Court restricts abortion access across the US by blocking the mailing of
mifepristone
[May 02, 2026]
By GEOFF MULVIHILL and HANNAH SCHOENBAUM
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.
Friday's unanimous ruling from a three-judge panel of the New
Orleans-based 5th U.S. Circuit Court of Appeals is requiring that the
abortion pill be distributed only in person and at clinics, overruling
regulations set by the federal Food and Drug Administration.
The ruling, which is likely to be appealed to the U.S. Supreme Court, is
the biggest jolt to abortion policy in the U.S. since the 2022 Supreme
Court ruling that overturned Roe v. Wade and allowed states to enforce
abortion bans.
In the ruling, Judge Kyle Duncan, who was appointed by President Donald
Trump, agreed with the state of Louisiana's contention that allowing the
drug to be mailed there makes moot the state's ban on abortion at all
stages of pregnancy.
“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 and is, therefore, a legal
person,’” the ruling states.
Mifepristone is involved in most abortions in the US
Mifepristone was approved in 2000 as a safe and effective way to end
early pregnancies. It is typically used in combination with a second
drug, misoprostol.
Surveys have found that the majority of abortions in the U.S. are
provided via pills and that about 1 in 4 abortions nationally are
prescribed via telehealth.
One survey of abortion providers last year estimated that more women in
states where abortion is banned obtained abortions that way than by
traveling to other states.
Some Democratic-led states have laws that seek to protect providers who
prescribe via telehealth to patients in places with bans.
That rise in prominence is why abortion opponents have targeted the
pills in legislation and litigation.
Ruling goes against how courts usually view FDA decisions
There is little precedent for a federal court overruling the scientific
regulations of the FDA, and it wasn’t immediately clear how quickly or
completely the decision would impact mailing of the drug throughout the
country.
Judges have long deferred to the agency's judgments on the safety and
appropriate regulation of drugs.
FDA officials under Trump have repeatedly stated that the agency is
conducting a new review of mifepristone’s safety, at the direction of
the president.
The judges, all nominated by Republican presidents, noted in their
ruling that the FDA “could not say when that review might be complete
and admitted it was still collecting data.”
Because of rare cases of excessive bleeding, the FDA initially imposed
strict limits on who could prescribe and distribute the pill — only
specially certified physicians and only after an in-person appointment
where the person would receive the pill.
Both those requirements were dropped during the COVID-19 years. At the
time, FDA officials under President Joe Biden said that after more than
20 years of monitoring mifepristone use, and reviewing dozens of studies
involving thousands of women, it was clear that women could safely use
the pill without direct supervision.
GenBioPro, which makes generic mifepristone, said in a statement the
court’s decision “ignores the FDA’s rigorous science and decades of safe
use of mifepristone in a case pursued by extremist abortion opponents.”
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Attorney General Liz Murrill speaks with the news media, Oct. 15,
2025, in Washington. (AP Photo/Cliff Owen, File)
 The impact isn't just in states
with bans
In a court filing, Louisiana’s attorney general and a woman who said
she was coerced into taking abortion pills requested that the FDA
rules be rolled back to when the pills were allowed to be prescribed
and dispensed only in person.
A Louisiana-based federal judge last month ruled that those
allowances undermined the state’s abortion ban but stopped short of
undoing the regulations immediately.
Friday's ruling is in effect as the case works its way through the
courts and extends beyond Louisiana and states with abortion bans.
Telehealth prescriptions have become common even in states where
abortion is allowed — and the ruling blocks them there, too.
“This is going to affect patients’ access to abortion and
miscarriage care in every state in the nation,” said Julia Kaye, an
ACLU lawyer. “When telemedicine is restricted, rural communities,
people with low incomes, people with disabilities, survivors of
intimate partner violence and communities of color suffer the most.”
The National Right to Life Committee said the ruling “restores a
critical layer of oversight" in women’s health.
“Women deserve better than an abortion-by-mail system that
prioritizes ideology over safety," said Carol Tobias, the group’s
president.
Next step could be an appeal to the nation's top court
Danco Laboratories, another mifepristone manufacturer and a
defendant in the lawsuit, asked the appeals court Friday after the
ruling to put its order on hold for one week to give the company
time to “seek relief” from the Supreme Court. If the court does not
grant the request, the company said it will file an emergency appeal
with the high court.
The conservative-majority Supreme Court overturned abortion as a
nationwide right in 2022 but unanimously preserved access to
mifepristone two years later.
That 2024 decision sidestepped the core issues, however, by ruling
that the anti-abortion doctors behind the case didn’t have legal
standing to sue.
“I look forward to continuing to defend women and babies as this
case continues,” Louisiana Attorney General Liz Murrill, a
Republican, said in a statement.
Representatives for the FDA and the U.S. Department of Justice did
not immediately respond to requests for comment Friday evening.
In the meantime, anti-abortion groups are celebrating Friday's
ruling. Marjorie Dannenfelser, president of Susan B. Anthony
Pro-Life America, applauded the ruling as “a huge victory for
victims and survivors of Biden’s reckless mail-order abortion drug
regime.” She also criticized the Trump administration for taking
time to conduct its own review of mifepristone, saying its slow
movement has forced states to take action.
“Women and children suffer and state sovereignty is violated every
day the FDA allows abortion drugs to flood the mail,” Dannenfelser
said.
___
Associated Press reporters John Hanna, Matthew Perrone and Lindsay
Whitehurst contributed.
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