A group of leading anti-abortion organizations sent a letter to newly confirmed U.S. Attorney General Todd Blanche urging him to review the U.S. Department of Justice’s authority to use  a 150-year-old anti-obscenity law to prevent people from obtaining abortion medication or other related materials through the mail.

Advancing American Freedom, a conservative advocacy group founded by former Republican Vice President Mike Pence, authored the Aug. 7 letter. It is co-signed by four major anti-abortion organizations, including Susan B. Anthony Pro-Life America, Americans United for Life and Students for Life of America. The nearly 30 other signees include the North Carolina House of Representatives, the Oklahoma Council of Public Affairs and The Conservative Caucus.

The Comstock Act, enacted in 1873, made it illegal to send “obscene material” by mail, which included any “article or thing designed, adapted or intended for producing abortion.” The Comstock Act is considered a “zombie law,” meaning it hasn’t been repealed, but has not been enforced in many decades. In 2022, during the Biden administration, the U.S. Department of Justice issued legal guidance stating that Comstock did not prohibit the mail of certain abortion drugs when the sender does not intend for the recipient to use them unlawfully.

“Not only does this language appear nowhere in the Comstock Act but, as a practical matter, a sender’s subjective intent and a recipient’s intended use are unknowable, making the Comstock Act a dead letter,” the letter to Blanche said.

The groups thanked Blanche for pledging to evaluate the 2022 opinion and said they look forward to the result of his review.

In a conference call hosted by the White House Faith Office on July 30, Blanche told thousands of religious leaders that he was committed to advancing policies that would outlaw abortion in every state.

In 2022, the U.S. Supreme Court’s Dobbs v. Jackson Women’s Health decision cleared the way for states to regulate abortion access for the first time in 50 years, prompting more than a dozen states to enact near-total abortion bans. In the wake of that ruling, the U.S. Food and Drug Administration in 2023 changed its rules on mifepristone, one of two drugs typically used to terminate a pregnancy before 10 weeks and to treat miscarriages.

Mifepristone halts the pregnancy, while a second drug, misoprostol, physically clears the uterus.

The new FDA rules allowed mifepristone to be dispensed without a visit to an in-person provider, which made it easier for people in states with bans to obtain the medication from online sources and receive the pills in the mail.

According to the Society of Family Planning’s #WeCount report, 27% of all abortions in the first six months of 2025 were obtained through telehealth, adding up to more than 162,000 cases.

Anti-abortion groups and Republican state attorneys general have sued the FDA trying to reverse the 2023 rules or establish legal authority to enforce Comstock. A Texas judge in 2023 ruled that Comstock was enforceable, but the U.S. Supreme Court eventually overturned that ruling.

If the challenges to FDA rules around mifepristone are successful, abortion-rights advocates have said they would continue prescribing misoprostol, which is effective on its own.

But enforcement of Comstock would apply to any equipment needed to perform abortions. Abortion-rights legal advocacy organization Center for Reproductive Rights said that could make supplies difficult or illegal to obtain for any type of obstetrical care, including miscarriages and pregnancy complications.

Gavin Oxley, spokesperson for Americans United for Life, told Stateline by email that the restrictions should extend to those categories and not just mifepristone.

“Any drug or instrument mailed with the intention of abortion falls under the law’s authority, proactively protecting women from new or adapted abortion methods, including misoprostol-only abortions,” Oxley said. “Righting the politicized Biden-era OLC opinion denying the strict application of Comstock must be an immediate priority for General Blanche.”

Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org.

Acting U.S. Attorney General Todd Blanche is one step closer to confirmation after the Republican Judiciary Committee voted to advance his appointment on a party-line vote on Tuesday, and based on promises he made to faith leaders around the country last week, that means national anti-abortion actions may be one step closer as well.

In a conference call hosted by the White House Faith Office on July 30 with thousands of religious leaders around the country, Blanche said he was committed to achieving policy solutions so that the U.S. Supreme Court’s Dobbs decision “becomes permanent in every single state.”

A recording of the call was publicly available on YouTube as of Tuesday, posted by Intercessors of America, a religious group in Virginia, but was removed by late Tuesday afternoon.

Blanche told the participants he is working “hand in hand” with U.S. Health and Human Services, the U.S. Food and Drug Administration and President Donald Trump’s White House team to fulfill those goals.

His comments come amid ongoing attempts to restrict access to mifepristone, one of two drugs approved by the FDA to terminate early pregnancies and to treat miscarriages. The state of Louisiana sued the FDA in October seeking to rescind a 2023 rule that allowed mifepristone to be dispensed without a visit to a provider in person. That rule has allowed people in states with abortion bans to order the pills by mail through telehealth visits with providers in states that don’t have bans.

The FDA has said it is conducting a safety review of mifepristone that won’t be ready until at least December.

“If states have said, ‘We are going to protect the unborn and we’re going to protect every life from the moment of conception,’ we’re putting practices and policies in place so that other states and other organizations can’t attack that and they can’t do things like they’re doing with mail-order drugs,” Blanche said on the faith call.

Health care providers who support abortion care have said they intend to keep prescribing misoprostol, the other drug used to end a pregnancy or treat miscarriages, even if mifepristone is restricted.

But anti-abortion activists and others have also called on the Trump administration to enforce the Comstock Act, a long-dormant law passed in 1873 that restricted the mailing of “obscene” materials. The law includes language prohibiting mailing anything “designed, adapted, or intended for preventing conception or producing abortion.” If that law were to be enforced, it could bar access to the mailing of both medications.

Blanche did not mention the Comstock Act in the call, but the administration has been pressured by anti-abortion groups to do more.

Blanche said the process of achieving his goals takes a lot of time, but he assured the faith leaders it will happen.

“We don’t have complete victory yet, but we will have victory, and victory will be soon and it will be permanent,” he said.

Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org.

A new study examining pollution levels across a 16-year span found that while general pollution levels from sources such as cars and industry have significantly declined, recent increases in wildfire smoke air pollution have offset those gains and could be contributing to negative outcomes for pregnant women and babies such as low birth weight and preterm births.  

Published by Frontiers in Environmental Health, the study included data from about 64.5 million pregnancies between 2003 and 2019, covering more than 2,800 counties in 48 states. Even in regions that are not strongly associated with wildfire, such as the southeast region of the U.S., wildfire pollution rates grew substantially during that time period. The study did not account for any movement between counties or regions during pregnancy, or whether pregnant people used any protection against smoke such as masks, air filters or temporary relocation.

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Wildfire pollution is included in the same type of pollution as exhaust from cars or industrial outputs, but the study authors looked at two models of pollutants, one of which removed all fire-related pollution to determine how much of it was correlated with wildfire. Over the study period, about 65% of the days that recorded pollution levels above the National Ambient Air Quality Standard could be attributed to wildfire smoke.

Menglu Liang, leading author of the study and assistant clinical professor of biostatistics at the University of Maryland, said in a news release that efforts to reduce other forms of pollution have not been in vain.

“Those gains have genuinely protected pregnant people and unborn babies, and without them, exposures today would be considerably worse,” Liang said. “What our findings show is that wildfire smoke is offsetting a growing share of these hard-won improvements.”

The study time period does not include some of the most recent, most explosive wildfire seasons in the United States and Canada, such as 2020, 2024 and this year. By mid-July this year, there were more than 800 wildfires burning across Canada, leading to hazardous levels of wildfire smoke across parts of the Midwest and northeast, and in late July, a rash of wildfires across Oregon created hazardous air over much of the northwest. 

Recent reports show Oregon is on track to have its worst fire season on record, with nearly 1.8 million acres already burned and at least two months left of the peak season. The previous record was set in 2024, with 1.9 million acres burned.

The study found that some regions were disproportionately affected by the smoke, including in the Northwest, where rates of pollution from wildfire more than doubled over that period. The study noted that the burdens were highest in low-income, rural areas with significant populations of American Indian and Alaska Native communities, and areas with maternity care shortages.

 Recent studies have correlated wildfire smoke exposure with an increased risk of preterm birth, low birth weight and other negative outcomes such as stillbirth and some congenital anomalies. Scientists believe the body’s inflammatory responses to wildfire smoke can be harmful to the placenta, which is central to fetal survival, and some of the pollutants could cross the placental barrier and affect fetal growth and development.

“These outcomes matter well beyond the delivery room and harms experienced before birth can echo for decades,” Liang said in the release. “That makes prenatal exposure a particular public health concern.”

Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org.

A federal judge in Virginia ruled Thursday that the U.S. Food and Drug Administration did not sufficiently justify restrictions imposed in 2023 on a drug used to terminate early pregnancies, adding another layer of complexity to a string of legal cases with opposing goals that could affect future abortion access.  

The lawsuit was filed in 2023 by abortion providers in Kansas, Montana and Virginia to challenge the restrictions as excessive, unwarranted and inconsistent with other legal requirements. A similar case in Hawaii was already decided in October, with a federal judge also finding that the restrictions were arbitrary.

In Virginia, U.S. District Court Judge Robert Ballou, an appointee of former President Joe Biden, said the FDA failed to conduct an appropriate review of the 2023 restrictions on mifepristone, which include rules that prescribing pharmacies and clinicians must be specially certified and prescribers and patients must sign a form acknowledging the medication’s risks.

“The 2023 REMS modification is unlawful and must be remanded to the FDA for review,” Ballou wrote, using the acronym for the FDA’s Risk Evaluation and Mitigation Strategies protocols.

Amy Hagstrom Miller, president and CEO of lead plaintiff Whole Woman’s Health Alliance, based in Virginia, said in a statement Friday that eliminating those three restrictions would help clinic staff focus on patient needs instead of “excessive paperwork.”

“I have worked in abortion care for over 30 years, and I can attest that these regulations serve no medical purpose, nor do they add value to our patients’ experience of abortion,” Hagstrom Miller said in the statement.

The FDA did not immediately respond to a request for comment from Stateline on Friday.

Ballou did not give a timeline for a review of the restrictions, but the FDA has said it is conducting a broader safety review and has sought to dismiss cases related to mifepristone regulation until it completes that review. Trump administration officials told the Wall Street Journal in June that the review was expected to take about six months, meaning it would conclude after the national midterm elections.

Katie Keith, founding director of the Center for Health Policy and the Law at the Georgetown University Law Center, said the Virginia and Hawaii decisions mean the FDA has been ordered by two courts to reconsider its restrictions and more thoroughly explain why they are necessary.

“They’re going to have to look at everything these various courts are telling them to look at,” Keith said.

But the two rulings come at the same time the administration is receiving pressure from anti-abortion groups to further restrict access to mifepristone, even in states where abortion is legal.

The 2023 rules, which were decided under the Biden administration, also eased restrictions to allow mifepristone to be dispensed without an in-person provider for the first time. That helped expand national access to the medication, which is one of two drugs typically used to end a pregnancy before 10 weeks and to treat miscarriages, and allowed people who live in one of the 13 states with near-total abortion bans to continue to receive it by mail.

That expanded access prompted three other lawsuits from attorneys general in states with abortion bans that are still pending in federal courts. In Louisiana, the 5th U.S. Circuit Court of Appeals is considering whether to strike down the provision allowing telehealth prescriptions, and will hear oral arguments in the case in September.

The 5th Circuit initially granted an emergency request from Louisiana to block telehealth access to the medication, but after drug manufacturers appealed the decision to the U.S. Supreme Court, the justices reversed the circuit court ruling. That stay from the high court will remain in place as the case continues.

Two other cases with different implications for the future of mifepristone are ongoing. One is in Missouri, joined by attorneys general from Idaho and Kansas, where they have asked the court to return all of the restrictions to what they were in 2016. The other is in Texas, joined by Florida’s attorney general, asking the federal court to revoke the drug’s approval entirely.

Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org.

The Trump administration has a new plan for teenagers learning about pregnancy: Beginning this summer, it will steer millions of dollars toward organizations that focus on anatomy, fertility tracking, hormonal production and “reproductive goals counseling.”

The plan will also emphasize abstinence from sex and the importance of marriage. 

In doing so, it will pivot away from programs that serve populations in areas with the greatest need and that use particular evidence-based programming to reduce teen pregnancies — and some say the new language puts a greater focus on planning for pregnancy rather than preventing it.

The new grant application terms are consistent with an approach called restorative reproductive medicine that has become popular among conservative groups, including those who identify with Make America Healthy Again initiatives.

The approach discourages the use of any type of contraception and instead focuses on fertility awareness methods, usually in the context of couples trying to get pregnant without medical intervention such as in vitro fertilization or other treatments. That typically means not using any birth control and instead tracking indicators such as cervical mucus, body temperature and other physical symptoms to monitor the menstrual cycle. 

Academic studies have repeatedly shown that abstinence-only approaches result in higher rates of teen pregnancy and births, even after adjusting for other socioeconomic factors.

Congress created the Teen Pregnancy Prevention Program in 2010, and has renewed funding for it on a bipartisan basis over the past 16 years, including the 2026 budget bill, despite President Donald Trump’s office targeting the program for defunding. 

During that time, teen birth rates declined by about 72%, according to federal Centers for Disease Control and Prevention data, and much of the drop in the overall national birth rate is because teen birth rates have fallen so sharply. Experts say more comprehensive sex education, better access to contraception for girls and general behavioral trends around sex explain that shift. 

Amy Friedrich-Karnik, director of federal policy at the reproductive rights-focused Guttmacher Institute, said the new language in the teen pregnancy program is similar to the new funding opportunity released for Title X, which is a more than 50-year-old grant program designed to help low-income populations receive reproductive healthcare.

“We do think that fertility awareness-based methods should be explained to patients and they should have the right to understand what those options are,” Friedrich-Karnik said, describing the administration’s approach. “But (patients) need to also be aware of the full options that are available and the pluses and minuses of every option that is out there.”

Body literacy modules

The intent of the program, according to the original law, was for grants to fund “medically accurate and age-appropriate programs that reduce teen pregnancy” and then to continue the programs shown to be most effective through rigorous academic evaluation. According to the Department of Health and Human Services’ Office of Population Affairs, those programs were developed for children and young adults between the ages of 10 and 24 and the people in their lives who support them.

Most of the grants that were canceled this year were programs implementing the methods proven effective in reducing teen pregnancy, while others were more research based, in which additional strategies are tested and refined. Several of those programs were canceled as well in states such as Louisiana, Texas and Washington.

A separate federal grant program called Sexual Risk Avoidance Education exists for abstinence-only programs, but the evidence-based criteria for Teen Pregnancy Prevention is much higher, said Rachel Fey, vice president of policy at national reproductive rights advocacy organization Power to Decide. She sees the new funding opportunity for teen pregnancy prevention as an extension of the sexual risk avoidance program — one of the pillars of the new description tells grantees to “incorporate sexual risk avoidance education.”

The funding notice requires applicants to pass an “alignment review” with agency priorities that is conducted by political appointees, a new process that the U.S. Office of Management and Budget is trying to implement for federal financial assistance across the government.

Applicants for the new teen pregnancy program are required to teach body literacy, including two distinct modules about anatomy and reproduction for girls and boys. 

Grace Stark, editor-in-chief of a Texas-based nonprofit called Natural Womanhood that promotes fertility awareness and restorative reproductive medicine, told Stateline by email that the new funding opportunity’s focus could be helpful, as it “encourages young people of both sexes to consider their reproductive goals now and in the future, and how their current health and lifestyle choices can impact those future goals.”

The female module must include instruction about the menstrual cycle and the patterns and key indicators of the phases of the cycle, and recognize ovulation as the “central event and primary indicator of hormonal health and fertility.” It must also include the advantages and disadvantages of “ovarian suppression” compared to approaches that address “root causes.” 

Restorative reproductive medicine focuses on identifying underlying conditions that contribute to infertility or other reproductive health-related problems, according to the International Institute of Restorative Reproductive Medicine. It refers to conventional approaches that use treatments that “suppress normal physiology,” such as various forms of birth control, and claims that RRM works with the body to treat problems. 

Republican U.S. Sen. Cindy Hyde-Smith of Mississippi introduced a bill in Congress in 2025 that would have directed federal health agencies to promote such training for medical students and professionals through existing funding opportunities in Title X and the HHS Office of Population Affairs. That bill didn’t advance.

Joely Pritzker, who has been a family nurse practitioner for more than 20 years and is the senior director of healthcare for Power to Decide, said the “ovarian suppression” language likely refers to one of the most common ways birth control works, which is to temporarily suppress ovulation. Typically, in medical practice, ovarian suppression refers to lowering the estrogen produced by the ovaries, sometimes to prevent or treat breast cancer.

Pritzker said most people in the reproductive health world would support the idea of teaching young people about their bodies, but said it comes down to how that information is interpreted and applied, and that the new program design is unclear about those intentions. Not wanting to use hormonal birth control is different from discouraging the use of it entirely, she said.

“I genuinely don’t know what (body literacy) means to the folks who wrote these proposals, other than based on everything else we know, there is an assumption that if people knew more about their bodies, they would choose not to use, for example, hormonal birth control,” Pritzker said, adding that the assumption is false.

Stark, of Natural Womanhood, said body literacy can help young people notice signs of reproductive health issues,“which (restorative reproductive medicine)-trained healthcare professionals can help diagnose and treat to improve current health and protect future fertility — and future reproductive health plans.”

The American College of Obstetricians and Gynecologists warns against leaning on restorative reproductive medicine in fertility discussions, saying it can be “ineffective and redundant” and unnecessarily delay a patient in seeking medical treatment when it is presented as the sole or best approach. 

The male health module, according to the federal grant funding notice, includes an emphasis on understanding how testosterone is a hormone that is responsive to sleep, physical activity and environmental factors. Instruction must include the physiology of arousal, and address how “repeated or artificially stimulated arousal may affect neural development and behavior over time,” seemingly referring to masturbation.

Testosterone has been a heavy focus of the Trump administration. HHS Secretary Robert F. Kennedy Jr. frequently refers to lower sperm counts among men, including teen males, despite no scientific evidence backing up those claims when it comes to young men. He cites it as a reason for birth rates that have remained flat or lowered slightly every year since 2015, though experts say the lower national birth rate is actually because of the lower teen pregnancy and birth rates. 

U.S. Department of Defense Secretary Pete Hegseth also announced last week that military men over the age of 30 would receive annual testosterone level checks, which doctors say could actually be counterproductive to military readiness and could risk infertility. 

The teen pregnancy prevention programs must also include counseling on reproductive goals, and “should affirm marriage and parenthood as meaningful and value components of adult life,” the federal description says.

New recipients could include crisis pregnancy centers 

Ginger Mullaney, CEO of former youth services grantee Healthy Futures of Texas, said its nearly $2 million grant funded 11 programs that served various populations, including young in foster care, and runaway and unhoused youth. The grant was cancelled, which shocked her, she said, because the group had already adapted all of its materials and programs to comply with new executive orders around diversity, equity and inclusion and other administration priorities. The new curriculum had been approved.

“We felt like we had already made all the necessary changes to comply,” Mullaney said.

Earlier this month, Healthy Futures was still deciding whether it would apply for the new round of funding. It’s not an easy task, she said, in part because the government documents no longer include a list of approved programs that qualify for the funding. Mullaney said there used to be a list of more than two dozen programs that the agency approved because they had been academically evaluated for effectiveness, but that list is gone now. However, the instructions still tell applicants they must use an evidence-based program. 

“We don’t know what (programs are) considered evidence based,” Mullaney said.

The new funding opportunity also awards more points to applicants that have never been awarded funds before.

Alison Macklin, director of public affairs at sex ed advocacy group SIECUS, said based on what she has seen at the local level, the new funding opportunity is paving the way for crisis pregnancy centers to apply for and receive federal dollars. 

Crisis pregnancy centers are anti-abortion organizations that typically offer free ultrasounds, pregnancy tests and parenting classes with a religious mission, and most often do not provide or refer for contraception. States Newsroom found earlier this year that the centers have received nearly $500 million in taxpayer dollars from state and federal sources since the U.S. Supreme Court’s decision to overturn Roe v. Wade in 2022.

“They’ve been given an inch, so they’re trying to take a mile, is what it seems to me,” Macklin said.

‘Losing trusted relationships’

In mid-May, staff at Children’s Aid said they expected their $936,700 Teen Pregnancy Prevention Program grant to be renewed for another year after meeting with U.S. Health and Human Services and receiving nothing but positive feedback about their program. It was eligible for funding through 2028.

But at the end of June, they received another letter letting them know the grant was canceled, effective immediately.

“It was an overnight shutdown with no transition period for staff, or for young people that were relying on these resources,” said Rhonda Braxton, vice president of health and wellness at Children’s Aid, a 170-year-old organization in New York City.

It was one of 53 grantees that received letters from the federal government agency notifying them that their funding had been terminated without notice. Most were told their programs were now misaligned with federal agency priorities and that they normalized sexual activity for minors. Three affected grantees and SIECUS: Sex Ed for Social Change filed a lawsuit challenging the action on July 14. 

Braxton said the abrupt termination is expected to result in nine people losing their jobs, six of whom worked full time, and will affect the 1,200 young people who were served each year in areas such as the South Bronx, Harlem and Washington Heights. A group of high school-aged peer educators also found themselves suddenly without the summer job they’d planned to have with Children’s Aid.

“These young people are losing trusted relationships in an era of misinformation and distrust,” Braxton said.

She said they’ve made the decision not to apply for the new funding because it seems to be aligned with promoting abstinence-only initiatives, and, “Our experience has been that that’s not evidence-based programming.”

Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org.