WASHINGTON — The Supreme Court extended a temporary order maintaining mail access to the abortion pill mifepristone until at least Thursday at 5 p.m. The court is considering whether to allow restrictions on the drug to take effect while litigation proceeds.

The extension allows women seeking abortions to continue obtaining mifepristone at pharmacies or through the mail without an in-person doctor's visit. Justice Samuel Alito, who handles emergency appeals arising from the 5th U.S. Circuit Court of Appeals, first provisionally blocked a lower court decision on May 4 that would have prevented mifepristone from being administered by mail.

The order came after a three-judge panel of the 5th Circuit ruled that mail access and telehealth visits for mifepristone should be suspended while the case plays out. The panel granted Louisiana's request to void Biden administration rules that allowed mifepristone to be administered without an in-person meeting, meaning the drug could be mailed anywhere in the country, even in states with strict abortion bans. The panel also restored a Food and Drug Administration rule requiring mifepristone to be dispensed in person. In its ruling, the panel wrote: "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.'"

Louisiana officials sued the FDA last year over its regulation allowing mifepristone to be mailed. A federal district court paused the lawsuit while the agency reviews mifepristone's safety. Louisiana officials appealed the pause, and the 5th Circuit temporarily blocked the 2023 policy allowing mifepristone to be prescribed remotely and sent through the mail. Danco Laboratories and GenBioPro then asked the Supreme Court to set aside the 5th Circuit's ruling and allow abortion providers to prescribe mifepristone online and send it to patients while legal proceedings continue.

Mifepristone is taken together with misoprostol to terminate an early pregnancy. The FDA first approved mifepristone in 2000, and its scientists have repeatedly deemed the drug safe and effective. In 2023, medication abortion accounted for 65% of all clinician-provided abortions in the United States, according to the Guttmacher Institute, representing nearly two-thirds of all abortions in the U.S.

Three years ago, lower courts sought to restrict access to mifepristone in a lawsuit filed by physicians who oppose abortion. Those physicians filed suit in the months after the Supreme Court overturned Roe v. Wade. The court blocked the 5th Circuit's ruling in that case from taking effect over dissenting votes from Justices Alito and Thomas. In 2024, the court unanimously dismissed the physicians' lawsuit, reasoning that they did not have standing to sue.