'Sweeping and Dangerous': US Appeals Court Blocks Mailing of Abortion Pills

Rights advocates swiftly sounded the alarm on Friday after the infamously far-right US Court of Appeals for the 5th Circuit temporarily blocked a federal rule allowing mifepristone to be dispensed by mail, dramatically curtailing access to the medication—commonly used for abortion and early miscarriage care—nationwide, particularly in states with policies hostile to reproductive freedom.

Just months after the US Supreme Court's right-wing supermajority reversed Roe v. Wade, the Food and Drug Administration permanently lifted mifepristone's in-person dispensing requirement in early 2023, under then-President Joe Biden. Louisiana—which has among the nation's most restrictive abortion policies—challenged the FDA's move.

A federal judge in Louisiana paused that lawsuit last month while President Donald Trump's administration conducts an FDA review that seems "designed to manufacture an excuse for further restricting medication abortion across the country," as Julia Kaye, senior staff attorney for the ACLU's Reproductive Freedom Project, warned at the time.

After a panel from the appellate court overturned that decision and revived the in-person dispensing rule on Friday, Kaye declared that "anti-abortion politicians have just made 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."

"Louisiana's legal attack on mifepristone shamelessly packaged lies and propaganda as an excuse to restrict abortion—and the 5th Circuit rubber-stamped it," she continued. "This decision defies clear science and settled law and advances an anti-abortion agenda that is deeply unpopular with the American people. For countless people, especially those who live in rural areas, face intimate partner violence, or live with disabilities, losing a telemedicine option will mean losing access to this vital medication altogether."

Brittany Fonteno, president and CEO of the National Abortion Federation (NAF), similarly stressed that "this ruling is a sweeping and dangerous rollback that disregards the well-established safety and efficacy of the use of mifepristone via telehealth, and will create immediate, medically unnecessary barriers to care for patients across the country."

"Make no mistake: This ruling is not grounded in science or patient safety," she said. "It is a politically driven decision that overrides medical expertise and years of research, and threatens to upend how abortion care is delivered nationwide. Through this litigation, Louisiana seeks to impose its cruel abortion ban across the nation—including in states with legal protections for abortion—and today the court has taken an extreme step toward that end."

While pledging that "NAF and our allies will continue to advocate to restore full access to medication abortion," Fonteno reminded patients that mifepristone "remains available in doctors' offices, clinics, and hospitals."

After Roe's reversal, the anti-choice movement and its allies in elected offices ramped up efforts to impose state-level restrictions on reproductive healthcare. A significant majority of abortions in the United States involve a two-drug regimen of mifepristone and misoprostol, and a quarter of those patients receive care via telemedicine.

"Telehealth has been the last bridge to care for many seeking abortion, which is precisely why Louisiana officials want it banned," said Nancy Northup, president and CEO of the Center for Reproductive Rights, which joined over 100 other reproductive health, justice, and rights groups, including the ACLU and NAF, that filed an amicus brief in this case.

"This isn't about science—it's about making abortion as difficult, expensive, and unreachable as possible," Northup added. "Telehealth has transformed healthcare. Selectively stripping that away from abortion patients is a political blockade."

The drug companies Danco Laboratories, which makes the brand-name version of mifepristone, Mifeprex, and GenBioPro, which makes the generic, have intervened in Louisiana v. FDA. GenBioPro is represented by the law firm Arnold & Porter and Democracy Forward, whose president and CEO, Skye Perryman, declared Friday that "this is the anti-abortion extremists' playbook in action once again: Weaponize the courts to serve their political interests, ignore decades of scientific evidence proving mifepristone’s safety, and put women directly in harm's way."

"Even as this assault defies the will of the overwhelming majority of the American public, these ideologically extreme politicians and organizations are determined to impose a narrow, autocratic agenda—no matter the cost," she continued, emphasizing that "our fight is not over."

The effects of the 5th Circuit's decision are expected to be immediate absent a quick intervention from the Supreme Court, and Nourbese Flint, president of All* Above All, warned that "as always, the people most impacted will be Black and brown communities and those already navigating systemic barriers to care."

Serra Sippel, executive director of the Brigid Alliance, a national abortion support group that helps coordinate and fund travel, said that "we expect to see an immediate increase in patients forced to travel hundreds or even thousands of miles for care. That includes many who are later in pregnancy—when care is more complex and more expensive."

"Over the past several years, we've seen a dramatic rise in abortion travel and a growing reliance on practical support networks like ours, particularly in states where patients already travel long distances for care," Sippel noted. "We will continue to monitor the impact of this ruling and are committed to ensuring abortion patients who need to travel can safely get to the care they need, regardless of where they live."