NEW ORLEANS — The 5th U.S. Circuit Court of Appeals in New Orleans on May 1 issued a ruling rolling back nationwide telemedicine access to mifepristone effective immediately. Two drugmakers appealed the decision to the Supreme Court immediately after it was issued.

The Supreme Court stayed the 5th Circuit's decision for one week, allowing mifepristone to continue to be prescribed through telemedicine and mailed through at least May 11, 2026. When the stay expires Monday, a justice could extend the temporary stay, grant a longer stay pending appeal, or allow the 5th Circuit's decision to take effect.

Judge Stuart Kyle Duncan wrote that telemedicine access to mifepristone "injures Louisiana by undermining its laws protecting unborn human life and also by causing it to spend Medicaid funds on emergency care for women harmed by mifepristone. Both injuries are irreparable."

Last fall, Louisiana sued the FDA, arguing that the availability of telemedicine for mifepristone undermines its strict abortion ban. In April 2026, a federal district court judge stayed the lawsuit, and Louisiana appealed that stay to the 5th Circuit. According to legal scholar Mary Ziegler, Louisiana is the first state to schedule mifepristone as a controlled substance and the first to criminally indict an out-of-state physician for providing telemedicine abortion.

The FDA approved mifepristone in 2000 with a requirement that patients go in person to a clinic or doctor's office to receive it. During the COVID-19 pandemic, the agency allowed the drug to be dispensed at local pharmacies or through the mail, and in 2023 made that policy official. The FDA's prescribing rules for medications apply nationwide.

Nearly two dozen Democratic-led states submitted an amicus brief asking the Supreme Court to keep the 5th Circuit's decision on hold. A group of former FDA leaders said the ruling would upend the agency's science-based drug approval system.

Telemedicine abortion accounts for one quarter of abortions nationwide. The Guttmacher Institute estimated there were 1.1 million abortions in the U.S. in 2025, including 9,000 in Louisiana. Some reproductive health providers have prepared to switch to a protocol using only misoprostol for medication abortion, which is not affected by the case but tends to have more frequent side effects.

The Supreme Court's Dobbs decision overturned the constitutional right to abortion. In 2023, a federal district court judge ruled that mifepristone should be pulled from the market. The Supreme Court unanimously dismissed the Texas mifepristone case in 2024 for lack of standing.

Jane, a 44-year-old Florida resident with two children, discovered her pregnancy in February 2024 and used a telemedicine provider to receive mifepristone by mail at her home. She said she was "relieved and grateful" to have the option. Other patients in remote parts of California, Louisiana, and Georgia have relied on telemedicine to obtain the drug.