Danco Laboratories and GenBioPro, makers of mifepristone, filed requests with the Supreme Court on Saturday to block a decision issued the previous day by the 5th U.S. Circuit Court of Appeals. The New Orleans-based court's unanimous ruling requires that mifepristone be distributed exclusively through in-person visits at clinics, overturning federal Food and Drug Administration regulations that allowed the drug to be dispensed by mail. Danco Laboratories argued in its emergency petition that the appellate ruling "injects immediate confusion and upheaval into highly time-sensitive medical decisions."
The appeals court decision marked a substantial victory for abortion opponents seeking to restrict abortion pills prescribed online, which they view as circumventing state bans. The ruling affects patients nationwide, including those in states without abortion restrictions. Louisiana Attorney General Liz Murrill, a Republican, had sued the FDA the previous year, contending that its rules permitting mail distribution of mifepristone undermined the state's ban on abortion at all stages of pregnancy. Murrill celebrated the court's decision as a "victory for life."
Mifepristone was approved in 2000 and is typically used alongside misoprostol in medication abortions. The ruling affects only mifepristone distribution; misoprostol remains available but is less effective on its own. Surveys indicate that the majority of abortions in the United States rely on pills, with roughly one in four performed through telehealth.
The decision creates immediate complications for providers and patients. Josh Thorburn, owner of Eddie's Pharmacy in Los Angeles, noted the access problems for patients without nearby providers willing to prescribe the medication. Dr. Angel Foster, who leads the Massachusetts Medication Abortion Project in a state with shield laws protecting out-of-state providers, said her organization would work with legal experts to understand the ruling's impact. Mini Timmaraju, president and CEO of Reproductive Freedom for All, said providers are in "limbo" as they await further court action but noted they could pivot to using misoprostol alone, though it would have "a chilling effect on providers across the country."
Mary Ziegler, an abortion law expert and professor at the University of California at Davis School of Law, characterized the decision as "a pretty significant change in terms of how people experience abortion access, probably as significant as anything we've seen since Roe was overturned." The ruling is expected to become a key issue in upcoming elections. Since the Supreme Court overturned Roe v. Wade, abortion has appeared directly on ballots in 17 states, with voters siding with abortion-rights positions in 14 of those contests.
Fatima Goss Graves, president and CEO of the National Women's Law Center, said the ruling is "deeply out of step with both the public and fact-based science." Some anti-abortion advocates, including Marjorie Dannenfelser of Susan B. Anthony Pro-Life America, criticized the Trump administration for not taking independent action to restrict the pill's distribution, calling the administration's inaction "shameful."
