A U.S. appeals court has temporarily blocked doctors from mailing mifepristone, a widely used abortion pill, to pregnant women, pausing a 2023 Food and Drug Administration (FDA) regulation that had allowed the medication to be sent without in-person visits. The ruling by a three-judge panel of the Fifth Circuit Court of Appeals, all appointed by Republican presidents, came on Friday and favors the state of Louisiana, which had challenged the FDA’s policy.

The panel found that Louisiana was likely to succeed in its argument that the FDA’s decision relied on flawed data and that the state would face irreparable harm if the mailing provision remained in effect during ongoing litigation. The court argued that each abortion enabled by the FDA regulation undermines Louisiana’s laws, which assert that “every unborn child is a human being from the moment of conception and is, therefore, a legal person.” Earlier, a federal trial judge had also ruled that Louisiana was likely to prevail on the merits of its challenge but allowed the mailing practice to continue, citing the public interest while the FDA conducts a review of the drug’s safety.

Mifepristone, used in combination with misoprostol, has been approved by the FDA since 2000 for medication abortion up to 10 weeks of pregnancy. Millions of women have used the drug, which is a central method for terminating early pregnancies in the United States. The Biden administration’s FDA authorized mailing of the pills during the past few years, expanding access especially through telemedicine, including in states that have banned or severely restricted abortion after the Supreme Court overturned the constitutional right to the procedure in 2022.

Louisiana Attorney General Liz Murrill, a Republican, welcomed the appeals court decision, calling it “the nightmare is over.” On the other hand, GenBioPro, a manufacturer of generic mifepristone, expressed concern that the ruling would impose “unnecessary barriers” to accessing the medication nationwide, including in states where abortion remains legal. Louisiana is among several GOP-led states pursuing legal challenges targeting FDA regulations governing abortion drugs.

Antiabortion advocates argue that existing studies supporting the safety and efficacy of mifepristone are flawed, contending that serious, nonfatal side effects are underreported due to insufficient federal tracking. Conversely, numerous research studies and medical groups continue to affirm the medication’s safety. In 2024, the Supreme Court declined on procedural grounds to revisit a case seeking to revoke FDA approval of mifepristone.

As the dispute continues, the ruling adds to a complex legal landscape surrounding abortion access in the United States, particularly amid shifting state laws and evolving federal oversight. The FDA’s review of mifepristone safety, ongoing since the court’s previous decisions, remains a pivotal factor in the future of medication abortion access.