Louisiana is pushing to temporarily reinstate an in-person requirement for dispensing abortion pills in a federal lawsuit that could protect thousands of unborn babies from chemical abortions enabled by a Biden administration rule.
The state’s motion, filed December 17 in U.S. District Court, challenges the 2023 Risk Evaluation and Mitigation Strategy rule from the Food and Drug Administration, which allows remote prescription and mailing of the abortion drug mifepristone. A hearing on the request to restore the in-person safeguard is set for February 24.
“Congress prohibits the use of ‘any express company or other common carrier or interactive computer service’ for ‘any drug, medicine, article, or thing designed, adapted, or intended for producing abortion,” the motion states. “Because a federal agency cannot permit what federal law expressly prohibits, FDA lacked authority to permanently remove the in-person dispensing requirement.”
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Louisiana Attorney General Elizabeth Murrill, who filed the original complaint Oct. 6, 2025, emphasized the dangers in a post on X: “We support the Trump administration which has acknowledged the flaws in the original rule. But unfettered and unsupervised access to these pills is dangerous. So the Biden-era rule should be enjoined.”
The lawsuit argues the rule targets pro-life states like Louisiana, where abortion is outlawed in nearly all cases, by facilitating mail-order abortion drugs from out-of-state companies. From April to June 2024, such shipments accounted for an average of 617 abortions per month in Louisiana, according to the Society of Family Planning’s #WeCount report cited in the complaint. That number rose to 800 abortions in December 2024.
“The 2023 REMS is the direct cause of extensive harm that Louisiana suffers every day that the REMS is in effect,” the complaint states. “Indeed, this was the intended effect of the Biden Administration’s 2023 REMS: to permit ‘dispensing of mifepristone through the mail … or through a mail-order pharmacy’ – specifically to target those pro-life states like Louisiana where abortion is prohibited (with narrow exceptions) or narrowly circumscribed.”
The action highlights risks to women, including those with Rh-negative blood types who face increased chances of stillbirth or brain injury in future pregnancies without proper treatment. It also notes mental health impacts, with women describing abortion-drug experiences as leaving them feeling unprepared, silenced, regretful or trapped.
In some instances, women dispose of fully formed aborted babies too large to flush, as instructed on the drug label, with abortion activists advising the act is untraceable “as long as you don’t tell anybody,” according to the lawsuit.
The complaint details coercion enabled by remote access, including a January 2025 indictment of a New York doctor for inducing an unwanted abortion in a Louisiana teenage girl whose mother ordered the pills against her wishes. The girl required emergency room treatment for complications, and the mother was also indicted, though New York Gov. Kathy Hochul refused extradition under a shield law.
Plaintiff Rosalie Markezich joined the suit after her boyfriend coerced her into taking abortion pills he obtained by mail from a California abortionist in October 2023, despite her desire to keep the baby. Fearing for her safety, she took the drugs but was unable to regurgitate them in time.
“If the Biden FDA had not removed in-person dispensing, my then-boyfriend would not have been able to obtain abortion drugs and pressure me to take them against my will,” Markezich said.
“The 2023 REMS caused Rosalie’s injuries, and her injuries are traceable to the 2023 REMS,” the complaint argues. “If FDA had required an in-person office visit, a medical professional would have screened Rosalie for coercion and abuse. … But the 2023 REMS allowed abortion drugs to be provided through the mail – enabling abusers to order them in others’ names and coerce pregnant women like Rosalie to take them. Had FDA required in-person dispensing, Rosalie’s boyfriend would not have been able to access the drugs and compel Rosalie to take them. She could have told a doctor that she did not want them.“
Alliance Defending Freedom attorneys representing Markezich and partnering with the state framed the rule as undermining protections for life.
“Out-of-state abortion drug peddlers are violating the criminal laws of Louisiana and other states across the country that choose life. They aren’t providing healthcare, they’re drug dealers,” Murrill said. “Louisiana’s new lawsuit seeks to hold the FDA accountable for unlawfully removing its original safeguard that ensured women receive an in-person office visit to check for life-threatening conditions, such as ectopic pregnancy, before taking high-risk abortion drugs. The FDA’s reckless actions also opened wide the door for women to suffer reproductive coercion and assault. We are simply asking the FDA to restore this basic safety standard for women’s health. Rosalie is bravely representing many woman who are victimized by the illegal, immoral, and unethical conduct of these drug dealers. I look forward to standing with her and the women of Louisiana as this case moves forward.”
