Fifth Circuit Blocks Mail-Order Access to Mifepristone Temporarily

A three-judge panel of the U.S. Court of Appeals for the Fifth Circuit issued a ruling on Friday that temporarily blocks the mailing of the abortion pill mifepristone nationwide, reinstating an in-person requirement for obtaining the drug. The decision affects rules established by the Food and Drug Administration (FDA) during the COVID-19 pandemic, which had allowed mifepristone to be dispensed through the mail without an in-person visit.

The court's order stems from a lawsuit filed by Louisiana and other states challenging the FDA's 2021 and 2023 actions that permitted mail-order distribution of mifepristone. In its ruling, the panel stated, "Every abortion facilitated by FDA’s action cancels Louisiana’s ban," highlighting that the federal policy allows out-of-state prescribers to provide the drug in ways that conflict with state laws.

Louisiana law recognizes an unborn child as a human being from the moment of conception and bans abortion with limited exceptions for maternal health. In 2024, Louisiana classified mifepristone as a controlled and dangerous substance, becoming the first state to do so.

The Fifth Circuit, based in New Orleans, has jurisdiction over federal cases from Louisiana, Mississippi, and Texas. The panel consists of judges appointed by former Presidents Donald Trump (two) and George W. Bush (one).

Danco Laboratories, the manufacturer of mifepristone, filed an emergency application with the Supreme Court on Saturday to pause the Fifth Circuit's ruling. In the application, Danco's attorneys wrote, "It bears emphasis how unprecedented the Fifth Circuit’s order is," arguing that the nationwide block disrupts access to an FDA-approved medication.

The FDA first approved mifepristone in 2000 under the Clinton administration, and for over two decades, it required in-person dispensing. The agency temporarily lifted this requirement in 2021 citing pandemic conditions and made it permanent in 2023, both under President Joe Biden.

The ruling follows the Supreme Court's 2022 decision overturning Roe v. Wade, which shifted abortion regulation to the states. " The U.S. government has not publicly released a detailed response to the Fifth Circuit's criticism of the FDA's data handling as of the latest available statements.

No publicly released evidence from the sources documents specific instances of adverse events that the court referenced beyond the agency's own reporting changes.