A federal appeals court has restricted access to one of the most common means of abortion in the U.S. by blocking the mailing of mifepristone prescriptions. The unanimous ruling from the New Orleans-based 5th U.S. Circuit Court of Appeals marks a substantial victory for abortion opponents seeking to stem the flow of abortion pills prescribed online, which they view as subverting state bans on the procedure.
Impact Extends Beyond States with Abortion Bans
Louisiana Attorney General Liz Murrill sued the FDA last month, arguing that its regulations undermined the state’s ban on abortions at all stages of pregnancy. Judge Kyle Duncan, appointed by President Donald Trump, wrote that the regulation creates an effective way for out-of-state prescribers to place the drug in the hands of Louisianans in defiance of state law. The ruling is in effect while the case works through the courts and affects all states, even those without abortion restrictions.
There is little precedent for a federal court overruling the FDA’s scientific regulations. It remains to be seen how the decision could impact long-term dispensing of the drug. Murrill celebrated the ruling as a “victory for life,” while other anti-abortion advocates cheered the reversal of rules finalized under President Joe Biden that ended the requirement for in-person doctor visits.
Mifepristone Long Considered Safe and Effective
Mifepristone was approved in 2000 as a safe and effective way to end early pregnancies. It is typically used with a second drug, misoprostol, which is not affected by the ruling but is less effective on its own. Surveys show that the majority of abortions in the U.S. are administered using pills, and about one in four are prescribed via telehealth. Providers suggest that telehealth availability is why abortion numbers have not fallen since Roe v. Wade was overturned in 2022.
Danco Laboratories, a mifepristone manufacturer, has asked the appeals court to put its order on hold for one week to seek relief from the Supreme Court. Some Democratic-led states have adopted shield laws to protect providers who prescribe via telehealth and mail pills to states with bans. These laws are being tested through civil and criminal cases in Louisiana and Texas.
Abortion Policy Could Influence Midterms
The case could again make abortion a key issue in the midterm elections. Recent electoral results suggest voters seeking to maintain abortion access have momentum. Since Roe was overturned, abortion has been on the ballot directly in 17 states, with voters siding with abortion-rights in 14 of those questions. Fatima Goss Graves, president of the National Women’s Law Center, slammed the ruling as “deeply out of step with both the public and fact-based science.”
Trump received criticism from some anti-abortion advocates who expressed frustration that he did not take action to block distribution of the pill. The FDA under Trump approved another generic version of mifepristone last year, which peeved some allies. Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, applauded the ruling but called it “shameful that the Trump administration’s inaction has forced pro-life states to take their battle to the federal courts.”
