Supreme Court Extends Temporary Access to Abortion Pill Mifepristone

The U.S. Supreme Court on Monday extended a temporary order maintaining nationwide access to the abortion pill mifepristone, allowing it to continue being prescribed and mailed while the court considers a case that could restrict its availability. Justice Samuel Alito issued a brief order extending an administrative stay until 5 p.m. Thursday, providing the court additional time to decide whether to block a recent appellate court ruling.

The case centers on a decision by the New Orleans-based 5th U.S. Circuit Court of Appeals, which granted Louisiana’s request to void Biden administration rules permitting mifepristone to be dispensed without an in-person clinician visit. This FDA regulation had allowed the pill to be prescribed online and mailed nationwide, including to states with strict abortion restrictions.

Two pharmaceutical companies, Danco Laboratories and GenBioPro, which manufacture mifepristone, had asked the Supreme Court to set aside the 5th Circuit’s ruling and maintain the current policy while legal proceedings continue. Justice Alito, who handles emergency appeals from the 5th Circuit, initially blocked the lower court decision on May 4 and extended that pause on Monday.

Mifepristone, taken alongside misoprostol, is used to terminate early pregnancies and accounted for 65% of clinician-provided abortions in 2023, according to the Guttmacher Institute, a research organization supporting abortion rights.

The legal challenge began last year when Louisiana officials sued the FDA over its regulation allowing the pill to be mailed, arguing that it undermines the state’s near-total abortion ban. Louisiana contends that the policy enables providers to circumvent its laws, resulting in “streams of mifepristone” being sent into the state and causing “thousands” of unlawful abortions annually.

A federal district court initially paused Louisiana’s lawsuit last month to allow the FDA to review the drug’s safety. However, Louisiana appealed, and the 5th Circuit temporarily blocked the FDA’s 2023 policy permitting remote prescription and mailing of mifepristone.

The 5th Circuit panel unanimously stated, “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.'”