Court restricts abortion access across the US by blocking the mailing of mifepristone

US court limits mail-order access to abortion pill mifepristone

6 minutes agoSareen HabeshianGetty ImagesA US court has issued an order significantly restricting access to the abortion pill mifepristone by mail.Friday's decision by the Fifth Circuit Court of Appeals temporarily reinstated a requirement that abortion pills be obtained in person, rather than allow them to be obtained by post or at a pharmacy through telemedicine.The move in particular curbs access to abortion pills - the most common method of terminating pregnancies in the US - in states where abortion is banned.The decision, which stems from a lawsuit brought by the state of Louisiana, pauses a 2023 regulation from the Food and Drug Administration (FDA) that allowed doctors to send pills without seeing patients in person."Every abortion facilitated by FDA's action cancels Louisiana's ban on medical abortions and undermines its policy that 'every unborn child is human being from the moment of conception and is, therefore, a legal person,'" the appeals court wrote in the order.The decision will remain in effect as the case plays out.Mifepristone is the first of a two-pill regimen recommended by the FDA to end a pregnancy. It is widely available in states where abortion is legal.The drugs' availability was expanded in April 2021, when the FDA said it would lift the in-person dispensing requirement for mifepristone for the duration of the Covid-19 pandemic. In 2023, the FDA permanently lifted that requirement, meaning the medication could be sent by mail.In 2024, the US Supreme Court unanimously rejected an effort to restrict access to mifepristone.But the decision, which came two years after the court rescinded the nationwide guarantee to an abortion, left the door open to other attempts to limit the availability of the drug.Friday's appellate order overrides a lower court's ruling from earlier this month that paused the case while the Trump administration conducts an FDA review.Louisiana Attorney General Liz Murrill celebrated the court's decision, saying the Biden-era rule "facilitated the deaths of thousands of Louisiana babies (and millions in other states)"."I look forward to continuing to defend women and babies as this case continues," she added.But Julia Kaye, an attorney with the American Civil Liberties Union (ACLU), said in a statement: "This decision defies clear science and settled law and advances an anti-abortion agenda that is deeply unpopular with the American people." New York Attorney General Letitia James said on Friday that abortion access would continue to be legal in her state, despite the appellate court's ruling."In New York, our laws ensure that anyone who needs abortion care can seek it here. That has not changed, and we will continue to protect access to abortion, including medication abortion," she said in a statement.But Marjorie Dannenfelser, head of Susan B Anthony Pro-Life America, said the ruling was "a huge victory for victims and survivors of Biden's reckless mail-order abortion drug regime".Mifepristone works by blocking a hormone called progesterone, which is necessary for a pregnancy to continue. The second drug, misoprostol, empties the uterus.The US first approved mifepristone for the medical termination of pregnancy through seven weeks of gestation in September 2000. In 2016, its approved use was extended to 10 weeks of pregnancy.Misoprostol has been available by prescription for decades as a treatment for stomach ulcers and to manage postpartum haemorrhaging. Its non-pregnancy related uses are probably why it has not attracted the same controversy as mifepristone.Mifepristone is also used to treat women who have suffered miscarriages and Cushing syndrome, a hormone-related condition.Over 3.7 million women used mifepristone in the US between 2000-18, according to the FDA.The American College of Obstetrics and Gynaecologists (ACOG) and other mainstream medical organisations say both mifepristone and misoprostol are safe.US studies say the two-step medication regime is about 95% effectiv

US court limits mail-order access to abortion pill mifepristone

Court restricts abortion access across the US by blocking the mailing of mifepristone

Mifepristone tablets sit on a table at a Planned Parenthood clinic in Ames, Iowa, on July 18, 2024.

Charlie Neibergall/AP

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Charlie Neibergall/AP

A federal appeals court has restricted access to one of the most common means of abortion in the U.S. by blocking the mailing of mifepristone. A panel of the New Orleans-based 5th U.S. Circuit Court of Appeals is requiring that the abortion pill be distributed only in-person at clinics. Since the Supreme Court's 2022 ruling that overturned Roe v. Wade and allowed enforcement of abortion bans, prescriptions by mail has become a major way that abortions are provided — including to states where bans are in place. The decision sets up a likely appeal to the Supreme Court.

A federal appeals court has restricted access to one of the most common means of abortion in the U.S. by blocking mailing of prescriptions of mifepristone.

A panel of the New Orleans-based 5th U.S. Circuit Court of Appeals is requiring that the abortion pill be distributed only in person at clinics.

"Every abortion facilitated by FDA's action cancels Louisiana's ban on medical abortions and undermines its policy that 'every unborn child is human being from the moment of conception and is, therefore, a legal person,'" the ruling states.

Judges have long deferred to the Food and Drug Administration's judgments on the safety and appropriate regulation of drugs.

FDA officials under President Donald Trump have repeatedly stated the agency is conducting a new review of mifepristone's safety, at the direction of the president.

The judges noted in their ruling that FDA "could not say when that review might be complete and admitted it was still collecting data."

In a court filing, Louisiana's attorney general and a woman who says 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.

A Louisiana-based federal judge last month ruled that those allowances undermined the state's abortion ban but stopped short of undoing the regulations immediately.

Since the Supreme Court's 2022 ruling that overturned Roe v. Wade and allowed enforcement of abortion bans, prescriptions by mail have become a major way that abortions are provided — including to states where bans are in place.

"This is going to affect patients' access to abortion and miscarriage care in every state in the nation," said Julia Kaye, an ACLU lawyer. "When telemedicine is restricted, rural communities, people with low incomes, people with disabilities, survivors of intimate partner violence and communities of color suffer the most."

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.

Because of rare cases of excessive bleeding, the FDA initially imposed strict limits on who could prescribe and distribute the pill — only specially certified physicians and only after an in-person appointment where the person would receive the pill.

Both those requirements were dropped during the COVID-19 years. At the time, FDA officials under President Joe 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.

Friday's ruling sets up a likely appeal to the Supreme Court.

The conservative-majority high court overturned abortion as a nationwide right in 2022 but unanimously preserved access to mifepristone two years later.

That 2024 decision sidestepped the core issues, however, by ruling that the anti-abortion doctors behind the case didn't have legal standing to sue.

Court restricts abortion access across the US by blocking the mailing of mifepristone

US court limits mail-order access to abortion pill mifepristone

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US court limits mail-order access to abortion pill mifepristone

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