The 5th U.S. Circuit Court of Appeals in New Orleans issued a unanimous ruling Friday that requires mifepristone to be distributed only in person at clinics, overturning regulations set by the Food and Drug Administration. The decision came in response to a lawsuit filed by Louisiana Attorney General Liz Murrill against the FDA, arguing that the agency's rules undermined the state's ban on abortions at all stages of pregnancy.
Judge Kyle Duncan, appointed by President Donald Trump, wrote that the FDA regulation had created "an effective way for an out-of-state prescriber to place the drug in the hands of Louisianans in defiance of Louisiana law." The ruling takes effect immediately while the case continues through the courts and applies to all states, regardless of whether they have abortion restrictions in place. The decision is expected to be appealed to the U.S. Supreme Court.
Mifepristone was approved in 2000 and is typically used in combination with a second drug, misoprostol. Surveys indicate that the majority of abortions in the U.S. are administered using pills, with approximately one in four abortions prescribed via telehealth. The pill's availability through online prescriptions and mail delivery has been cited as a reason why abortion numbers in the country have not declined since Roe v. Wade was overturned in 2022.
Mary Ziegler, an abortion law expert and professor at University of California at Davis School of Law, characterized the ruling as significant. "We're now going to see, I think in a way we haven't before, what the nation will look like when abortion bans are actually in effect," Ziegler said. She added that the decision puts increased pressure on political leadership to address the issue ahead of midterm elections.
Some Democratic-led states have enacted shield laws designed to protect providers who prescribe medication abortions via telehealth and mail pills to states with bans. Dr. Angel Foster, who works with The Massachusetts Medication Abortion Project, stated that her organization would "do everything in our power to continue providing care to people in all 50 states." Danco Laboratories, a mifepristone manufacturer and defendant in the lawsuit, asked the Supreme Court on Saturday to block the ruling while appeals are pending.
Abortion-rights advocate 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." Since Roe was overturned, voters have sided with abortion-rights positions in 14 of 17 state ballot measures on the issue. Some anti-abortion advocates, however, criticized Trump for not taking unilateral action to block the pill's distribution, noting that his administration approved a generic version of mifepristone last year.
