NEW ORLEANS — A federal appeals court has ordered a severe nationwide restriction on the abortion pill mifepristone, effectively halting mail-order delivery of the medication used in the majority of U.S. abortions.
The ruling, issued Friday by a three-judge panel of the New Orleans-based 5th U.S. Circuit Court of Appeals, requires patients to obtain the drug in person at a health clinic. The decision overrides a 2021 Food and Drug Administration (FDA) policy that had allowed the pills to be prescribed via telehealth and sent through the mail.
“Every abortion facilitated by FDA’s action cancels Louisiana’s ban on medical abortions and undermines its policy that ‘every unborn child is a human being from the moment of conception,’” the court stated in its ruling.
The order stems from a lawsuit brought by the state of Louisiana against the FDA. Louisiana Attorney General Liz Murrill hailed the decision, arguing that the current federal regulations allowed out-of-state prescribers to defy state laws.The court’s conservative panel agreed, stating the FDA failed to justify removing the in-person requirement.
Danco Laboratories, a major manufacturer of mifepristone, swiftly filed an emergency motion Saturday for a one-week pause on the order. The company argued the ruling has already resulted in “immediate chaos” and requested time to seek relief from the U.S. Supreme Court.
Reproductive rights advocates warned the decision would have a devastating impact on patients in rural areas or those living with disabilities. Julia Kaye, a senior staff attorney for the ACLU’s Reproductive Freedom Project, called the ruling a “rubber-stamp” of anti-abortion propaganda that defies clear science.
Mifepristone was originally approved by the FDA in 2000 and is now used in nearly two-thirds of all U.S. abortions.Since the Supreme Court overturned Roe v. Wade in 2022, telehealth prescriptions have become a primary method for maintaining access in states with restrictive bans.
The ruling comes as the FDA, currently under the Trump administration, is conducting a new review of mifepristone’s safety. While judges typically defer to the agency’s scientific expertise, the 5th Circuit noted the FDA “could not say when that review might be complete”.
Why It Matters
This decision marks the most sweeping threat to abortion access since 2022, according to the Guttmacher Institute. By blocking mifepristone mail delivery, the court has upended the delivery model for approximately one in four people in the U.S. who seek an abortion via telemedicine. Even in states where abortion remains legal, patients may now be forced to travel hundreds of miles to a brick-and-mortar clinic just to pick up a pill.
What Happens Next
The order remains in effect while the underlying case continues, though a temporary stay could be granted by May 8.Legal experts expect the case to move quickly to the U.S. Supreme Court. While the high court unanimously preserved access to the pill in 2024, that ruling was based on the plaintiffs’ lack of legal standing and did not address the core safety or mailing regulations now at issue.
