Fifth Circuit Issues Temporary Nationwide Mifepristone Order

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.

That decision followed the court's 2022 overturning of Roe v. Wade, which had established a nationwide right to abortion.

" Julia Kaye, an attorney with the American Civil Liberties Union, said the decision "defies clear science and settled law and advances an anti-abortion agenda that is deeply unpopular with the American people," adding that it would affect access to abortion and miscarriage care nationwide, particularly for rural communities, low-income individuals, people with disabilities, survivors of intimate partner violence, and communities of color.

" The American College of Obstetricians and Gynecologists has stated that mifepristone is one of the most common methods of abortion in the U.S. and has been used safely by millions over more than two decades. No public comments from the FDA on the specific order were available as of May 1, 2026, according to agency statements.