In a major legal victory for the pro-life movement, the U.S. Court of Appeals for the Fifth Circuit on Friday ordered a nationwide halt to a Biden-era policy allowing the abortion pill mifepristone to be prescribed online and delivered by mail, ruling that the regulation is likely unlawful and poses ongoing harm while litigation proceeds.
The unanimous panel granted Louisiana’s request to block the Food and Drug Administration’s 2023 rules, which removed longstanding in-person requirements for the drug. The court found the state is “strongly likely to succeed on the merits” of its challenge and is suffering irreparable harm from the policy, including violations of its pro-life laws and increased taxpayer-funded medical costs.
“The public interest is not served by perpetuating a medical practice whose safety the agency admits was inadequately studied,” the court wrote. “Indeed, the public interest demands the opposite.”
The ruling immediately blocks the mail-order distribution framework put in place after the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, when the Biden administration expanded access to chemical abortion nationwide. Under the 2023 rules, mifepristone could be prescribed via telehealth and shipped without an in-person doctor visit.
Louisiana challenged the policy under the Administrative Procedure Act, arguing the FDA relied on flawed or nonexistent data while eliminating safety protocols. During litigation, the agency acknowledged it had failed to adequately study the safety of remote dispensing and is still conducting a review with no clear timeline for completion.
The Fifth Circuit rejected the argument that courts should wait on the FDA’s ongoing review. Allowing the policy to continue, the panel suggested, would effectively permit the agency to maintain a potentially unlawful regulation indefinitely while promising future study.
The court also found that Louisiana demonstrated concrete harm. According to the record, the mail-order regime has facilitated nearly 1,000 illegal chemical abortions per month in the state, directly undermining its laws protecting unborn life. In addition, Louisiana documented tens of thousands of dollars in Medicaid spending tied to emergency care for complications from the drug.
“Every abortion facilitated by FDA’s action cancels Louisiana’s ban,” the court wrote, emphasizing that such sovereign harms cannot be undone.
The decision reverses a lower court ruling that found Louisiana likely to win and suffering harm but declined to grant immediate relief. The Fifth Circuit said that balancing the equities weighed in favor of blocking the policy, stating plainly that neither the FDA nor the public has an interest in enforcing a regulation that likely violates federal law.
Pro-life leaders quickly hailed the ruling. Susan B. Anthony Pro-Life America President Marjorie Dannenfelser called it “a huge victory for victims and survivors,” arguing that the removal of in-person safeguards has led to predictable harms for both women and unborn children.
The case is one of several brought by Republican-led states challenging federal abortion drug policy in the wake of Dobbs. Other states, including Idaho, Kansas, and Missouri, have pursued similar efforts to block telehealth distribution, while Texas and Florida are seeking broader restrictions on the drug itself.
An appeal to the U.S. Supreme Court is expected, but for now, the Fifth Circuit’s order reinstates a key pro-life position: that abortion-inducing drugs should not be distributed through the mail without direct medical oversight, especially amid acknowledged gaps in safety data.