Alabama Attorney General Steve Marshall has issued cease-and-desist letters to six companies accused of illegally advertising, facilitating and enabling the sale and procurement of chemical abortion drugs to Alabama consumers while also joining a multistate effort urging federal regulators to increase oversight of the abortion-inducing drug mifepristone.

The cease-and-desist letters were sent to Plan C, a project of Possibility Labs in San Francisco; Southern Woven of New York; ybycmeds of Sanborn, New York; Abortion Pills in Private of the United Arab Emirates; Red State Access of New York; and Cambridge Reproductive Health Consultants of Cambridge, Massachusetts.

According to Marshall's office, each letter demands that the companies stop advertising, selling and delivering abortion-inducing drugs to consumers in Alabama. The attorney general warned that failure to comply could result in formal investigations and possible legal action for unlawful trade practices. Under Alabama consumer protection laws, civil penalties can reach up to $2,000 per violation.

“Alabama's law is clear, abortion is illegal in this state. These companies are not only breaking the law, they are deceiving Alabama consumers about the very real dangers of these drugs. That stops now. Anyone who tries to exploit Alabamians for profit while flouting our laws will be prosecuted to the fullest extent permitted by law,” Marshall said in a news release from his office.

The attorney general's office said Alabama law prohibits the use, prescription or administration of any medicine, drug or other substance intended to terminate the pregnancy of a woman known to be pregnant. Based on that law, the office said it is unlawful for out-of-state companies to mail abortion-inducing drugs to individuals in Alabama.

Marshall's office also alleged that the companies are misleading consumers by describing abortion pills as safe. The office cited a 2025 analysis of an all-payer insurance claims database that found 10.93% of 865,727 women prescribed mifepristone experienced serious adverse symptoms, including sepsis, infection, hemorrhaging and other life-threatening complications.

The enforcement effort comes as Marshall joins a 14-state coalition calling on the U.S. Environmental Protection Agency to place mifepristone and its generic equivalents on the agency's Contaminant Candidate List, a step that could lead to stricter regulation under the Safe Drinking Water Act.

In a separate announcement, Marshall said the coalition is seeking increased monitoring of waterways because of concerns that chemically contaminated medical waste associated with abortion drugs could enter public water systems.

“There is a booming black-market for drug-inducing abortions operating completely outside of lawful medical oversight, and it has created a serious public health crisis. This is not just for those obtaining and using these illegal and dangerous drugs,” Marshall said. “Our coalition is demanding the EPA add mifepristone and its generic equivalents to their official watch list for immediate monitoring of local waterways. As medical waste is discarded and washed away, it risks contaminating the very water supply millions of Americans drink every day, and the long-term consequences could be severe.”

Marshall's office said mifepristone works by blocking progesterone, a hormone necessary to sustain pregnancy. The office contends that increasing use of the drug has resulted in more chemically tainted medical waste being discarded into waterways.

The coalition's request cites a letter led by Missouri officials that criticizes changes made by the U.S. Food and Drug Administration to mifepristone regulations.

“Over the last decade,” the Missouri-led letter states, “the FDA has eliminated many of the protections that minimized the health risks posed by mifepristone and its approved generics, including the in-person dispensing and check-up requirements that kept medical staff involved in the process. Not only were the FDA’s changes to the regimen and risk evaluation and mitigation strategy (REMS) unlawful and unsafe, but the loosened regulations have also increased the number of chemical abortions occurring in the home, resulting in tons of chemically tainted medical waste being flushed into American waterways.”

According to the attorney general's office, if mifepristone reaches sufficient concentrations in public water supplies, pregnant women who unintentionally ingest the drug could face greater health risks than the general population. The office also cited research it said suggests mifepristone may affect reproductive organ development and fertility.

Marshall's office noted that chemical abortions accounted for 63% of all U.S. abortions within the formal health care system in 2023, up from 31% in 2014 and 14% in 2005. The office said those figures do not include self-managed chemical abortions involving mailed abortion drugs that it says violate state law.

The coalition's letter to the EPA is available at www.alabamaag.gov.