Abortion Pill Still Available by Mail After Judge Refuses to Block It

• A federal judge paused a Louisiana lawsuit challenging mail-order mifepristone prescriptions, keeping access intact while the FDA completes its own review of the drug’s safety rules.
• Medication abortion now accounts for nearly two-thirds of all U.S. abortions, with telehealth delivering one in four — a share that could shrink if the FDA’s safety framework changes.
• Louisiana’s attorney general has taken her case to the Fifth Circuit Court of Appeals, asking the court to suspend the 2023 mifepristone rules while litigation continues.

Females seeking to end a pregnancy can still get the abortion pill mifepristone delivered by mail across the United States — at least for now.

In Louisiana, U.S. District Judge David Joseph paused a legal case challenging the Food and Drug Administration’s mail-access rules while the agency completes its review of whether its own safety requirements for the drug are sound.

According to the judge’s decision, the FDA has 60 days to update the court on its review of the REMS rules, which dictate who can prescribe the drug and whether it can be mailed. The agency has six months to finish.

But Louisiana Attorney General Liz Murrill isn’t waiting. In a post on X, she said she has already asked the Fifth Circuit to suspend the 2023 rules, arguing the state “is likely to succeed in showing that the 2023 REMS is unlawful.”

“Decades of evidence and research from the U.S. and around the world show that mifepristone is safe and effective,” Amy Friedrich-Karnik, director of federal policy at the Guttmacher Institute, told Healthline.

Friedrich-Karnik called the FDA review a “sham” designed to cut off access. Murrill said Louisiana is likely to win. The Fifth Circuit will hear arguments next.

For the estimated 1 in 4 people currently seeking abortion through telehealth, the outcome will determine whether this remains an option.

“While this case is paused and mifepristone access remains unchanged for now, we know the fight is far from over. The judge’s ruling leaves the door open for future restrictions to mifepristone access, said Alexis McGill Johnson, president and CEO, Planned Parenthood Federation of America (PPFA), in a statement shared with Healthline.

“From the courts to the Trump administration to state legislatures across the country, mifepristone and abortion access are very much still under attack. Planned Parenthood organizations will continue to fight for patients to have the freedom to access care that is safe and effective — free from political interference,” McGill Johnson continued.

Medication abortion involves two drugs taken days apart: mifepristone, which blocks the hormone a pregnancy needs to continue, and misoprostol, taken 24 to 48 hours later, that causes the uterus to empty.

Guttmacher later estimated that in 2025, residents of the 13 states with total abortion bans received about 91,000 telehealth abortions, including about 9,350 in Louisiana. The state has already issued the first post-Dobbs criminal indictment of an abortion provider — a New York physician who prescribed pills via telehealth to a Louisiana teenager.

“Reimposing barriers on mifepristone use would upend abortion provision nationwide, deepen racial and socioeconomic inequities in who can access care, and place additional strain on providers who are already navigating a fractured landscape,” said Friedrich-Karnik.

Part of what’s driving demand for telehealth abortion is the disappearance of local abortion clinics.

When Planned Parenthood in Marquette, Michigan, closed last spring, it left about 1,100 patients without an in-person provider.

Brown, who described herself as ‘individually pro-life,’ added medication abortions to her urgent care practice to fill the gap.”

Through a telehealth appointment, a provider reviews a patient’s medical history, confirms eligibility, and issues a prescription — all without an in-person visit.

The pills are then mailed directly to the patient, who completes the process at home. Follow-up care, including confirming the abortion is complete, can also happen remotely.

Abortion access across the United States varies widely from state to state. More information on finding access can be found here.