A US appeals court has blocked one of the main methods of obtaining abortion drugs for people living in banned states. At the end of February in the American court named after John M. Shaw in Lafayette, LA, held a hearing in the Louisiana case regarding access to telehealth. (Photo: Greg LaRose/Louisiana Illuminator)
One of the main methods of obtaining abortion drugs for people living in banned states is now blocked nationwide following a federal appeals court decision issued Friday afternoon.
5th District Court of Appeals blocked a 2023 U.S. Food and Drug Administration rule that allowed mifepristone, one of two drugs used to terminate pregnancies before 10 weeks and treat miscarriages, to be dispensed without an in-person visit to a doctor.
Since then, states with abortion access have increased their telemedicine offerings, allowing medications to be prescribed remotely and sent via mail. Many of these states also enacted shield laws to prevent officials from states with abortion bans from prosecuting or investigating providers, meaning many patients may have received their drugs across state lines.
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The block will remain in effect as the case proceeds in a lower court, but the FDA may file an emergency appeal to the U.S. Supreme Court in the coming weeks.
According to the Family Planning Society, a research and advisory group that publishes a report called #WeCount, in the first six months of 2025, more than 27% of all abortions were performed via telehealth. The report shows that during the same period, almost 15,000 abortions were performed per month under the abortion shield regulations.
Republican Louisiana Attorney General Liz Murrill sued the FDA in October, seeking to repeal the rule for 2023, but a lower court declined in early April. U.S. District Judge David C. Joseph said at the time that the halt was premature because the FDA had completed its safety review of mifepristone, but he gave state officials the opportunity to resubmit the application once that review was completed. The state appealed this decision to the Fifth Circuit.
“Any abortion facilitated by FDA’s actions invalidates Louisiana’s ban on medical abortions and undermines its policy that ‘every unborn child is a human being from the moment of conception and therefore has legal personality,’” Friday’s decision said.
There were no disagreements between Judge Leslie Southwick, an appointee of former Republican President George H. W. Bush, and Judges Stuart Kyle Duncan and Kurt D. Engelhardt, both appointees of Republican President Donald Trump.
Without access to telemedicine and the ability to get the medication by mail, people in the 13 states with near-total abortion bans may have to travel to another state to get an abortion.
Some providers may apply misoprostol-only abortion pills, but they are slightly less effective and require higher doses, which may augment side effects.
“Reinstituting requirements for in-person drug distribution would force people to travel longer, take longer vacations and incur costs that are simply too high. For people living in states already hostile to abortion access, many of which are home to Black women and families, this is not health care,” Regina Davis-Moss, CEO of the advocacy group In Our Own Voice: National Black Women’s Reproductive Justice Agenda, said in a statement.
In a statement Friday, Murrill said former Democratic President Joe Biden’s administration facilitated “the illegal mail-order sale of abortion pills.”
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“Today, this 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 the women and children in this case,” Murrill said, praising the legal organization that helped with the case.
The court also said Friday that the 2023 rule harms Louisiana by forcing it to spend Medicaid funds on emergency assistance for women harmed by drug apply. The state identified $92,000 paid by Medicaid to two women who needed emergency care in 2025 for complications “caused by out-of-state mifepristone.”
Numerous studies have shown that mifepristone is sheltered to apply and has a very low complication rate. A pooled review of studies spanning 10 years from 2005 to 2015 found that earnest side effects requiring blood transfusions and hospitalization occurred in less than 1% of cases.
“We are disturbed by the court’s decision to ignore the FDA’s rigorous scientific findings and decades of safe use of mifepristone in a case brought by extremist abortion opponents. We are reviewing the court’s ruling carefully,” Evan Masingill, CEO of GenBioPro, one of the main manufacturers of mifepristone, said in a statement. “We remain committed to taking all actions necessary to make mifepristone available to as many people in the country as possible, regardless of anti-abortion special interests attempting to impede patient access.”
Stateline reporter Kelcie Moseley-Morris can be reached at: kmoseley@stateline.org.
This story was originally produced by state linewhich is part of States Newsroom, a nonprofit news network that includes the Ohio Capital Journal and is supported by grants and a coalition of donors as a 501c(3) public charity.
