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The United States Supreme Court restored broad access to the abortion pill mifepristone on Monday, temporarily suspending the order from the Fifth Circuit Court of Appeals that had blocked its distribution by mail and via telemedicine nationwide.
The order was signed by Judge Samuel Alito and allows women seeking to terminate a pregnancy to obtain the pill at pharmacies or by mail without the need for an in-person visit to a doctor, reversing the restrictions imposed just days earlier.
The measure will remain in effect for at least one additional week while both parties present their arguments and the court considers the matter more thoroughly.
The case originated from a lawsuit filed by the state of Louisiana against the Food and Drug Administration (FDA) in October 2025, under the case "State of Louisiana v. FDA."
The Fifth Circuit blocked the postal delivery of the abortion pill last Thursday through a unanimous order written by Judge Stuart Kyle Duncan - appointed by President Donald Trump - with the support of Judges Southwick and Engelhardt.
That ruling reversed the policy adopted by the FDA in January 2023, which had enabled telemedicine and the postal delivery of mifepristone nationwide and expanded its use up to ten weeks of gestation.
Louisiana argued that this policy was based on faulty data, facilitated illegal abortions, and generated additional costs in the state's Medicaid program.
Judge Duncan stated in his ruling that the gradual relaxation of mifepristone safeguards "likely lacked a basis in data and scientific literature," and that "each abortion facilitated by the FDA's action nullifies Louisiana's ban on medical abortions."
The manufacturers of mifepristone, Danco Laboratories and GenBioPro, filed emergency appeals with the Supreme Court to intervene, resulting in the order signed this Monday.
The decision is highly significant because medication abortions account for the majority of procedures in the United States: in 2023, 63% of all recorded abortions—approximately 642,700 cases—were through medication, according to the Guttmacher Institute.
In 2024, one in four abortions (25%) was conducted via telemedicine, with an average of 12,330 procedures per month by the end of the year.
The availability of mifepristone has mitigated the impact of the state bans that most Republican states began implementing following the 2022 Dobbs decision, which overturned Roe v. Wade and returned abortion regulation to the states.
In June 2024, the Supreme Court had already unanimously rejected a previous lawsuit against the FDA related to mifepristone - filed by the Alliance for Hippocratic Medicine - due to the lack of standing of the plaintiffs, temporarily preserving access without resolving the underlying issue.
Several Democratic states have enacted protective laws to shield telemedicine providers who prescribe the pill to patients in states with bans, safeguarding them against extradition and legal actions.
Julia Kaye, an attorney with the American Civil Liberties Union (ACLU), warned that the Fifth Circuit's restriction "will affect patients' access to both abortion and care in cases of miscarriage in all states across the nation" and that "when telemedicine is restricted, it is rural communities, low-income individuals, people with disabilities, and communities of color who suffer the most."
Planned Parenthood described the Fifth Circuit ruling as "the biggest impact on abortion policy since Dobbs," while mifepristone, approved by the FDA in 2000, has been used by approximately seven million patients in the United States since then.
The Supreme Court will rule on the substance of the matter once both parties present their arguments within the week-long timeframe established in Alito's order.
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