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WASHINGTON — The Supreme Court on Monday temporarily restored mail-order access to the abortion pill mifepristone, blocking a lower court’s order restricting the prescription of the drug via telemedicine and mail.

Justice Samuel Alito paused the order by the conservative Fifth Circuit Court of Appeals until May 11.

The New Orleans-based Fifth Circuit ordered the Food and Drug Administration on May 1 to require doctors to prescribe mifepristone in person.


  An abortion-rights activist holding a box of mifepristone pills at a demonstration outside of the Supreme Court building on March 26, 2024. The Supreme Court on Monday temporarily restored mail-order access to mifepristone after an appeals court ruling. AP An abortion-rights activist holding a box of mifepristone pills at a demonstration outside of the Supreme Court building on March 26, 2024. The Supreme Court on Monday temporarily restored mail-order access to mifepristone after an appeals court ruling. AP

Mifepristone, part of a two-drug regimen given to women to terminate a pregnancy, was approved by the FDA in 2000 and access to it has expanded over recent years.

Up until 2021, patients were required to visit doctors to get mifepristone. The Biden administration lifted that requirement, only for the Fifth Circuit to reinstate it.

Louisiana had sued the FDA, arguing that its lax regulations have allowed abortion pills to be mailed into the state in violation of its ban on the procedure.  

Alito, who famously authored the Dobbs v. Jackson Women’s Health Organization decision overturning Roe v. Wade in 2022, gave Louisiana until close of business Thursday to respond to an emergency petition against the Fifth Circuit’s order filed by two drug manufacturers.  .

About two-thirds of abortions across the country are medication-induced, according to the pro-choice Guttmacher Institute. Anti-abortion advocates have expressed concerns about a growth in known instances of women getting tricked into taking the pill without their consent.


  The Fifth Circuit Court of Appeals ordered the FDA to require doctors to prescribe the pill in person on May 1. AFP via Getty Images The Fifth Circuit Court of Appeals ordered the FDA to require doctors to prescribe the pill in person on May 1. AFP via Getty Images

Mifepristone is also used to treat Cushing’s syndrome and manage miscarriages by restricting the supply of hormones to the uterus that are needed to support a pregnancy. The drug is typically paired with misoprostol, which empties the uterus.

The manufacturers, Danco Laboratories and GenBioPro, had pushed for the Supreme Court to step in and rebuff the Fifth Circuit’s order. 

The Fifth Circuit has a history of making decisions that are further to the right of where the Supreme Court would go. 

Back in 2023, the appeals court blocked changes the FDA made in 2016 that made access to mifepristone more easily accessible.

The Supreme Court unanimously rejected that challenge to expanded mifepristone access the following year, finding a group of anti-abortion doctors that brought the case lacked standing.

Pro-life groups have criticized the Trump administration for not reversing the Biden-era FDA’s loosening of requirements to get access to the abortion pill. 

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