Fifth Circuit blocks mailing of abortion pill nationwide

(CN) — A Fifth Circuit panel further restricted abortion access across the U.S. on Friday and reinstated a Food and Drug Administration requirement for in-person dispensing of the abortion drug mifepristone.

“Every abortion facilitated by FDA’s action cancels Louisiana’s ban on medical abortions and undermines its policy that ‘every unborn child is human being from the moment of conception and is, therefore, a legal person,’” U.S. Circuit Judge Kyle Duncan, a Donald Trump appointee, wrote for the three-judge panel in an 18-page ruling.

Louisiana, which has one of the nation’s strictest bans on abortion, had claimed the FDA’s 2023 regulations allowing the drug to be prescribed online and dispensed through the mail violated the Administrative Procedure Act.

The ruling by New Orleans-based panel — also consisting of U.S. Circuit judges Leslie Southwick, a George W. Bush appointee, and Kurt Engelhardt, a Trump appointee — doesn’t just stop at Louisiana.

While a lower federal court had declined to block the altered 2023 regulations, citing possible conflicts from multiple parallel lawsuits, the Fifth Circuit panel dismissed those worries.

Directly noting the lower court’s concern over the U.S. Supreme Court June 2025 decision restricting nationwide injunctions, Duncan said “In CASA, the Supreme Court plainly said it was addressing only equitable relief and not remedies under the APA.”

Alexis McGill Johnson, president and CEO of the Planned Parenthood Action Fund, said in a statement: “This is yet another attack on abortion that is rooted in politics, not science. The impact of restricting access to mifepristone means that it will be harder for everyone, everywhere to get an abortion.”

The ruling will likely be appealed to the Supreme Court, which ruled in 2023 to preserve access to mifepristone, despite overturning the right to abortion in 2022.

Louisiana, which sued the FDA in 2025, had asked for a stay on the regulations after the lower federal court had paused the case as whole in April — without blocking the regulations themselves — to allow the agency to complete a scientific review on the safety of mifepristone.

“We have now three times found that the agency’s progressive relaxation of mifepristone’s guardrails likely lacked a basis in data and scientific literature. FDA itself now concedes the regulations were marred by ‘procedural deficits’ and a ‘lack of adequate consideration.’ The public interest is not served by perpetuating a medical practice whose safety the agency admits was inadequately studied,” Duncan wrote.

The judge wrote that the state’s appeal concerns the 2023 alteration to the regulations, not the ongoing review. Duncan also noted the FDA “could not say when that review might be complete and admitted it was still collecting data.”

The FDA did not immediately return a request for comment.

Louisiana Attorney General Liz Murrill praised the ruling in a statement.

“The Biden abortion cartel facilitated the deaths of thousands of Louisiana babies (and millions in other states) through illegal mail-order abortion pills. Today, that nightmare is over, thanks to the hard work of my office and our friends at Alliance Defending Freedom. I look forward to continuing to defend women and babies as this case continues,” she said.

The FDA approved mifepristone over two decades ago as a safe way to end pregnancies. It is typically used in combination with the drug misoprostol. According to the Guttmacher Institute, 65% of abortions in the U.S. in 2023 were medication abortions, with one-fourth provided via telehealth.

Since the fall of Roe v. Wade in 2022, telehealth has become a primary path to mifepristone for residents of states like Louisiana where access is blocked. Research has indicated that remote dispensing of medication abortion is as safe as taking the medication in a clinic.

“Telehealth has been the last bridge to care for many seeking abortion, which is precisely why Louisiana officials want it banned,” Nancy Northup, president and CEO of the Center for Reproductive Rights, said in a statement. “This isn’t about science — it’s about making abortion as difficult, expensive and unreachable as possible. Telehealth has transformed healthcare. Selectively stripping that away from abortion patients is a political blockade.”