NEW ORLEANS\u00a0\u2014\u00a0A federal appeals court has restricted access to one of the most common means of abortion in the U.S. by blocking mailing of mifepristone prescriptions.<\/p>\n
Friday\u2019s unanimous ruling from a three-judge panel of the New Orleans-based 5th U.S. Circuit Court of Appeals is requiring that the abortion pill be distributed only in person and at clinics, overruling regulations set by the federal Food and Drug Administration.<\/p>\n
The ruling, which is likely to be appealed to the U.S. Supreme Court, is the biggest jolt to abortion policy in the U.S. since the 2022 Supreme Court ruling that overturned Roe vs. Wade and allowed states to enforce abortion bans.<\/p>\n
In the ruling, Judge Kyle Duncan, who was appointed by President Trump, agreed with the state of Louisiana\u2019s contention that allowing the drug to be mailed there makes moot the state\u2019s ban on abortion at all stages of pregnancy.<\/p>\n
\u201cEvery abortion facilitated by FDA\u2019s action cancels Louisiana\u2019s ban on medical abortions and undermines its policy that \u2018every unborn child is a human being from the moment of conception and is, therefore, a legal person,\u2019\u201d the ruling states.<\/p>\n
Commonplace treatment<\/p>\n
Mifepristone was approved in 2000 as a safe and effective way to end early pregnancies. It is typically used in combination with a second drug, misoprostol.<\/p>\n
Surveys have found that the majority of abortions in the U.S. are provided via pills and that about 1 in 4 abortions nationally are prescribed via telehealth.<\/p>\n
One survey of abortion providers last year estimated that more women in states where abortion is banned obtained abortions that way than by traveling to other states.<\/p>\n
Some Democratic-led states have laws that seek to protect providers who prescribe via telehealth to patients in places with bans.<\/p>\n
That rise in prominence is why abortion opponents have targeted the pills in legislation and litigation.<\/p>\n
Little precedent<\/p>\n
There is little precedent for a federal court overruling the scientific regulations of the FDA, and it wasn\u2019t immediately clear how quickly or completely the decision would affect mailing of the drug throughout the country.<\/p>\n
Judges have long deferred to the agency\u2019s judgments on the safety and appropriate regulation of drugs.<\/p>\n
FDA officials under Trump have repeatedly stated that the agency is conducting a new review of mifepristone\u2019s safety, at the direction of the president.<\/p>\n
The judges, all nominated by Republican presidents, noted in their ruling that the FDA \u201ccould not say when that review might be complete and admitted it was still collecting data.\u201d<\/p>\n
Because of rare cases of excessive bleeding, the FDA initially imposed strict limits on who could prescribe and distribute the pill \u2014 only specially certified physicians and only after an in-person appointment where the person would receive the pill.<\/p>\n
Both requirements were dropped during the COVID-19 emergency. At the time, FDA officials under President Biden said that after more than 20 years of monitoring mifepristone use, and reviewing dozens of studies involving thousands of women, it was clear that women could safely use the pill without direct supervision.<\/p>\n
GenBioPro, which makes generic mifepristone, said in a statement that the court\u2019s decision \u201cignores the FDA\u2019s rigorous science and decades of safe use of mifepristone in a case pursued by extremist abortion opponents.\u201d<\/p>\n
Broader impact<\/p>\n
In a court filing, Louisiana\u2019s attorney general and a woman who said she was coerced into taking abortion pills requested that the FDA rules be rolled back to when the pills were allowed to be prescribed and dispensed only in person.<\/p>\n
A Louisiana-based federal judge last month ruled that those allowances undermined the state\u2019s abortion ban but stopped short of undoing the regulations immediately.<\/p>\n
Friday\u2019s ruling is in effect as the case works its way through the courts and extends beyond Louisiana and other states with abortion bans.<\/p>\n
Telehealth prescriptions have become common even in states where abortion is allowed \u2014 and the ruling blocks them there, too.<\/p>\n
\u201cThis is going to affect patients\u2019 access to abortion and miscarriage care in every state in the nation,\u201d said Julia Kaye, an ACLU lawyer. \u201cWhen telemedicine is restricted, rural communities, people with low incomes, people with disabilities, survivors of intimate partner violence and communities of color suffer the most.\u201d<\/p>\n
The National Right to Life Committee said the ruling \u201crestores a critical layer of oversight\u201d in women\u2019s health.<\/p>\n
\u201cWomen deserve better than an abortion-by-mail system that prioritizes ideology over safety,\u201d said Carol Tobias, the group\u2019s president.<\/p>\n
Next step<\/p>\n
Friday\u2019s ruling sets up a likely appeal to the Supreme Court.<\/p>\n
\u201cI look forward to continuing to defend women and babies as this case continues,\u201d Louisiana Atty. Gen. Liz Murrill, a Republican, said in a statement.<\/p>\n