to the wastewater, which would mean this argument is both harmful and false.

Mifepristone in our wastewater

In this form, environmental hazard proponents make a more specific argument: that the danger is only those aborted embryos (and placenta and related pregnancy tissues) tainted with mifepristone.

Is proposed legislation is internally consistent?

A few points:

• Mifepristone is increasingly used to manage missed and incomplete miscarriage.

• Mifepristone is also used to manage Cushing’s disease starting at 300mg/day but can increase to 1200mg/day, taken indefinitely. This is far more than the 400mg total recommended in the abortion pill protocol. Estimates vary, but it’s possible that more mifepristone is going into the water due to management of a few thousand people with Cushing’s than due to at-home abortions.

• Mifepristone is primarily excreted through feces and urine (“83% of the drug has been accounted for by the feces and 9% by the urine”). If the primary concern is the environment, it seems legislation would focus on stool or urine collection rather than collecting only embryonic and fetal remains.

Legislation meant to minimize mifepristone in our waters would presumably address all major sources of mifepristone, rather than only mifepristone found in aborted embryonic and fetal remains.

What about the remains of miscarried children?

Proponents of environmental hazard legislation have suggested that their efforts will not apply to people enduring miscarriage. First they argue that miscarried remains won’t contain mifepristone. As mentioned above, this is not always true. They also suggest that most women experience miscarriage in a medical setting, and that miscarriages are too unpredictable to require catch kits.

These two claims contradict each other. Unpredictable miscarriages mean many women miscarry without being able to first get to a medical setting. Many women miscarry in our bathrooms at home, at work, or in other non-medical places.

At the same time, not all miscarriages are so unpredictable. Threatened, incomplete, and missed miscarriages can all take more time. But these circumstances also don’t necessarily mean a woman will miscarry in a medical setting. It’s common for women to go to an ER in the midst of a miscarriage, and once the medical team examines her, they tell her she is not in danger and discharge her to complete her miscarriage at home (or work or wherever she ends up when it actually resolves).

Women experiencing these types of miscarriages—that have some forewarning—sometimes do take the opportunity to obtain catch kits in the hopes of retaining the remains for cremation, burial, and grieving processes. (Many women don’t realize this is even an option, and it’s common for medical teams to leave women entirely unprepared about what to expect physically and emotionally as we miscarry.)

To my knowledge, environmental hazard proponents have not addressed whether a woman taking mifepristone to manage an incomplete or missed miscarriage would be required to return the remains of her child in a biohazard bag to a facility to be incinerated as medical waste. Speaking as a mother who has had two miscarriages, and who went through considerable effort to retain the remains of one of our lost children, I find this prospect cruel and entirely unacceptable.

What did the FDA calculate?

In January 2025 the FDA published a letter explaining in some detail the environmental assessment already conducted on mifepristone and the reasoning behind their conclusions. They used very conservative assumptions combined with the current rates of mifepristone use (significantly higher than decades past) to calculate a sort of worst-case scenario of the amount of mifepristone that would go into the environment. Specifically they assumed:

• all mifepristone produced would actually be used

• there would be even distribution throughout the United States

• none of the mifepristone would be metabolized by the human body, and

• none of it would be depleted or removed through normal waste treatment processes.

Even under these unrealistic assumptions, the FDA calculated that the amount of mifepristone excreted by patients would result in less than 1 part per billion (ppb) in the aquatic environment. In other words, they argue, it still wouldn’t be enough mifepristone to be any danger.

Should the EPA test the waters anyway?

Those concerned with the potential environmental hazard of abortion pills argue that predictions based on calculations aren’t enough—the Environmental Protection Agency should conduct actual tests of the water to confirm.

Given finite resources, the EPA doesn’t test for all known contaminant in our waters. Instead it chooses which contaminants should be monitored or regulated based on

1. how likely a contaminant is to cause health problems at the levels calculated in drinking water,

2. how often the contaminant appears in water systems, and

3. how cost-effective it is to detect and remove the contaminant.

Conservative calculations suggest that mifepristone is very unlikely to cause health problems at current levels. However, given the politicization of abortion pills, I understand a deep skepticism of our current political and cultural institutions to faithfully monitor mifepristone. I’m not convinced there’s enough evidence of a threat to require testing the waters, but I still wouldn’t mind if the EPA chose to do so anyway, as added reassurance.

Our society does not have consistent protocols or training for medical professionals regarding compassionate options for disposition of embryonic and fetal remains after pregnancy loss. At Secular Pro-Life, we’ve written a proposed hospital protocol to address this gap. Consider contacting your local healthcare providers to ask if they have such a protocol and, if not, if you could speak with someone about getting a protocol in place.

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This article was originally published on July 18, 2025 at secularprolife.org.