Supreme Court Stays Louisiana’s Mifepristone Mail-Order Restriction as FDA In-Person Rule Fight Continues

The Supreme Court granted a stay blocking enforcement of a lower court ruling that would have restricted access to the abortion pill mifepristone by mail, while Louisiana’s lawsuit seeking to require the FDA to reinstate the in-person dispensing requirement continues.

“The Supreme Court Thursdaygranteda stay blocking enforcement of a lower court ruling that would have restricted access to the abortion pill mifepristone by mail”

Focus on the Family

The Court’s decision allows abortionists to continue prescribing mifepristone through telehealth appointments and sending it through the mail, and it comes after the agency removed the requirement during the Biden presidency.

Radio France

In dissent, Justice Thomas cited the Comstock Act, writing that it “bans using ‘the mails’ to ship any ‘drug … for producing abortion.’”

Justice Alito argued Louisiana’s request for the FDA to reinstate the in-person dispensing requirement is commonsense, writing that “Louisiana [responded toDobbsby making] abortion illegal except in narrow circumstances,” and that efforts to enforce it were thwarted by providers and states that “abhor laws like Louisiana.”

The Intercept described the dissent as foreshadowing a future showdown over abortion rights after the Court ruled telehealth access to mifepristone could continue.

It reported that Justices Clarence Thomas and Samuel Alito “found themselves in the minority” and that Alito called the ruling a “scheme” to get around the Dobbs decision that eliminated the nationwide right to an abortion in 2022.

The Conversation

The Intercept also quoted Thomas arguing that the Comstock Act prohibits mailing abortion medication, writing, “The Comstock Act bans using ‘the mails’ to ship any ‘drug … for producing abortion,’” and adding, “Applicants are not entitled to a stay of an adverse court order based on lost profits from their criminal enterprise.”

Claire Teylouni of Reproductive Equity Now said, “We’re breathing a sigh of relief. I would say that the immediate threat to mifepristone is over,” while warning that “it’s certainly clear from reading those dissents that the threat … is far from over.”

The Intercept said advocates warn that dissents from Thomas and Alito highlight that the threat to abortion access “still looms large,” even as the Thursday ruling allows providers to continue sending mifepristone through the mail or to retail pharmacies while the case plays out.

“After half a century, the constitutional right of American women to obtain an abortion has been struck down by the Supreme Court”

The Conversation

It reported that in late 2025 the Food and Drug Administration began a safety review of mifepristone, despite “over 20 years of evidence that it’s a safe medication,” and that Anna Bernstein of the Guttmacher Institute said her organization is keeping a close eye on the “politically motivated” review at the FDA.

The article stated that the combined regimen of mifepristone and misoprostol carries a “less than 1 percent risk of serious adverse events,” and compared that to “roughly 14 times higher” risk of maternal death associated with childbirth.

It added that FDA Commissioner Marty Makary resigned earlier this week and was replaced by Kyle Diamantas, and that within hours of his appointment on Tuesday, Diamantas was reportedly on the phone with anti-abortion advocates reassuring them of his moral opposition to abortion, with one anti-abortion advocate saying he promised the review would be a “top priority” and that he was “pro-life.”