Louisiana sued the Food and Drug Administration on Monday, charging that the agency’s 2023 policy allowing mail-order abortion drugs has unleashed a torrent of illegal shipments into the pro-life state, enabling coercion, abuse and the deaths of countless unborn children while endangering women’s health.
The lawsuit, filed in U.S. District Court in New Orleans by Attorney General Liz Murrill and joined by Florida, Missouri and Texas, seeks to overturn the FDA’s removal of in-person dispensing requirements for mifepristone, the primary chemical abortion drug responsible for over half of the more than 1 million abortions performed annually nationwide.
Pro-life advocates hail the action as a vital defense of state sovereignty and the sanctity of life, arguing it halts an “illegal scheme” that treats unborn babies as disposable and turns abortion pills into tools for abusers.
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The lawsuit notes that “from April to June 2024 alone, mail-order abortion drugs–sent into Louisiana from doctors and activists in other states–accounted for an average of 617 abortions in Louisiana per month.”
The lawsuit asks the U.S. District Court for the Western District of Louisiana to re-instate the pre-2023 Risk Evaluation and Mitigation Strategy (REMS) on the abortion drug, once again require in-person dispensing and prohibit mail-order pharmacies from dispensing mifepristone, preventing the interstate mailing of it.
The complaint accuses the Biden-era FDA of acting “for avowedly political reasons” by lifting safeguards that once ensured face-to-face medical oversight, including ultrasounds to detect life-threatening ectopic pregnancies and follow-up care to address hemorrhaging or infections — complications that strike 11% of users, according to federal data.
“Shortly after Dobbs, pro-abortion activists and doctors launched a nationwide effort to effectuate abortions in pro-life states like Louisiana — all without setting foot in those states. How? By mail,” the lawsuit states, detailing how the policy empowers out-of-state abortionists to ship mifepristone directly to residents, nullifying Louisiana’s ban on abortion enacted after the Supreme Court’s 2022 Dobbs decision restored protections for the unborn.
“Every year, doctors and activists in states like California and New York mail a U.S. Food and Drug Administration (FDA)-approved abortion drug called mifepristone to thousands of Louisiana residents for the express purpose of causing abortions in Louisiana that are blatantly unlawful,” the filing continues. Without the old rules, it warns, “activists in New York and California could not blanket pro-life states like Louisiana with mifepristone by mail.”
The suit spotlights the harrowing case of Rosalie Markezich, a Louisiana woman coerced in 2023 by her boyfriend into taking mifepristone shipped from California abortionist Remy Coeytaux. Markezich, who did not want an abortion, used her email to order the pills under duress; she now grieves her lost child and battles lasting trauma.
“But some of the women who ingest the drugs do not want an abortion. Since FDA effectively allowed ‘blind’ dispensing without the in-person care of a doctor, bad actors have been able to obtain FDA-approved abortion drugs from prescribers in other states and then secretly spike women’s drinks without their knowledge or force women into taking them against their will. This is what happened to Rosalie Markezich,” the complaint recounts.
“Rosalie did not want to have an abortion. But far from empowering Rosalie to make her own choice and preserving her autonomy, mail-order abortion drugs had Rosalie feeling trapped and terrified. She grieves the loss of her child and endures lasting emotional trauma,” it adds. “If it weren’t for the FDA’s provision allowing ‘telehealth’ prescription and dispensation of the drug, then ‘Rosalie would have received the protection of a private in-person medical appointment. And if she had been able to tell a doctor that she did not want an abortion, the drugs that took her baby’s life would never have been provided.’”
Murrill, appearing on the “Washington Watch” radio program, framed the lawsuit as a bulwark against an abortion industry bent on evading justice.
“Rosalie’s story is similar to some of the others that we’ve seen in some other states and here, where the pills were obtained by somebody else, and they coerced her into taking them,” she said. “The biggest problem is that the Biden administration never should have withdrawn the restrictions on these pills to begin with.”
“The abortion lobby and cartel [were] trying to basically take down all of our abortion laws and all restrictions on access to these pills. It’s dangerous. And now we have drug dealers, basically, from other states who are mailing them illegally into our states to anybody who asks for them. And we’ve seen a number of cases where coercion is involved,” Murrill continued. “Even under circumstances where someone takes them by consent, it is very dangerous for women.”
She decried the lack of safeguards: “Before the Biden administration basically took all these restrictions away, the rules required a face-to-face relationship with a doctor who conducted an ultrasound to ensure that there was not an ectopic pregnancy, and they required a follow-up visit three weeks later. I don’t think this is hard. The data was never there for the rule that they put in place in the first instance. So I think they need to withdraw it based on the complete lies that were relied on to withdraw the REMS protocols that used to be in place on these pills.”
Murrill also blasted “shield laws” in blue states that block enforcement.
“We certainly have seen these doctors and other organizations like Aid Access who are willing to facilitate obtaining the pills. Now, they’ll give them to anybody that asks for them. You can lie. You can set up fake Facebook accounts. They’re not careful. There is no medical relationship here. They take your money and they mail you these pills, and you don’t know where they came from, and they don’t know who they’re sending them to. That’s concerning enough.”
“But when we try to enforce our laws, as we have against the doctors in other states who are participating in this illegal scheme, we’ve been blocked by the governor of New York from trying to extradite a doctor who was indicted here for violating our criminal laws. And I expect that we will be blocked by Governor Newsom when we try to extradite a California doctor who sent the pills to Rosalee’s boyfriend,” she said. “To be clear, it is illegal to send these pills by mail, even under federal law — that violates the Comstock Act.”
“It is frustrating. It’s never been legal to mail these pills. Under the prior law, there were restrictions, and if a doctor prescribed them in this state legally, they still had to comply with all of those restrictions. I don’t think another state should have the ability to nullify the laws of this state when someone is committing a crime in this state intentionally. It is no different than if they were dealing fentanyl or anything else that we’ve declared illegal or subject to very, very restrictive use under only certain circumstances.”
“All the rules go away when it involves abortion and it’s incredibly dangerous to women. It’s just appalling,” Murrill concluded.
Family Research Council President Tony Perkins, a former Louisiana state legislator, commented on the lawsuit:
“Mifepristone has become a murder weapon. The drug is under review because it is unsafe for women–but it is also a tool used by killers–many times against a woman’s will or without her knowledge. While a transparent, unbiased review of mifepristone is taking place, abusers could be disarmed if the Trump administration would re-enact and strengthen the FDA safety protocols originally governing the drug. I applaud my home state of Louisiana for filing this lawsuit to reinstate commonsense safety requirements that the Biden administration so callously and dangerously removed. The Trump administration should repeal approval of mifepristone altogether, but it should also swiftly adopt a policy that aligns with its declaration that abortion belongs under state jurisdiction,” Perkins concluded.
The lawsuit arrives amid aggressive enforcement: Louisiana issued an arrest warrant last week for Coeytaux, who remains at large, accused of illegally distributing mifepristone in violation of state law.
Similar coercion cases abound, including one involving the sister of state Sen. Thomas Pressly, whose estranged husband spiked her food with the drug.
