A US federal appeals court has reinstated a requirement that the abortion pill mifepristone be obtained in person, effectively ending mail-order access to the drug for patients in states where abortion is restricted.
The Fifth Circuit Court of Appeals issued the order Friday, pausing a 2023 FDA regulation that allowed doctors to prescribe the medication via telemedicine and send it by mail. The ruling stems from a lawsuit filed by Louisiana, which argued the FDA’s rule undermined its state ban on abortion.
In its order, the court 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.'"
The decision overrides a lower court ruling from earlier this month that had paused the case pending an FDA review under the Trump administration.
The American Civil Liberties Union condemned the ruling, with attorney Julia Kaye saying it “defies clear science and settled law.” She added that for many-especially those in rural areas, survivors of domestic violence, or people with disabilities-losing telemedicine access will mean losing access to the medication entirely.
Louisiana Attorney General Liz Murrill celebrated the decision, saying the Biden-era rule “facilitated the deaths of thousands of Louisiana babies.”
Mifepristone is the first drug in a two-pill regimen used to end early pregnancy. It was first approved by the FDA in 2000 and is considered safe by major medical organizations. The Supreme Court had rejected a previous attempt to restrict the drug in 2024.
New York Attorney General Letitia James affirmed that abortion access remains legal in her state, calling mifepristone “safe, effective, and essential.”