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A panel of the United States Court of Appeals for the Fifth Circuit, based in New Orleans, blocked the nationwide mailing of mifepristone prescriptions, requiring that the abortion pill be distributed only in person at clinics.
The temporary order, issued last Friday, reverses the policy of the Food and Drug Administration (FDA) adopted in January 2023, which had allowed telemedicine and mail delivery of the medication nationwide.
The ruling was written by Judge Stuart Kyle Duncan, appointed by President Donald Trump, with the unanimous support of Judges Southwick and Engelhardt, in the context of the case "State of Louisiana vs. the FDA," initiated by Louisiana in October 2025.
The state sued the FDA, arguing that the elimination of the in-person requirement was based on faulty data, facilitated illegal abortions, and incurred costs in the Medicaid program.
The court stated that the gradual relaxation of the safeguards for mifepristone "probably lacked a basis in data and scientific literature."
The ruling also stated that "each abortion facilitated by the FDA's action nullifies Louisiana's ban on medical abortions and undermines its policy that 'every unborn child is a human being from the moment of conception and is, therefore, a legal person.'"
The decision has a national scope and directly impacts one of the most commonly used abortion methods in the country: in 2023, medication abortions accounted for 63% of all recorded abortions in the U.S., according to the Guttmacher Institute.
In 2024, one in four abortions in the country was performed via telemedicine, and in 2025 it is estimated that 91,000 procedures were provided through this method to states with total bans.
Since the Supreme Court overturned the Roe v. Wade case in 2022, mail delivery became the primary means of accessing abortion in states where the ban is in effect, and telemedicine requests have doubled.
In June 2024, the Supreme Court unanimously dismissed a previous lawsuit against the FDA regarding mifepristone, temporarily preserving access to the abortion pill due to a lack of standing by the plaintiffs.
The reaction from reproductive rights groups was immediate.
Julia Kaye, a lawyer for the American Civil Liberties Union (ACLU), warned that the measure "will affect patients' access to both abortion and care in cases of miscarriage in all states across the nation."
"When telemedicine is restricted, it is rural communities, low-income individuals, people with disabilities, survivors of intimate partner violence, and communities of color who suffer the most," stated Kaye.
Planned Parenthood described the decision as the most significant impact on abortion policy since Dobbs in 2022, when the Supreme Court eliminated the federal right to abortion and returned its regulation to the states.
The order is temporary while the litigation progresses, but analysts suggest that the case could escalate to the Supreme Court, which has a conservative majority of six to three.
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