Prof. Jessie Hill: Legal Battle Over Mifepristone

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): The Good Men Project

Publication Date (yyyy/mm/dd): 2025/06/27

Jessie Hill, Judge Ben C. Green Professor of Law at Case Western Reserve University, about the lawsuit challenging FDA approval of Mifepristone. Hill explains that both the Biden and Trump administrations seek dismissal on procedural grounds—standing and improper venue—without contesting the drug’s safety or effectiveness. Anti‑abortion physicians and intervening states aim to pull or heavily restrict Mifepristone because telehealth distribution undercuts state abortion bans after Dobbs. The case typifies a broader post‑Roe strategy to curtail reproductive freedom by attacking medication abortion and reviving tools like the nineteenth‑century Comstock Act. Hill warns that success could let ideologues weaponize courts against any FDA‑approved medicine, from vaccines to contraception. She argues resistance must pivot from top‑down federal litigation to state‑driven coalitions linking lawyers, clinicians, grassroots organizers, and supportive faith groups. A district ruling on the motion to dismiss is expected within weeks, yet appellate battles could drag on for years.

Scott Douglas Jacobsen: Today, we are here with Jessie Hill, JD, the Judge Ben C. Green Professor of Law at Case Western Reserve University School of Law. She is a leading expert in constitutional law, civil rights, reproductive rights, and law and religion. She currently serves as the Director of the Reproductive Rights Law Initiative at the university. Previously, she served as the Associate Dean for Research and Faculty Development.

Professor Hill joined the Case Western Reserve University faculty in 2003. Before entering academia, she practiced First Amendment and civil rights law in Cleveland and worked at the ACLU’s Reproductive Freedom Project in New York. She also clerked for Judge Karen Nelson Moore of the United States Court of Appeals for the Sixth Circuit. Professor Hill is a prominent legal voice in debates surrounding reproductive freedom and constitutional protections.

Thank you for joining me today. Let us begin with the Trump administration’s request to dismiss the lawsuit, which challenges access to Mifepristone. What are the legal grounds for that request?

Jessie Hill: The Trump administration’s reply brief relies entirely on procedural grounds. It argues that the plaintiffs, who at that point in the case were state governments, lack standing, meaning they are not the appropriate parties to bring the case. It also contends that the case was filed in an improper venue, another technical procedural issue. These are threshold defences—they do not address the substantive merits of the case, such as whether the FDA acted appropriately or based its decisions on solid evidence.

Jacobsen: When you refer to procedural grounds, what would be considered substantive grounds, and how do the two differ?

Hill: That is a great question. Let me give a small quantity of context first. This reply brief was filed to support a motion to dismiss, which is typically focused on procedural issues. In this case, the Biden administration had previously filed a brief arguing that the lawsuit should be dismissed for lack of standing and improper venue. The plaintiffs then responded, opposing the motion. The Trump administration filed a reply brief that aligned with the Biden administration’s position on these procedural matters.

Because this case was in its early stages, it is not unusual for the legal arguments to focus on procedural thresholds, such as whether the right parties brought the case or whether the Court has jurisdiction. These are common early-stage arguments.

In contrast, a substantive defence would focus on the underlying legal and factual basis for the FDA’s actions, arguing, for example, that the FDA had a sound evidentiary and scientific basis for approving Mifepristone and modifying the conditions under which it could be prescribed and dispensed.

So when I say “procedural,” I mean the arguments relate to legal processes, jurisdiction, and plaintiff qualifications. When I say “substantive,” I mean arguments about the case’s merits—the evidence, the law, and whether the government followed proper decision-making standards.

Again, it is unsurprising that the administration focused on procedural defences at this stage. Courts typically resolve these threshold issues before allowing a case to proceed to substantive adjudication.

Jacobsen: How does this case fit into the broader legal and political strategy to restrict abortion access on narrow grounds, but also to limit reproductive rights access more broadly? So, I am taking “reproductive rights” as more abstract, but I could also rephrase that as something more concrete, like reproductive health care access.

Hill: Yes, right. You may be aware that this case already has some history.

It was initially filed in 2022 by a group of anti-abortion physicians. They aimed to pull Mifepristone—the medication used for medication abortions—completely off the market. That was their initial request to the Court. If the plaintiffs had succeeded, this case could be a complete game changer—a bombshell.

Moreover, I say that for a couple of reasons. First, Mifepristone has become incredibly important in abortion care. It now accounts for the majority of abortions performed in the United States. Many people rely on the availability of this medication as their preferred method for early abortion.

It became even more critical after Dobbs, because it can be prescribed via telehealth and provided through the mail. It allows people in states that have banned or heavily restricted abortion to still access care. That access would be much more difficult if patients had to go into a clinic, lie down on an exam table, and undergo an in-person procedural abortion. So, Mifepristone provides a more accessible option, which greatly matters in the post-Dobbs landscape.

Also, Mifepristone is not used only for abortion. It is also used in reproductive health care more broadly, such as for managing miscarriages. It is used when someone is experiencing a miscarriage to help complete the process and avoid complications. So, its medical role is broader than just abortion access.

Now, I can get into the nitty-gritty of the case if you would like, but the bigger picture is this: for those who want to see abortion banned nationwide, targeting Mifepristone has become a key strategy. That is the central focus for many of these anti-abortion advocates, because Mifepristone has made abortion so much more accessible since its approval by the FDA.

Over the years, the FDA has lifted several restrictions on the drug, making it harder for opponents to limit its distribution. As long as Mifepristone is approved and available, abortion in the U.S. cannot be eliminated. That is why they see this as the necessary legal avenue.

Jacobsen: Now, based on the stated motivations of those bringing this legal challenge—rather than inferred ones—it seems the goal is to stop not only abortions but also access to the surrounding reproductive health care. What distinction are you making when it comes to miscarriage care? Or did I miss something?

Hill: Yes, sure. So, anti-abortion groups—or as they would phrase it, “pro-life” groups—are evident in their language: they want to stop access to abortion because they believe that abortion is killing a baby. That is the core of their moral and legal position.

However, the legal implications of restricting Mifepristone go beyond abortion alone. If the drug were removed from the market, it would also impact miscarriage care, because the same medication is used in both contexts. So the effect of their strategy is not only to restrict elective abortions but also to limit access to standard care for miscarriages, which affects a broad group of people, often in emotionally or physically vulnerable situations.

Jacobsen: That is the stated reason. Based on demographics, you can infer that much of the reasoning is grounded in some form of theology. So, that is one distinction in your answer—the difference between stated and inferred motives. However, focusing on the more concrete issue of stated motive, what is the reason for restricting mifepristone access?

Hill: You are right. I was speaking more broadly, looking back at the larger political context. However, if we focus on this particular case, it is interesting.

The original group that brought the lawsuit was composed of physicians, individuals, and an association that opposes abortion. They claimed they were seeking either to remove Mifepristone from the market entirely or to reimpose significant restrictions on its use. Their stated reason was that Mifepristone is unsafe and that patients are experiencing too many complications. On that basis, they argued that the FDA should be forced to reconsider its approval and withdraw or restrict the drug.

Interestingly, and I do not know how closely you have followed the legal developments, this case went to the U.S. Supreme Court. The Court ultimately found that the original plaintiffs lacked standing. That is, they were not the appropriate parties to bring the lawsuit because they failed to demonstrate a concrete injury caused by the drug’s availability. As a result, the Court sent the case back.

While that was happening, several states—Missouri, Idaho, and Kansas, among others—intervened in the case to keep it alive. Their stated concern was different from the original one. They argue that while they are trying to ban or restrict abortion within their borders, the widespread availability of Mifepristone, especially the ability to receive it by mail or obtain it through telehealth, makes it too easy for people in their states to access the drug, effectively undermining their laws.

For example, even when Missouri had a near-total abortion ban, people were still receiving Mifepristone shipments into the state. Because the drug can be prescribed remotely and mailed, it bypasses in-person restrictions and undermines state-level prohibitions.

They also raise safety concerns, similar to those of the original plaintiffs, claiming that their citizens are experiencing complications after using the medication. However, their added legal concern is state sovereignty—their inability to enforce state laws effectively because of the federal regulatory regime, which permits access to Mifepristone under broader conditions.

So their core argument now is that federal policy is making it impossible for them to enforce their abortion laws.

Jacobsen: So the fundamental issue, then, becomes not only access to abortion, but also the ability of states to control access to medication that they oppose, especially in light of federal rules permitting it.

Compared to other countries—wealthy industrialized nations with functioning health care systems—the U.S. stands apart. The costs are higher, and the outcomes are worse. By some estimates, Americans pay twice as much for half the health outcomes, which is a fourfold inefficiency.

In many comparable countries, even where people may hold personal or religious objections to abortion, human rights frameworks still ensure access to reproductive health care, including abortion. There seems to be a more explicit commitment to public health over ideological enforcement.

Hill: Yes, exactly. In many other countries, even when abortion is contested morally or theologically, access to health care remains protected as a matter of individual rights and public health policy. In the U.S., however, we often see ideological debates driving health care restrictions in ways that are out of step with evidence-based medicine and international human rights norms.

Jacobsen: Mifepristone—or any other reproductive health care service—is available. If someone has a theological or other objection to using Mifepristone, or to the broader conversation around reproductive health care and rights, they do not have to use it. The point is ensuring availability for those who need or want it. It is a health care service.

There are many things people pay taxes for that they may not personally use or support. However, the principle is access. So, when you conduct a comparative legal analysis, how does the United States compare to similar countries?

Hill: Yes. That is one of the stark differences. First, we must recognize that the United States has a fundamentally different health care system from most industrialized countries.

In the U.S., there are federal and state laws that restrict the use of public insurance, like Medicaid, to pay for abortion services. Under the Hyde Amendment, for example, federal funds cannot be used for abortion except in minimal cases—rape, incest, or when the life of the pregnant person is at risk. Some states apply even tighter restrictions.

By contrast, in many Western European countries, abortion is either covered by public health systems or available with minimal out-of-pocket costs. While some private insurance exists in those countries, the state typically ensures access, and the process is often faster and simpler.

That said, there is some irony in the comparison. In many European countries, abortion access is cut off earlier, often around 15 or 16 weeks of pregnancy, into the early second trimester. In the U.S., in many states, abortion is legally permitted until 22 to 24 weeks, which seems more permissive on paper.

However, here is the paradox: although the gestational limits in the U.S. are longer, access is more functionally limited, especially for low-income people or those living in restrictive states. Lack of funding, waiting periods, mandatory counselling, clinic closures, and travel requirements delay access. As a result, some people end up having abortions later in pregnancy simply because it takes them time to arrange logistics, childcare, transportation, and money.

So, in short, the U.S. might seem more permissive in legal terms, but it is often more restrictive in practical terms.

Jacobsen: And of course, everything is now governed state by state. Since Dobbs, it is a legal patchwork. Each state sets its own rules, and many conflict with federal guidance and even with each other. This has created confusion and uneven access across the country. So, with that in mind, how is this case reflective of broader efforts we have seen since 2022—living now in a Dobbs and post-Roe world?

Hill: This case is emblematic of the fact that we are now in a post-Roe, Dobbs legal reality.

For decades, Roe v. Wade provided a nationwide constitutional right to abortion. For a long time, overturning Roe was a key goal of social and political conservatives. With the Dobbs v. Jackson Women’s Health Organization decision in 2022, that goal was achieved—the Supreme Court overturned Roe, eliminating the federal constitutional right to abortion.

Now, what we are seeing is a multi-pronged strategy to continue restricting abortion access—not just through direct bans, but also through regulatory frameworks, like this attack on Mifepristone, that seek to make legal access effectively meaningless.

This case is part of that broader Dobbs legal strategy: if abortion cannot be banned outright everywhere, then make it as inaccessible as possible, including by targeting medication abortion, which is currently the most common method of abortion in the U.S.

What Dobbs meant—and what everyone in the legal world understood it to mean—was that it would return abortion policy to the individual states. Each state could decide for itself: ban abortion, allow it, impose some restrictions, or create broader protections. Whatever policy a state wanted to implement now had the authority to do so.

However, once that longstanding goal was realized with the Dobbs decision, it quickly became clear that returning abortion to the states was never the endpoint for many of the conservatives who had pushed to overturn Roe. The fundamental aim was, and continues to be, a nationwide ban on abortion—no abortion, of any kind, anywhere in the U.S.

The fact that this lawsuit was filed in fall 2022, just a few months after the Dobbs ruling, is a strong indicator of that deeper strategy. The original plaintiffs sought to remove Mifepristone from the market entirely. Had they succeeded, it would have devastated abortion access, especially in states where abortion is already banned, but people are still receiving medication abortion by mail. Everyone knows that is happening. So this legal effort essentially said: The only way to ban abortion nationwide is to stop the mailing of these medications, and that is precisely what they are trying to do.

It was also made clear in Project 2025—you are probably familiar with it—that restricting access to medication abortion is a central part of the roadmap toward a nationwide abortion ban. That document outlines strategies for a potential future conservative administration, and yes, it includes specific proposals to curtail medication abortion access.

Jacobsen: Yes. I am part of the humanist community, and we often hear about Project 2025 through American humanist networks. Given your work, I assume you’re following U.S. politics closely. Two quiet, almost ubiquitous assumptions are embedded in many of these conversations.

The first is often unspoken but becomes evident if you pause and reflect: the politicization of women’s bodies. On the left, this issue is typically framed in terms of “choice”—but that term can feel a bit highfalutin or abstract. That may sound radical, but what I mean is this: choice is often a secondary concept to something far more visceral—the reality of pregnancy, of responsibility, of autonomy over one’s body.

So, while conservatives may approach the issue with visceral reactions around “life” and “the unborn,” it’s also important to recognize that on the other side, there’s a deeply embodied experience of control over one’s own life and future. This makes the issue inherently political, not just moral or religious, mainly because the battleground is the female body.

It reframes the whole conversation across North America. And Canada, of course, is quite different. Because of Dr. Henry Morgentaler, the founder of Humanist Canada, abortion was decriminalized here. But we’re in a peculiar and precarious position: We don’t have a law against abortion, and we don’t have a law for it either. It exists in a legal vacuum, protected through case law but without codified legislation.

Hill: Yes, Canada’s legal structure on abortion is unique. The absence of a criminal law regulating abortion provides de facto broad access, but it also means a federal statute does not guarantee access. That creates a vulnerability, especially if the political climate ever shifts. It contrasts the U.S., where the legal terrain is over-regulated and constantly moving, now even more so in the wake of Dobbs.

Jacobsen: We do not—there is a penury of law around this. 

Hill: Yes. That’s what we are doing—trying to clarify this vacuum. 

Jacobsen: Then there’s the second point, which is rarely discussed but essential to avoid a one-sided framing. We need to make this multi-sided, not just binary, especially in the context of gender, autonomy, and reproductive responsibility.

If people do not want to give the option of abortion, then where is the option of vasectomy being promoted? This is not just a one-person issue—we are talking about the next generation, about reproductive systems that involve more than one person.

Who are these women supposedly having all these abortions? That question implies others are involved—men. So why is there so little public or legal conversation about male responsibility in reproductive matters? Not just nationwide, but even within jurisdictions, are there any legal or policy conversations that address this imbalance?

Hill: I have to say—only ironically, and even then, not seriously. There have been bills proposed by Democrats in some conservative state legislatures, largely satirical or symbolic, intended to make a point. One was called something like the “Responsible Ejaculation Act”—meant to show the absurdity of regulating men’s reproductive health in the same way that women’s reproductive rights are regulated.

Some of these proposals reference biblical passages—for example, the prohibition on “spilling seed”—and even lean into the cultural absurdity captured in things like Monty Python’s “Every Sperm is Sacred.” The bills would propose things like mandatory waiting periods, counselling, or restrictions on vasectomies, but again, these are introduced ironically to expose the hypocrisy. They never intend to become law and never go anywhere legislatively.

But yes, your point is valid. Part of this debate touches on the religious dimension of many of these laws, which is a significant factor. But even more broadly, we are seeing a push toward traditional gender ideology in the U.S.

This fits into a bigger narrative—again, it shows up in Project 2025. That initiative tries to mythologize the past, fabricate an idealized vision of traditional family and gender roles, and project it onto the future as a political blueprint. It is not grounded in reality but used to score ideological points.

Jacobsen: Absolutely. And the current political movement is also driving pronatalism—you have likely heard the term. It is not about responsibility or encouraging birth control. It is about increasing birth rates among specific populations—promoting the idea that Americans, often coded in racial terms, need to have more babies.

“Make more Americans”—that is the underlying directive. You hear echoes of it in the rhetoric: blonde hair, blue eyes, fair skin. That’s the subtext. There is a racialized and nationalist overtone that cannot be ignored.

I remember talking with someone from the L. Ron Hubbard Foundation once. I later realized he was a Scientologist. The L. Ron Hubbard Foundation came later. I had to pause and collect myself. Because it is the same with people like Elon Musk, who is vocally anti-abortion, yet has many children, some with different women. Or someone like Pavel Durov, who is reportedly the father of over a hundred children and runs a tech company. 

So, Pavel Durov, the Russian-born tech entrepreneur known as the founder and CEO of Telegram, an encrypted messaging platform with over one billion users as of 2025, was arrested in France in 2024 on charges related to alleged criminal activity on Telegram. That incident sparked significant debate over platform accountability.

Now, Durov has also publicly claimed to be the biological father of over 100 children, attributing this to extensive sperm donations over the past fifteen years. He said it began with a friend’s request and continued as a personal initiative. All that’s accurate and fine. That kind of sentiment does exist in some conversations about demographics and fertility.

Of course, you know all the simultaneous efforts to restrict immigration. Except, of course, not if the immigrants are persecuted Afrikaners in South Africa, right? Then those individuals are somehow the exception. So the message becomes mixed: Do we need more people, or don’t we? The rhetoric says we need more people, but only certain people. It is coded, often racially.

I analyzed the UN’s demographic data, and fewer than 50 countries are experiencing a population decline. Around 60 countries are stagnant, meaning their populations are neither growing nor shrinking significantly. The other ~93 countries are experiencing population growth.

This excludes places like the Holy See and Gaza. Gaza is clearly in a humanitarian crisis. The Holy See is functionally an intellectual retirement community, with a small, older, celibate population. So, the global population panic is mostly false. Based on current UN projections, the world population will peak around 2080. That’s a long horizon.

The core argument remains: The panic is unfounded. When you look closely at which countries are highlighted—China, Japan, South Korea—or the fixation on European and Anglophone nations, there is an unspoken emphasis on nations perceived as majority-white.

So, this is not a demography conversation—it is a sociopolitical conversation, often with racialized undertones. And even the concept of “white” is ambiguous. It does not have scientific or consistent sociological boundaries. For instance, some South Asians, including many Indians, are classified as Caucasian under specific anthropological categories that are still used in global databases. So “white” becomes a pseudo-mystical sociological category—imprecise, yet loaded with political and cultural significance.

Hill: Yes, I agree. It’s deeply problematic and often built on myths of racial and cultural purity that have no basis in genetics or law. And of course, underlying all of this are the legal challenges to what should be considered fundamental reproductive rights. These rights form the foundation for access to reproductive health care at the state, federal, or county-level public health infrastructure.

So, when you attack the legal basis of reproductive rights, you are undermining health care delivery and human rights protections as a whole. Another concern surrounding the attempts to restrict Mifepristone and similar medications is that these targeted legal challenges could be used as precedents to pursue other medications.

The implications extend well beyond reproductive health care. If the legal theory here is that plaintiffs can assemble their evidence outside the established regulatory framework and argue that it raises doubts about a drug’s safety or efficacy, then any group with a political or ideological agenda could try to do the same.

We could see that happen with vaccines—again. That would not be surprising, especially given today’s climate. Or it could happen with other kinds of medications that people, for whatever reason, disapprove of. And that would set a perilous precedent.

That is part of the reason I believe that, ultimately, the courts will reject this challenge. Even judges who might otherwise oppose abortion may not be willing to open the door to this kind of broad-based regulatory chaos. The potential implications are just too wide-reaching.

Jacobsen: I want to ensure we cover this comprehensively because this keeps happening. There are no answers; it’s just legal noise. It feels like we’re seeing a copy of the same tactics, over and over again. So, I want to leave you with this question: How are human rights advocates, reproductive rights advocates, and legal professionals working effectively and strategically to push back? That’s probably a good point when we pick back up.

There are some noteworthy pro-choice religious and political groups. For example, the Religious Coalition for Reproductive Choice, Catholics for Choice—I interviewed their president years ago—United Church of Christ, Unitarian Universalist Association, Episcopal Church, Presbyterian Church (USA), National Council of Jewish Women, Reform Judaism, Jewish Women International, and Faith in Public Life.

In Texas, Faith Voices for Reproductive Justice and the Methodist Federation for Social Action have been vocal. There are even pro-choice Republicans. I want to nod to Senator Susan Collins of Maine and Senator Lisa Murkowski of Alaska. 

Governor Phil Scott of Vermont and former Governor Christine Todd Whitman of New Jersey are also strong examples. Former Senator Olympia Snowe, also from Maine, is another strong example. Former Senator Arlen Spectre from Pennsylvania and former Governor William Weld; there were also Republicans for Choice and Majority for Choice, both now defunct, and some Lincoln Project members who have been supportive. Essentially, coalition-building is critical. So what works—and what doesn’t?

Hill: That question is evolving rapidly because the legal and political landscape has changed dramatically.

Before Dobbs, the strategy around reproductive rights was largely lawyer-led and focused on federal constitutional protections. The movement was coordinated nationally because we had a federal constitutional right to abortion, so advocacy groups focused on national litigation strategies. Legal organizations would challenge restrictive state laws, knowing the cases would go up through the federal court system to the U.S. Supreme Court.

That required a centralized, national strategy—and that model worked, for a while. But Dobbs obliterated all of that. It ended federal constitutional protection and returned the issue to the states. So now, we are operating in 50 different legal environments, with varying levels of support or opposition. Political organizations, legal advocacy groups, grassroots activists—everyone is trying to figure out how to adapt, collaborate, and pivot strategically.

In this domain and others, the American left neglected state and local advocacy for far too long. The national groups need to step back, at least to some extent, and let state-based organizations or groups with strong local networks take the lead. We need to build power from the bottom up, because the federal, top-down approach—while logical in the pre-Dobbs era—is no longer viable in this highly fragmented legal landscape.

Jacobsen: So, as a foreigner, hearing this, it sounds like the U.S. legal context for abortion is now starting to resemble something like the European Union—fragmented, variegated, and deeply individualized, perhaps even down to the county level. Do you think there will ever be another opportunity at the federal level, or will this remain a state- and county-level battleground for the foreseeable future?

Hill: You’re right—it’s tough to say. It is a crystal ball question because no one knows how this will happen with certainty. Eventually, I think there will be a federal resolution—one way or another. But it’s going to take time. After the Dobbsdecision in 2022, we entered a period of absolute chaos—legal, policy, and medical chaos. That’s only the beginning of the settlement; we still live through the reverberations. So yes, a couple of years of Dobbs brings us to 2024. In many ways, we are starting to see the realignment of strategies, institutions, and alliances.

Jacobsen: Yes, I am saying it’s true. It still feels a bit chaotic, but it also feels like things are starting to settle, at least slightly. Would you agree?

Hill: Yes. It’s still a little chaotic, but there are some signs of stabilization—though maybe not quite stable, perhaps more like a pause or stagnation in certain areas. For example, many states that support abortion rights have put ballot initiatives forward to amend their state constitutions to protect abortion access. That phase seems to have run its course for now—most states that could pursue that strategy have already done it. So, things are starting to level out, or at least settle into a new normal, even if it is a high-conflict normal.

Jacobsen: Maybe this issue—abortion access—has lost some political salience in the broader news cycle, but the depth of emotion on both sides is still substantial. I do not see it disappearing.

Hill: I agree. The passion is so intense that I think both sides will continue to fight until one side feels they’ve “won”—if possible. It’s not going to go away.

Jacobsen: Americans love to argue, especially about sex, gender, religion, and politics. They also love to study each other along those lines—often in a pseudo-academic way, making it weirder. So much of it is paradoxical—micro paradoxes are everywhere.

Hill: Yes, very much so.

Jacobsen: Regarding legal cases, this has gone far beyond just Mifepristone or a single court case. Based on yourprevious comments and your understanding of the evolving landscape, I have a more observational question. What do youobserve about the demographics of support, particularly by gender, among those who are for restricting Mifepristone and those who are against? How does the support divide?

Hill: It is not as simple as people often assume. From what I understand—and I do not have the exact data in front of me—women in the U.S. are generally somewhat more pro-choice than men. That said, there are undoubtedly many women who oppose abortion and who are very prominent voices in the anti-abortion movement.

Erin Hawley, the attorney who argued the Mifepristone case before the U.S. Supreme Court, is a good example. She is Senator Josh Hawley’s wife, a prominent legal figure.

So, although women tend to be more pro-choice in aggregate, gender is not a perfect predictor. Much of this is driven by religious beliefs, ideologies around motherhood, and traditional gender roles. And we cannot ignore the role that racial ideologies and historical narratives play as well.

It is a multi-dimensional issue. The dividing lines are not cleanly gendered, and that complexity is often lost in political messaging.

Jacobsen: As a sociological observer and writer, I see parallels in popular media narratives, not necessarily in semi-popular legal media, which doesn’t always catch fire the same way.

Distinct cultural phenomena are emerging. On the progressive side, we have the “boss babe” archetype. On the conservative side, we see the rise of “trad wives”—traditional wives. Both are, in many ways, caricatures of women’s life choices.

There have been prominent cases within the traditional wife movement where individuals present themselves on social media as proud, traditional, submissive wives. But it turns out they were performing a role, in some cases, explicitly for monetary gain. They would generate followers, accept donations, and monetize that identity. It became a source of income, not necessarily a reflection of their fundamental beliefs or lifestyle. That is not to say all cases are fraudulent, but enough have been that it is part of the trend.

So having Erin Hawley, Senator Josh Hawley’s wife, as a legal and media spokesperson for the anti-abortion movement is, in my view, a very strategic PR decision. She’s an effective messenger. There is also a sociological pattern in some evangelical and conservative communities where married women vote in alignment with their husbands, or at least are encouraged to.

That said, do you observe a trend similar to traditional wife performance—where some women publicly espouse views that align with their community or movement but may privately believe otherwise?

Hill: Yes, far be it from me to say what is in someone’s heart, whether they genuinely believe what they are saying. Butthis is a longstanding dynamic in American politics.

Take Phyllis Schlafly, for example. She was the original American anti-feminist icon. She was outspoken against women in the workforce, promoted traditional gender roles, and emphasized that women should be mothers and homemakers. And yet, she was an incredibly active public political figure, constantly working, organizing, and influencing national debates.

You see echoes of that today. Look at Usha Vance, the wife of Senator JD Vance. He has argued that childcare is harmful and should not be subsidized by the government. But Usha Vance is a highly educated, successful professional.

So yes, there’s often an element of hypocrisy in the way these ideologies are promoted, especially when women who serve as messengers are themselves products of the very empowerment they argue against. Yet, these women can be highly effective spokespeople. So, the movement continues to promote them, even if their message contradicts their lived example.

Jacobsen: So, based on your expert legal and constitutional analysis—and yes, I’m citing an expert—let me ask you a few yes or no questions: Are reproductive health care and reproductive rights fundamental legal and human rights?

Hill: Yes.

Jacobsen: Should people be free to practice their religion in the United States?

Hill: Yes.

Jacobsen: Should individuals be allowed to use their religious freedom rights to override someone else’s bodily autonomy, according to a sound legal framework?

Hill: No, they should not.

Jacobsen: Good. I think it encapsulates where we are. That is the legal and moral battleground in the United States right now. We are watching these constitutional principles clash in real time. That could be a separate interview on the state of religious freedom, how the U.S. Supreme Court interprets it, and how that impacts the broader legal terrain. And that leads us into the multi-billion-dollar voucher system now, right? Was it a $5 billion announcement for vouchers for private schools?

That means religious and charter schools heavily emphasize religion. So the intelligent design proponents will have a heyday, teaching what many would consider pseudoscience in place of biology. Then, we will have all these students graduating from high school and trying to enter biology programs or medical school, and they will be educationally behind. So, let’s run through some more rapid-fire questions. You can keep them as yes/no or elaborate where needed.

Should people have the freedom of speech to say another person is demonic because they support abortion rights?

Hill: Yes. Free speech includes that, even if it’s offensive.

Jacobsen: I’m throwing out what people typically say. Trying to surface familiar rhetoric. Should taxpayers have to fund reproductive health care?

Hill: Yes.

Jacobsen: You can expand on that one if you’d like.

Hill: Yes, because it is health care. It is basic health care, and people have a fundamental human right to access it. Public funds already support many forms of health care, and reproductive health care should be no different.

Jacobsen: Do rich and poor women receive different levels of care in the U.S.?

Hill: Yes—absolutely.

Jacobsen: So, are the maternal mortality rate and infant mortality rate higher for poor women than for rich women?

Hill: I believe so. However, the data I’m most familiar with shows that racial minorities, especially Black women, have much higher maternal mortality rates.

Jacobsen: So, is there a correlation between race and economic status?

Hill: Yes. There’s a racial overlay on top of the economic disparities. That’s exactly right.

Jacobsen: I’ve seen a lot of the data by race, but not always broken down purely by income.

Hill: Same. However, household income differs significantly by race in the U.S.

Jacobsen: Is household income significantly different between races in the United States?

Hill: Yes.

Jacobsen: There you go. Question answered. If we’re talking demographic population dynamics, then the question of overpopulation should apply. That’s an appropriate statistical context.

Hill: Yes.

Jacobsen: What do you think is the hardest moral quandary coming out of these abortion-related legal cases?

Hill: Wow. Gosh—that’s a good question.

For me, and you can probably tell where I sit on this issue, the most complex moral question is: where do we draw the line for individuals who, for religious or conscientious reasons, do not want to participate in abortion?

I fully accept that some people are personally or religiously opposed to abortion. That is part of what underpins the Mifepristone case. The doctors who originally filed the lawsuit said they felt they were being forced to participate in treating abortion complications, which they claimed violated their beliefs. That came up during oral arguments as well.

But where is the line?

I think it is fair to say that if you are an OB-GYN and you are religiously opposed to abortion, you should not have to perform abortions yourself. I can accept that.

However, then we have to ask: What about emergency care? What about prescribing medication that someone else will use for an abortion? What about aftercare for someone who has had a miscarriage or abortion? What if you are not even a medical provider, but a security guard or administrator at the hospital—do you get to claim religious exemption?

These questions have many layers, and the line drawing is complicated.

Jacobsen: So I find a recurring pattern in the intelligent design and creationist legal battles necessary. I’ve gone through a lot of their material and comprehensively examined everything in Canada.

In the United States, though, it’s peculiar because the legal efforts are persistent and relatively constant. These kinds of cases come up regularly, and the National Center for Science Education (NCSE) is often involved—educating, responding, and staying on the front lines of these legal fights.

The 1996 case—you probably know the one—was not peculiar in its outcome, but it was certainly theatrical. You had Ken Miller bringing out his illustrations and doing live scientific demonstrations. And he is Catholic, which added an extra dimension. These challenges happen periodically.

But it often comes down to this: they want to bypass peer review and go straight to high schools with unvetted, ideologically driven curricula. Then, during President George W. Bush’s administration, we got the infamous “teach the controversy” approach. The idea was to make creationism and intelligent design sound like scientifically viable alternatives, even though they weren’t.

The main point here is that these efforts don’t stop. The courts may issue rulings and set clear legal precedents, but the ideological movement behind them continues. You get all kinds: those who believe in a 6,000—to 10,000-year-old Earth, who say man was created separately from animals and sometimes even from women, depending on their literal reading.

Then you have the more “sophisticated” creationists who accept microevolution but deny macroevolution, and who concede that the Earth is billions of years old, but still want to reject the naturalistic basis of evolution.

Regardless of their view, they all tried to use the court system to get this into public high school curricula, most famously with their textbook, Of Pandas and People. There was also a bizarre international example: Adnan Oktar in Turkey, who wrote the Atlas of Creation. He mailed lavish, glossy volumes—we still don’t know who funded them—to people like Richard Dawkins and others. He framed his views within an Islamic context, but much of the content was copied directly from intelligent design literature in the U.S.

Later, Oktar was jailed for serious crimes and had this entourage of aesthetically distinct women he called his “kittens.” They were essentially ornamental figures in his public image. It was an absurd scene, like an Arabic or Persian version of a Playboy cult.

So, you get these wild stories—but behind them is a serious point: these court cases don’t exist in a vacuum. The people behind them are committed and relentless. Which brings me to my question:

Let’s say the Mifepristone case wins big, meaning it remains accessible and legal for those who need it. Do you think we’ll then see county-by-county legal challenges targeting Mifepristone again and again for years to come?

Hill: Yes. I do think that’s a real possibility.

They’re not going to give up. If Mifepristone remains somewhat accessible, the anti-abortion movement will pursue alternative legal strategies.

We’re already seeing it in this case. Many people were surprised that the Trump administration defended Mifepristone in its reply brief. This made some think this case may not be the ultimate vehicle to ban or restrict it.

But now we’re seeing new studies being published by anti-abortion groups—or at least aligned researchers—claiming a high complication rate with Mifepristone. These studies are methodologically questionable, to say the least, but they’realready being used as fuel for renewed legal and legislative challenges.

But the group that published that recent study is trying to attract attention. So, they may try to take another route—perhaps going directly to the FDA.

The former FDA director under Trump has said he’s not currently planning to do anything on Mifepristone, but he is open to evaluating new evidence.

Martin Makary or something along those lines. There’s potentially an administrative route through the FDA. But there’salso a strategy being promoted through Project 2025, which includes reinvigorating the Comstock Act. The Department of Justice could enforce a prohibition on mailing Mifepristone.

Although possible, I don’t think we’ll see many county-level legal challenges. However, other avenues—administrative, legislative, and federal enforcement strategies—will still be pursued, even if this case does not go the way the challengers hope.

Jacobsen: When is this case likely to close?

Hill: So they filed the reply brief about a week and a half ago. The judge will rule on dismissing the motion in the next couple of months.

But a final resolution? That could take much longer. If the case goes back to the U.S. Supreme Court, it could be a year or more, even several years, before we get a definitive ruling.

That said, the district judge in this case is known for being efficient, so we’ll likely have a ruling on the motion to dismiss within the next four to eight weeks.

From there, things could unfold in multiple ways: the motion could be denied, and the case could continue. Or, the FDA could take new action, which might put the case on hold. There are several unpredictable legal paths it could follow.

Did you hear about RFK Jr. swimming in a sewage-contaminated creek with his grandkids? On May 11, 2025, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. sparked controversy by sharing photos of himself swimming with his grandchildren in Washington, D.C.’s Rock Creek—a waterway long designated unsafe due to high bacterial contamination from sewage runoff.

It’s not sewage water directly—it’s sewage runoff. The National Park Service has prohibited swimming and wading in Rock Creek since 1971 due to E. coli and Giardia risks. Clear signage is posted.

Jacobsen: So the question is: Did RFK Jr. break the law? If a public servant or park authority posts clear signage and public health advisories, and someone willfully ignores them and enters a prohibited waterway, is that technically breaking the law, or just ignoring a warning?

Hill: I do not know. That would be a question for someone in environmental law or public safety enforcement. Maybe it’sa civil violation, maybe not. But it’s not something I can speak to definitively.

Jacobsen: Fair enough. What else is important about this case?

Hill: I will say this: it was unexpected that the Trump administration continued to defend Mifepristone. As I mentioned earlier, the Biden administration had initially taken that position.

The Trump administration had a brief due and asked for more time to determine its position. Eventually, they filed a brief consistent with the Biden administration’s stance. That, in and of itself, was surprising.

However, there’s some context: there have been other cases involving challenges to mifepristone restrictions—but from the other side. Those were brought by pro-choice groups, arguing that the limits are too tight. In those cases, the government also defended Mifepristone’s availability, maintaining a consistent posture. They did not take any radically aggressive stance against Mifepristone.

So the most you can read into it now is that the Trump administration is not ready to take an aggressive approach to outlawing abortion, yet. That does not mean they never will. But for the moment, they are certainly disappointing those who hoped they would come out of the gate with a clear anti-abortion agenda.

Jacobsen: Thank you so much, Jessie. I appreciate it. 

Hill: Thanks again!

Jacobsen: Bye.

Hill: Bye!

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