Judge Refuses to Block Mailed Abortion Pills but Says FDA Must Finish Review

A federal judge Tuesday refused to block filling prescriptions for the abortion pill mifepristone by mail across the U.S. — at least for now — in a setback to Louisiana’s effort to stifle groups that send it into states where abortion is banned.

U.S. District Judge David Joseph, who sits in Lafayette, Louisiana, ruled against Louisiana Attorney General Liz Murrill, who asked that FDA rules that allow mifepristone to be dispensed through the mail be paused while a challenge to those 2023 regulations moves through the courts.

He granted the government’s request to put the case on hold for now, though he warned that the pause would not be indefinite — and that he could side with Louisiana later.

Murrill said in a statement that she would ask an appeals court to throw out the federal rules, noting that the judge “concluded that Louisiana suffers irreparable harm every day” the current rules are in effect.

In his opinion, Joseph, who was nominated to the bench by President Trump, said that he would follow an FDA study of the drug that is in the works. He also told the agency to update him on the status of its investigation within 6 months.

“Should the agency fail to complete its review and make any necessary revisions” to the rules “within a reasonable time frame, the Court’s analysis — and the weight accorded to these factors — will inevitably change,” he wrote.

He also said that he believes the plaintiffs are “likely to succeed on the merits.”

Murrill contends that allowing the prescriptions to be filled by mail undermines the abortion ban in Louisiana, one of 13 states that now bar it at all stages of pregnancy. Republican state officials elsewhere have made similar court challenges in other districts.

Groups that advocate for abortion rights also stressed that Tuesday’s ruling isn’t a final one.

“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 Federation of America President and CEO Alexis McGill Johnson said in a statement.

Mifepristone, usually taken in combination with misoprostol, has moved to the center of legal fights over abortion access since the 2022 Supreme Court ruling that overturned Roe v. Wade and allowed states to ban abortion.

In 2024, the nation’s top court refused to block filling prescriptions for mifepristone by mail. That case was different because it was brought by anti-abortion doctors, who the court said did not have legal standing to challenge the rules.

While conservative states have moved to ban or restrict abortion, liberal states have moved to protect access. Eight now have laws that seek to protect providers who prescribe abortion pills by telehealth and have them mailed into states with bans.

One study found that by the end of 2024, one-fourth of abortions were accessed by telehealth — a fivefold increase in 2 years. Another study found that in 2025, women in states where abortion is banned were more likely to obtain one by getting pills through telehealth than by traveling to other states.

Murrill is pursuing criminal cases against two doctors — one each in California and New York — accused of sending pills to patients in Louisiana. Those states have not been willing to have the doctors extradited to face the charges.

Joining Murrill as a plaintiff is a Louisiana woman who says her boyfriend coerced her into taking mifepristone from a California doctor.

Arguments surrounding coercion, particularly when an abusive partner controls a victim’s reproductive care, became a major theme for the plaintiffs’ legal case. They say without in-person requirements surrounding the abortion pill, intimate partner abuse will only increase. Some anti-domestic abuse advocates pushed back, saying telehealth can be a valuable lifeline for survivors.

Trump’s administration last year outraged anti-abortion groups when it approved an additional generic version of mifepristone.

A Hawaii judge last year ruled that the FDA violated the law by imposing restrictions on mifepristone, which is also used for miscarriage management.