Supreme Court Expected to Issue Decision on Mail-Order Abortions This Week

The Supreme Court is expected to rule this week on whether to uphold restrictions on the mail-order distribution of the dangerous abortion drug mifepristone. The abortion pill has killed millions of babies and injured thousands of women.

The nation’s highest court could temporarily block the abortion drug while the case against selling it by mail continues or it could maintain current rules that Joe Biden put in place that have exponentially increased abortions.

Justice Samuel Alito extended a temporary administrative stay Monday, preserving Food and Drug Administration rules that permit remote prescriptions and mail delivery of mifepristone through at least 5 p.m. Thursday.

The order blocks a 5th U.S. Circuit Court of Appeals ruling that would have required in-person dispensing of the drug.

The case stems from a challenge by Louisiana to the FDA’s 2023 rules. Louisiana argues that the federal rules undermine its laws protecting unborn human life and have forced the state to spend Medicaid funds on emergency care for women who suffered complications after taking the drug.

A three-judge panel of the 5th Circuit sided with Louisiana, at least temporarily, finding the state had standing because its Medicaid program covered emergency-room care for two women who experienced complications after receiving mifepristone from an out-of-state provider.

Drug manufacturers Danco Laboratories, maker of the branded mifepristone abortion drug, and GenBioPro, maker of the generic version, asked the Supreme Court to intervene.

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Louisiana on Thursday urged the Supreme Court to uphold a lower-court order that would bar the mailing of abortion pills nationwide, arguing the practice enables approximately 1,000 illegal abortions each month in the state and undermines its abortion ban.

In a 58-page brief filed in the cases Danco Laboratories v. Louisiana and GenBioPro v. Louisiana, state attorneys asked the justices to leave in place a recent ruling by the U.S. Court of Appeals for the 5th Circuit reinstating the requirement that mifepristone — the first drug in the two-drug regimen used for most medication abortions — be dispensed in person rather than sent through the mail.

Not only would that save babies from abortions it would help protect women from death or injury – as the abortion pill has killed women and 11% of women who take the drug developed medical problems.

“Although Louisiana law generally prohibits abortion and the dispensing of mifepristone to pregnant women, out-of-state prescribers — freed from the in-person dispensing requirement — are causing approximately 1,000 illegal abortions in Louisiana each month by mailing FDA-approved mifepristone into the state,” the filing states.

Louisiana contends the Biden administration’s policy of allowing telemedicine prescriptions and mail delivery of the drug was part of an effort to undermine the Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization, which overturned the constitutional right to abortion and returned regulation to the states.

“When the Supreme Court was considering the Dobbs case, which overruled Roe vs. Wade and the right to abortion, ‘the Biden Administration was preparing a plan that predictably would undermine that decision,’” the state brief says.

The state also cited financial costs, including more than $17,000 spent investigating three cases involving mailed mifepristone and over $92,000 in Medicaid dollars for emergency room care and hospitalization resulting from just two mifepristone-induced abortions in 2025.

Louisiana Attorney General Liz Murrill said the 5th Circuit ruling ended what she called a “nightmare” enabled by federal policy.

“The Biden abortion cartel facilitated the deaths of thousands of Louisiana babies (and millions in other states) through illegal mail-order abortion pills,” Murrill said. “Today, that nightmare is over, thanks to the hard work of my office and our friends at Alliance Defending Freedom. I look forward to continuing to defend women and babies as this case continues.”

National Right to Life President Carol Tobias called the 5th Circuit decision “an important step toward restoring common-sense medical safeguards that were recklessly discarded by the Biden administration in the rush to expand abortion pill access.”

A recent analysis of commercial insurance claims involving 865,727 mifepristone prescriptions from 2017 to 2023. It found 94,605 women — nearly 11% — suffered serious complications within 45 days, including hemorrhage in 3.31% of cases, emergency room visits in 4.73%, and sepsis in 0.10%.

Peer-reviewed research found three quarters of ER visits within 30 days after abortion drug use were coded as severe or critical. Two separate, independent studies also found more than 1 in 10 women experience at least one severe adverse event. Complications can include hemorrhaging, infection, sepsis, and even death.

Other issues encompassed infections, transfusions, hospitalizations and life-threatening events like cardiac problems or anaphylaxis. In nearly 3% of cases, the drug failed, requiring surgical follow-up. Multiple women have died from the abortion pill.

A large national poll found 7 in 10 voters want to roll back Biden’s mail-order abortion drug rule and reinstate safeguards like in-person doctor visits.

The FDA approved mifepristone in 2000. The agency later relaxed restrictions, including eliminating the in-person visit requirement that helps protect women’s health, such as in ectopic pregnancy situations.

Louisiana filed suit challenging those changes, arguing they conflict with its laws protecting unborn children.

Justice Samuel A. Alito Jr., who handles emergency applications from the 5th Circuit, issued a temporary stay of the appeals court’s order on May 4, keeping mail-order abortions available at least until May 11.