Supreme Court Reinstates Access to Mail-Order Abortion Drug

Pro-choice advocates were handed a win on Monday when the U.S. Supreme Court temporarily reinstated mail-order access to the abortion drug mifepristone. Read on for a closer look at the decision and what it may mean for widespread access to the widely used drug.

Supreme Court Temporarily Reinstates Access to Abortion Drug

The Supreme Court ruled on May 4 that they needed more time to consider whether Americans should have mail-order access to the abortion drug mifepristone. The temporary decision will give the court more time to consider the controversial issue.

The decision by the highest court in the land came after the U.S. Food and Drug Administration (FDA) ordered on May 1 to reinstate the requirement that physicians prescribe mifepristone only after an in-person exam. The FDA decision marked the first time that access to the drug had been significantly restricted since its approval in 2000. The divisive drug was first approved in 2000 and has been the target of years of litigation as supporters on both sides of the abortion issue take on the cause.

Supreme Court Justice Samuel Alito paused the access restriction until May 11 at the request of the drugmakers. The decision came on the heels of a restrictive ruling by a lower court. The full slate of Supreme Court justices will soon decide what the rules for the drug should be as the state of Louisiana challenges the easier access.

By fast-tracking the case, the hot-button issue of abortion is back on the docket and in the headlines less than two years after the court rejected a similar challenge. Alito made the decision, as he is the justice in charge of emergency appeals coming out of the nation's 5th U.S. Circuit based in New Orleans.

Nancy Northup, head of the Center for Reproductive Rights, cautioned that the ruling is not final and should not be celebrated yet. Northup noted, “Getting abortion pills through telehealth has been a lifeline for women since Roe v. Wade was overturned. There is no reason people shouldn’t be able to get mifepristone at a pharmacy or through the mail.”

Louisiana Argues Access to Drug Allows Women to Skirt State's Abortion Ban

Louisiana state officials are arguing that the drug should not be dispensed through the mail or a pharmacy, as it does not protect against the threat of complications. Potential complications associated with mifepristone include hemorrhage and sepsis. Louisiana Attorney General Liz Murrill is also arguing that the mail-order access to mifepristone allows women to skirt abortion bans in states where the procedure is illegal.

Danco Laboratories, manufacturer of the brand-name version of mifepristone, said that the decision by the lower courts to restrict access caused “immediate confusion and upheaval in highly time-sensitive medical decisions.” Attorneys representing Danco also told the Supreme Court justices that the challenge by Louisiana should be thrown out on the same grounds that the justices leaned on to reject a similar lawsuit from 2024. In that ruling, the court said that anti-abortion doctors who brought the case could not sue because they had not demonstrated that they had been harmed by the FDA's relaxation of access to mifepristone in 2023.

With the current case facing the court, Louisiana is arguing that its ability to enforce the state's anti-abortion laws is abused by the fact that women are able to easily access mifepristone through the mail. Louisiana health authorities noted that the state Medicaid program had to pay $92,000 for the care of two women who suffered complications after taking the abortion pill.

The case in Louisiana is not happening in a vacuum. Other red states have attempted to make it more difficult for women to access mifepristone.

However, according to pharmaceutical company GenBioPro, Louisiana "is alone in seeking such sweeping preliminary relief." GenBioPro makes a generic version of mifepristone, giving them a say in the case being argued in front of the Supreme Court.

The FDA is currently reviewing the safety issues associated with the drug. Pro-choice advocates say that the FDA review is a sham, contending that the agency has already reviewed the drug and that the existing science is enough to deem its use safe.

According to Guttmacher Institute research, medication abortions accounted for more than 60% of abortions in the U.S. in 2023. This data includes use in states where abortion is illegal. A recent analysis of mifepristone data indicates that the drug has fewer reported side effects than the more commonly used Viagra or penicillin

The Trump administration asked a judge in January to pause Louisiana's challenge until after the FDA review is complete. While a federal judge agreed with the decision to pause the challenge, an appeals court blocked that decision and ruled that the state's in-person dispensing rules should be reinstated.

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