US court limits mail-order access to abortion pill mifepristone

A US court has issued an order significantly restricting access to the abortion pill mifepristone by mail.

Friday's decision by the Fifth Circuit Court of Appeals temporarily reinstated a requirement that abortion pills be obtained in person, rather than allow them to be obtained by post or at a pharmacy through telemedicine.

The move in particular curbs access to abortion pills - the most common method of terminating pregnancies in the US - in states where abortion is banned.

The decision, which stems from a lawsuit brought by the state of Louisiana, pauses a 2023 regulation from the Food and Drug Administration (FDA) that allowed doctors to send pills without seeing patients in person.

"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,'" the appeals court wrote in the order.

The decision will remain in effect as the case plays out.

Mifepristone is the first of a two-pill regimen recommended by the FDA to end a pregnancy. It is widely available in states where abortion is legal.

The drugs' availability was expanded in April 2021, when the FDA said it would lift the in-person dispensing requirement for mifepristone for the duration of the Covid-19 pandemic. In 2023, the FDA permanently lifted that requirement, meaning the medication could be sent by mail.

In 2024, the US Supreme Court unanimously rejected an effort to restrict access to mifepristone.

But the decision, which came two years after the court rescinded the nationwide guarantee to an abortion, left the door open to other attempts to limit the availability of the drug.

Friday's appellate order overrides a lower court's ruling from earlier this month that paused the case while the Trump administration conducts an FDA review.

Louisiana Attorney General Liz Murrill celebrated the court's decision, saying the Biden-era rule "facilitated the deaths of thousands of Louisiana babies (and millions in other states)".

"I look forward to continuing to defend women and babies as this case continues," she added.

But Julia Kaye, an attorney with the American Civil Liberties Union (ACLU), said in a statement: "This decision defies clear science and settled law and advances an anti-abortion agenda that is deeply unpopular with the American people."

New York Attorney General Letitia James said on Friday that abortion access would continue to be legal in her state, despite the appellate court's ruling.

"In New York, our laws ensure that anyone who needs abortion care can seek it here. That has not changed, and we will continue to protect access to abortion, including medication abortion," she said in a statement.

But Marjorie Dannenfelser, head of Susan B Anthony Pro-Life America, said the ruling was "a huge victory for victims and survivors of Biden's reckless mail-order abortion drug regime".