A US appeals court has temporarily blocked the distribution of mifepristone, the FDA-approved abortion medication, through the mail. The ruling, issued on Friday by a conservative three-judge panel of the Fifth Circuit Court of Appeals in New Orleans, responded to a lawsuit from Louisiana challenging the FDA's elimination of in-person dispensing requirements.
Abortion rights advocates have condemned the decision, calling it the most significant threat to access since the Supreme Court overturned federal abortion protections in 2022. Kelly Baden, vice-president at the Guttmacher Institute, warned that if upheld, the ruling would severely restrict mifepristone access in every state, including those where abortion remains legal.
Mifepristone is part of a two-drug regimen used in the majority of US abortions, backed by decades of safety evidence. Its use increased after the 2022 Supreme Court ruling, particularly through telehealth prescriptions. The FDA had modified regulations to allow online prescribing, expanding access even in states with restrictive laws.
The ruling was welcomed by Louisiana's Republican attorney general, Liz Murrill, who said she looked forward to defending women and babies. Meanwhile, the FDA, now under the Trump administration, has opened a review of the medication, raising concerns among reproductive rights advocates that further restrictions may follow.
Julia Kaye, senior staff attorney for the ACLU's Reproductive Freedom Project, criticised the decision as based on lies and propaganda. Despite the ruling, mifepristone remains authorised in 96 countries and is supported by extensive research. The Guttmacher Institute reported that 9,350 abortions were provided via telehealth in Louisiana in 2025, highlighting the drug's role in maintaining access in ban states.
