A federal appeals court on Friday halted the delivery of abortion pills by mail, restoring a nationwide requirement that patients pick up the medication in person.
The three-judge panel of the 5th U.S. Circuit Court of Appeals sided with Louisiana in its lawsuit against the Food and Drug Administration. Louisiana argued that a 2023 FDA rule allowing the pill mifepristone to be sent through the mail undermined the state’s near-total abortion ban.
Friday’s ruling temporarily blocks that FDA rule for the duration of the legal fight. The order requires women to get the medication at a clinic, pharmacy or hospital, and stops deliveries through telehealth or by mail.
Danco Laboratories, a manufacturer of the drug, asked the court to pause its ruling for one week to allow time for an emergency appeal to the U.S. Supreme Court. In court papers, the company called the decision “unprecedented” and said it would cause “immediate chaos” for patients and pharmacies.
Drug manufacturers have long defended the safety of mifepristone. The FDA first approved the medication in 2000. More than 100 studies back its use, and it is now the most common method for abortion care in the United States. The drug is also used to treat early miscarriages.
Access to mifepristone has expanded in recent years. The FDA dropped the in-person pickup requirement in 2023 under the Biden administration. That change made the pill available by mail and allowed doctors to prescribe it through virtual visits. The Supreme Court in 2024 turned away a separate challenge to the drug, ruling that the doctors who sued lacked legal standing to do so.
According to a survey of abortion providers, one in four abortions in the U.S. is now prescribed through telehealth, a practice that Friday’s ruling may disrupt nationwide.
In its ruling, the appellate panel wrote that “every abortion facilitated by FDA’s action cancels Louisiana’s ban on medical abortions” and undermines the state’s policy that “every unborn child is a human being from the moment of conception”. The judges noted that the FDA “could not say when” its ongoing safety review of mifepristone would be complete and “admitted it was still collecting data”.
Louisiana Attorney General Liz Murrill celebrated the decision. “The Biden abortion cartel facilitated the deaths of thousands of Louisiana babies (and millions in other states) through illegal mail-order abortion pills,” Murrill said in a statement. “Today, that nightmare is over”.
Opponents of the ruling condemned the court’s action. Nancy Northup, president of the Center for Reproductive Rights, said the decision “isn’t about science — it’s about making abortion as difficult, expensive, and unreachable as possible”. Julia Kaye, an attorney with the American Civil Liberties Union, said it will “make it much harder for people everywhere in the country to get a medication that abortion and miscarriage patients have been safely using for more than 25 years”.
The case returns mifepristone access to the legal landscape that existed before the 2023 FDA rule change, at least while the courts weigh the merits of Louisiana’s challenge.