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Fifth Circuit Issues Temporary Nationwide Order on Mifepristone
A U.S. appeals court issued an order on May 1, 2026, pausing FDA rules that allowed mifepristone to be obtained by mail or telemedicine. The decision, stemming from a Louisiana lawsuit, requires in-person dispensing nationwide. Stakeholders on both sides reacted, with the case likely headed to the Supreme Court.
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The U.S. Court of Appeals for the Fifth Circuit issued an order on May 1, 2026, temporarily requiring that the abortion medication mifepristone be dispensed in person at clinics, hospitals, or medical offices, rather than through mail or telemedicine prescriptions.
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The order, which has nationwide effect, stems from a lawsuit filed by the state of Louisiana challenging a 2023 Food and Drug Administration regulation that permitted mailing of the drug after virtual consultations.
" The court further noted that the ruling "protects fetal life consistent with state policy on personhood from conception," according to the filing. The decision overrides a lower court ruling from earlier in the month that had paused the case pending an FDA review directed by the Trump administration.
Mifepristone, approved by the FDA in September 2000 for terminating pregnancies up to seven weeks gestation (later extended to 10 weeks), blocks the hormone progesterone needed for pregnancy continuation. It is typically used in combination with misoprostol, with FDA data indicating the regimen is about 95% effective and requires follow-up care in less than 1% of cases.
The FDA temporarily lifted in-person dispensing requirements in April 2021 due to the COVID-19 pandemic and made the change permanent in 2023, citing over 20 years of monitoring and studies involving thousands of women showing safe use without direct supervision.
" Under the Trump administration, the agency announced it is conducting a new safety review of mifepristone at the president's direction, though it could not specify a completion date and noted it was still collecting data. The U.S. Supreme Court in 2024 unanimously rejected a separate challenge to mifepristone access, ruling that the anti-abortion doctors involved lacked legal standing to sue.
