Mifepristone is the primary drug in the regimen that euthanizes a baby in utero and expels it from a mother’s body. After it was first approved by the U.S. Food and Drug Administration in 2000, federal safety guardrails required a doctor to examine a woman in person before prescribing it.
Such regulations helped to protect women with ectopic pregnancies, for whom the drug could be deadly, and women at risk of being given the drug against their will. But in 2023, at the direction of then-President Joe Biden, the FDA removed these longstanding protections, allowing abortion pills to be trafficked through the mail without any in-person safeguards.
In 2025, the state of Louisiana sued the FDA, pointing to problems with data the FDA used to justify such a drastic rollback of safeguards. As the 5th Circuit noted, Louisiana “documented how the new regulation had resulted in numerous illegal abortions in Louisiana and in Louisiana paying thousands in Medicaid bills for women harmed by mifepristone.” Later in the decision, the court added that almost 1,000 illegal abortions occurred in Louisiana every month due to the FDA policy. The state asked for a pause on mail-order abortion drugs until the case was decided.
On Friday, the 5th Circuit granted Louisiana’s request. Judge Kyle Duncan, writing for the unanimous panel, observed the lower district court had agreed Louisiana “had standing, was likely to succeed on the merits, and was suffering irreparable harm” from the lax policy. Nevertheless, the district court refused to pause it. Louisiana appealed the district court’s decision, arguing the harms caused by the policy were severe enough to merit the stay.
The 5th Circuit agreed: “We have now three times found that the agency’s progressive relaxation of mifepristone’s guardrails likely lacked a basis in data and scientific literature,” Duncan wrote. “FDA itself now concedes the regulations were marred by ‘procedural deficits’ and a ‘lack of adequate consideration.’”
The Federalist 
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