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A panel of the New Orleans-based 5th U.S. Circuit Court of Appeals blocked the mailing of prescriptions for the abortion pill mifepristone, requiring that the pill be distributed only in person at clinics.
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"Every abortion facilitated by FDA's action cancels Louisiana's ban on medical abortions and undermines its policy that 'every unborn child is human being from the moment of conception and is, therefore, a legal person.'"
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"The FDA could not say when that review might be complete and admitted it was still collecting data," the judges wrote.
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FDA officials under President Donald Trump repeatedly stated the agency is conducting a new review of mifepristone's safety at the direction of the president.
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In a court filing, Louisiana's attorney general and a woman who says she was coerced into taking abortion pills requested that FDA rules be rolled back to when mifepristone could only be prescribed and dispensed in person.
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A Louisiana-based federal judge last month ruled that the in-person prescribing and dispensing allowances for mifepristone undermined the state's abortion ban but stopped short of undoing the regulations immediately.
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Since the Supreme Court's 2022 ruling that overturned Roe v. Wade and allowed enforcement of abortion bans, prescriptions by mail have become a major way that abortions are provided, including to states where bans are in place.
Julia Kaye, ACLU lawyer
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"This is going to affect patients' access to abortion and miscarriage care in every state in the nation. When telemedicine is restricted, rural communities, people with low incomes, people with disabilities, survivors of intimate partner violence and communities of color suffer the most," said Julia Kaye, an ACLU lawyer.
Julia Kaye, American Civil Liberties Union attorney
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"This decision defies clear science and settled law and advances an anti-abortion agenda that is deeply unpopular with the American people," said Julia Kaye, an attorney with the American Civil Liberties Union.
Julia Kaye, American Civil Liberties Union attorney
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"For countless people, especially those who live in rural areas, face intimate partner violence, or live with disabilities, losing a telemedicine option will mean losing access to this vital medication altogether," said Julia Kaye, an attorney with the American Civil Liberties Union.
Mini Timmaraju, President and CEO, Reproductive Freedom for All
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"Anti-abortion politicians know their policies are unpopular, so they are using every lever of government they can," said Mini Timmaraju, President and CEO of Reproductive Freedom for All.
Mini Timmaraju, President and CEO, Reproductive Freedom for All
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"Louisiana built this case on debunked, junk science. The safety of mifepristone has never actually been in question. As this case moves towards the U.S. Supreme Court, we will fight until every person has access to the care they need," said Mini Timmaraju, President and CEO of Reproductive Freedom for All.
Liz Murrill, Louisiana Attorney General
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"The Biden-era rule facilitated the deaths of thousands of Louisiana babies and millions in other states," said Liz Murrill, Louisiana Attorney General.
Liz Murrill, Louisiana Attorney General
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"I look forward to continuing to defend women and babies as this case continues," said Liz Murrill, Louisiana Attorney General.
Letitia James, New York Attorney General
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"In New York, our laws ensure that anyone who needs abortion care can seek it here. That has not changed, and we will continue to protect access to abortion, including medication abortion," said Letitia James, New York Attorney General.
Letitia James, New York Attorney General
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"Mifepristone is safe, effective, and essential. Restrictions on abortion care are restrictions on life-saving health care. This decision puts lives at risk," said Letitia James, New York Attorney General.
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Mifepristone was first approved by the U.S. Food and Drug Administration in September 2000 for medical termination of pregnancy through seven weeks of gestation.
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In 2016, the FDA extended the approved use of mifepristone to 10 weeks of pregnancy.
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Mifepristone is typically used in combination with misoprostol to end early pregnancies.
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Because of rare cases of excessive bleeding, the FDA initially imposed strict limits on who could prescribe and distribute mifepristone, restricting it to specially certified physicians and requiring an in-person appointment to receive the pill.
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During the COVID-19 years, the FDA dropped the in-person prescribing and certification requirements for mifepristone.
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In April 2021, the FDA lifted the in-person dispensing requirement for mifepristone for the duration of the COVID-19 pandemic.
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In 2023, the FDA permanently lifted the in-person dispensing requirement for mifepristone, allowing the medication to be sent by mail.
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The U.S. Supreme Court in 2024 unanimously preserved access to mifepristone while ruling that the anti-abortion doctors behind the case lacked legal standing to sue.
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Under a Texas law passed in 2025, doctors who prescribe or companies that distribute abortion-inducing drugs like mifepristone can be sued for up to $100,000.
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Twenty-two states have shield laws that provide civil and criminal protections for healthcare providers who assist patients from states with restrictive abortion laws, and exempt pregnant people who seek or take abortion pills from litigation.
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A 2023 FDA regulation allowed doctors to prescribe mifepristone remotely and have the drug mailed to patients, including those in states where abortion is banned.
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The 5th U.S. Circuit Court of Appeals' Friday decision stems from a lawsuit brought by the state of Louisiana.
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