NEW ORLEANS, USA — A federal appeals court on Friday, May 1, 2026, temporarily reinstated a nationwide requirement that mifepristone, a widely used abortion pill, be dispensed in person, blocking access to the drug by mail and through telehealth while a lawsuit brought by Louisiana proceeds.
The ruling by the U.S. Court of Appeals for the Fifth Circuit granted Louisiana’s request to pause a Food and Drug Administration regulation that had allowed mifepristone to be prescribed remotely and sent by mail.
The decision is expected to intensify legal battles over medication abortion, which has become central to abortion access since the Supreme Court overturned Roe v. Wade in 2022.
Louisiana Challenge Prevails for Now
Louisiana sued the FDA over its 2023 decision to permanently remove the requirement that mifepristone be dispensed only in clinics, medical offices or hospitals.
The state argued that the rule undermined its abortion restrictions and created safety concerns.
A lower court had paused the case while the Trump administration conducted a safety review of mifepristone and declined to reinstate the in-person requirement during that review.
Louisiana appealed, and the Fifth Circuit ruled in the state’s favour.
“The district court agreed that Louisiana was likely to win its challenge to the mifepristone regulation and was suffering irreparable harm from it,” Circuit Judge Stuart Kyle Duncan wrote for the panel.
“Nonetheless, the court declined to stay the regulation based on its balancing of the equities and the public interest. Louisiana appealed to our court and sought a stay pending appeal. We grant the stay.”
Drugmaker Seeks Emergency Relief
Danco Laboratories, which makes and distributes mifepristone, filed a request for a one-week pause of the order on Friday night.
The company said it would seek relief from the U.S. Supreme Court if the appeals court did not intervene.
“Never before has a federal court purported to immediately change a drug’s conditions of use upon issuance of its order. The Order results in immediate chaos,” lawyers for Danco wrote.
“It is now unclear whether pharmacies nationwide may still dispense mifepristone to women tonight,” the company’s lawyers said.
GenBioPro, which manufactures a generic form of the drug, also criticised the decision.
“We are alarmed by this court’s decision to ignore the FDA’s rigorous science and decades of safe use of mifepristone in a case pursued by extremist abortion opponents,” Evan Masingill, the company’s chief executive, said in a statement.
Abortion-Rights Groups Condemn Ruling
Abortion-rights advocates said the ruling would sharply reduce access, especially for patients in states where abortion is banned or heavily restricted and where telehealth prescriptions have allowed some patients to obtain medication from providers in other states.
“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,” said Julia Kaye, a senior staff attorney for the Reproductive Freedom Project of the ACLU.
Alexis McGill Johnson, chief executive of Planned Parenthood Action Fund, said the organisation’s health centres “remain committed to providing abortion care where legal.”
Opponents of Abortion Welcome Decision
Louisiana Attorney General Liz Murrill, who brought the case with Alliance Defending Freedom, praised the ruling.
“I look forward to continuing to defend women and babies as this case continues,” Murrill said.
Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life America, called the decision “a huge victory for victims and survivors of Biden’s reckless mail-order abortion drug regime.”
Wider Legal Battle
Mifepristone was first approved by the FDA in 2000 and is used with another drug in medication abortion.
During the COVID-19 pandemic, the Biden administration temporarily removed the in-person dispensing requirement, and the FDA made that change permanent in 2023.
Multiple studies have found medication abortion to be safe and effective when taken at home after consultation with a clinician, and peer-reviewed research has shown serious adverse reactions are rare.
Five other Republican-led states are pursuing separate challenges to FDA regulations governing abortion medication, including the original approval of mifepristone.
The Trump administration has moved to pause those cases while it reviews the drug.
Louisiana and Texas have also pursued legal action against health care providers in other states accused of prescribing abortion pills to their residents, testing shield laws in states such as New York and California that protect providers from out-of-state investigations and prosecutions.
The Fifth Circuit order is temporary, but its nationwide reach immediately places mail-order and telehealth access to mifepristone in legal uncertainty while the case moves toward a likely Supreme Court fight.
