NEW YORK — A federal appeals court in New York on Friday restricted mail access to mifepristone prescriptions, one of the most common abortion methods in the country. The ruling is the biggest shift to federal abortion policy since the Supreme Court's 2022 decision allowing states to enforce abortion bans.

On Monday, the Supreme Court temporarily restored broad access to mifepristone while it further considers the case. The Food and Drug Administration is conducting a separate safety review of the drug.

Also on Monday, the anti-abortion group SBA Pro-Life America called for the firing of FDA commissioner Dr. Marty Makary over the mifepristone review. "This is a five-alarm crisis for the pro-life movement and for the GOP. The GOP cannot win without its base and simply will not get the enthusiasm that drives turnout without leadership from the top," SBA Pro-Life America President Marjorie Dannenfelser said.

The midterm elections this year will determine control of Congress for the second half of President Donald Trump's term. Democratic pollster Celinda Lake said Friday's ruling reminded voters that their access to abortion medication through telehealth is not guaranteed even in states where abortion rights are protected, and presented a "horrific" opportunity to tell voters what could be at stake in this year's midterms.

Mini Timmaraju, president and CEO of Reproductive Freedom for All, said outreach to voters about the volatility of abortion access will be part of her group's strategy in the midterms, including contacting voters who supported Trump but also backed abortion rights in their state elections in 2024. "The only way for us to really stop this back and forth is to have abortion access be legal in all 50 states. The only way we do that is through federal legislation, which makes the midterm elections even more urgent," Timmaraju said.

After the overturning of Roe v. Wade in 2022, several states voted to enshrine abortion rights into their own constitutions. Trump's first-term nominations to the Supreme Court set the stage for the court's vote to overturn Roe v. Wade. Trump has said he believes abortion policy should be left to the states, has made an effort to withhold funds from Planned Parenthood, and launched investigations into states that require state-regulated health insurance plans to cover abortion.

About two-thirds of Americans opposed nationwide bans on mifepristone, according to a KFF poll conducted late last year. About two-thirds of U.S. adults said abortion should be legal in all or most cases, according to AP-NORC polling, with relatively few saying it should be illegal in all cases.