The Supreme Court on Thursday, May 14, kept the abortion pill Mifepristone available by mail and through telemedicine, rejecting a last-minute push by Louisiana to tighten access.
In a brief order, the justices lifted a ruling from the 5th U.S. Circuit Court of Appeals that would have required women to see a doctor in person before getting the drug.
The decision restores a 2023 FDA rule that made it easier to prescribe and receive mifepristone without an office visit.
The order was unsigned and offered no detailed explanation, which is typical for emergency cases at the high court. Conservative Justices Samuel Alito and Clarence Thomas dissented.
Use of Mifepristone Pill
The fight is over one of the most common ways women terminate pregnancies in the U.S. Medication abortions, which involve the use of mifepristone followed by misoprostol, now make up about two-thirds of all abortions. It is used early in pregnancy, usually in the first 10 weeks.
Louisiana sued the FDA last year, arguing the 2023 changes ignored safety risks and clashed with the state’s near-total ban on abortion.
State officials pointed to possible complications like heavy bleeding and infection. The 5th Circuit backed Louisiana on May 1 and ordered the stricter rules reinstated.
Drug companies that make mifepristone quickly appealed, and the Supreme Court issued temporary stays on May 4 and May 11 before issuing Thursday’s ruling.
The two manufacturers, Danco Laboratories, which sells the brand-name Mifeprex, and GenBioPro, which makes the generic, told the court that the restrictions would hurt their businesses and limit access for women in states where abortion remains legal.
The FDA officials say mifepristone has been safely used for decades and that serious problems are rare when the drug is taken as directed.
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Medical groups that support abortion rights point to dozens of studies showing the same thing. They argue opponents have overstated the dangers, especially for women who get the pills after a telehealth visit or receive them by mail.
Mifepristone was first approved by the FDA in 2000. Over the years, regulators have loosened some rules, including the in-person requirement, as safety data have grown.
Abortion opponents say those changes went too far, especially after the Supreme Court overturned Roe v. Wade in 2022.
That Dobbs decision sent abortion policy back to the states. Thirteen states now ban the procedure in nearly all cases.
Others have added waiting periods, clinic requirements, or gestational limits. With surgical abortions harder to get in many places, medication abortion has filled much of the gap, often through online services and mailed pills.
Thursday’s order keeps the current rules alive while the full lawsuit plays out in lower courts. It does not settle the bigger legal questions.
Trump Administration Stance on Mifepristone
The Trump administration said it is reviewing mifepristone safety data but opposed Louisiana’s immediate push to restrict the drug.
Lawyers for the administration questioned whether the state had legal standing to bring the case in the first place.
Abortion rights groups called the Supreme Court’s move a temporary victory but warned the fight is far from over. They see continued attacks on the pill as the main threat to abortion access since Dobbs.
Anti-abortion organizations, meanwhile, expressed disappointment and said they would keep pressing courts and lawmakers to tighten rules.
Congressional elections are coming in November, and both parties know abortion remains a powerful issue with voters.
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Republicans hold narrow majorities in Congress and are working to keep them. Democrats plan to use abortion access as a rallying point on the campaign trail.
Meanwhile, women in states that allow medication abortion can continue getting mifepristone the same way they have for the past few years, through a remote consultation with a provider and a package in the mail.
That reality frustrates states like Louisiana, which say the federal government is undermining their own laws.
