U.S. Supreme Court Temporarily Restores Mifepristone Access Through Mail and Telehealth

The U.S. Supreme Court on Monday temporarily restored broad access to the abortion pill mifepristone, blocking a lower-court ruling that had threatened to upend one of the main ways abortions are provided across the nation.

“The Supreme Court on Monday restored broad access to the abortion pill mifepristone, blocking a ruling that had threatened to upend one of the main ways abortions are provided across the nation”

ABC

In brief orders, Justice Samuel Alito said the decision by the New Orleans-based 5th U.S. Circuit Court of Appeals would remain on hold until at least May 11, while the high court considered next steps.

ABC

The order signed by Alito temporarily allows women seeking abortions to obtain the pill at pharmacies or through the mail, without an in-person visit to a doctor, and it also paused the Friday restrictions that would have limited prescribing through telehealth and shipping by mail.

The temporary pause was tied to the emergency issues Alito handles for the appeals court that covers Texas, Louisiana and Mississippi, and it followed Friday’s appeals court action that granted Louisiana’s request to void Biden administration rules.

NBC News described the nationwide availability of mifepristone as cast into jeopardy Friday when the appeals court granted Louisiana’s request to void Biden administration rules that allowed the drug to be administered without an in-person meeting.

SCOTUSblog reported that on Saturday, two companies that manufacture mifepristone came to the court asking the justices to pause the 5th Circuit ruling in a lawsuit by Louisiana that reinstated the requirement that the drug be dispensed only in person.

SCOTUSblog reported that on Saturday, two companies that manufacture mifepristone came to the court asking the justices to pause the 5th Circuit ruling in a lawsuit by Louisiana that reinstated the requirement that the drug be dispensed only in person.

The Supreme Court’s administrative stay, as described by SCOTUSblog, put the 5th Circuit’s order on hold and temporarily restored access to mifepristone by mail while the justices considered the drug companies’ request, with the administrative stay expiring on Monday, May 11, at 5 p.m. EDT.

The Supreme Court’s temporary order restored a system that, as AP News described, had been permitted for several years until the 5th Circuit imposed new restrictions last week.

AP News said the order allows women seeking abortions to obtain mifepristone at pharmacies or through the mail without an in-person visit to a doctor, and it said those practices had been permitted for several years until the federal appeals court imposed new restrictions last week.

ABC News

The dispute centers on how mifepristone is prescribed and dispensed, with NBC News describing that Friday’s ruling would have limited availability nationwide by requiring an in-person meeting, meaning the drug could in theory be mailed anywhere in the country even in states with strict abortion bans.

AP News also emphasized that most abortions use pills rather than procedures, stating that “The majority of abortions in the U.S. are obtained through medications.”

It further described the two-drug regimen, saying mifepristone is usually taken with a second drug, misoprostol, and that “the combination completes medical abortion 97.4% of the time” according to the FDA label on mifepristone.

AP News added that misoprostol can also be used alone, with some studies putting its effectiveness at around 80% or higher, and it noted that misoprostol is frequently used alone in countries where mifepristone is banned or unavailable.

Scientific American reported that the Supreme Court’s stay reinstates access to mifepristone by mail until at least May 11 and sets the stage for the nation’s highest court to consider whether the pills can be shipped to patients or not.

Scientific American also described the case as revolving around a lawsuit brought in 2025 by Louisiana against the U.S. Food and Drug Administration over a Biden administration rule that allowed telehealth practitioners to prescribe mifepristone to people living anywhere in the country, including states with abortion bans.

The temporary stay came as the legal fight over mifepristone’s access continued alongside questions about safety and FDA safeguards.

AP News said the case also questioned the safety of the drug, which was approved 25 years ago and has repeatedly been deemed safe and effective by FDA scientists, and it described Louisiana’s lawsuit as seeking to roll back the Food and Drug Administration’s rules on how mifepristone can be prescribed.

NBC News reported that in January the FDA requested the case be paused until the agency finished conducting its own safety review of mifepristone, and it said Health Secretary Robert F. Kennedy Jr. commissioned the review last year in response to a report that claimed to find a higher rate of serious complications from mifepristone than reported by the FDA.

NBC News added that researchers who study reproductive health said the report amounted to junk science and exaggerated the risks of the medication, and it specified that the report was released online by the Ethics and Public Policy Center, a conservative think tank, and that it was not peer-reviewed nor published in a medical journal.

Scientific American reported that the FDA approved mifepristone for medical abortions up to 49 days of gestation in 2000 and for 70 days of gestation in 2016, and it said the agency has declared the drug safe so long as it’s taken according to medical guidelines.

Scientific American also said that according to the FDA, as of late December 2024, there have been 36 deaths among people who had taken mifepristone since its first approval in 2000, and it noted that in two cases the medication was taken during an ectopic pregnancy, which has not been advised.

The article further stated that the agency has noted that no causal relation can definitively be declared in any reported adverse events, including the deaths, and that such reports are common for approved prescription drugs.

AP News quoted Dr. Angel Foster, founder of The Massachusetts Abortion Access Project, saying, “Regardless of what happens with this regulatory issue, we and other groups will continue to provide high-quality abortion care to patients in all 50 states,” linking the safety and access dispute to operational planning for providers.

Reactions to the Supreme Court’s temporary restoration of access came quickly from abortion-rights advocates and from anti-abortion leaders who framed the stay as a setback.

NBC News reported that Alexis McGill Johnson, president of abortion rights group Planned Parenthood Action Fund, welcomed the decision and said, “While mifepristone access returns to where it was on Friday morning, the whiplash and chaos that patients and providers are navigating have already had real consequences for real peoples’ lives and futures.”

ABC7 New York

AP News similarly quoted Julie Burkhart, founder of Wellspring Health Access, saying, “We have a little bit more time to navigate this new landscape with the stay,” and it quoted Elizabeth Ling, associate director of legal services at If/When/How, saying, “The outcome is not going to make it a crime for people to access care.”

The Guardian reported that Alexis McGill Johnson said, “While mifepristone access returns to where it was on Friday morning, the whiplash and chaos that patients and providers are navigating have already had real consequences for real people’s lives and futures,” and it added that Julia Kaye, a senior staff attorney with the American Civil Liberties Union’s Reproductive Freedom Project, said, “While this is a positive short-term development, no one can rest easy when our ability to get this safe, effective medication for abortion and miscarriage care still hangs in the balance.”

On the opposition side, AP News quoted Carol Tobias, president of National Right to Life, saying Monday’s ruling “is a temporary procedural step that leaves unresolved the very real concerns about the safety of these drugs and the decision under the Biden administration’s FDA to recklessly remove longstanding safeguards.”

ABC News quoted Kristan Hawkins, president of the anti-abortion group Students for Life, saying, “Pill pushers receive every benefit of the doubt, including today, as Justice Alito allows pill traffickers and big pharma to operate temporarily while arguments are sent to the Court.”

NBC News included a statement from Louisiana Attorney General Liz Murrill, who said, “Big abortion pharma claims they need an emergency stay because they will lose massive amounts of money if they can’t kill more babies quickly and efficiently by mail without medical oversight,” and she added, “The administrative stay is temporary, and I am confident life and the law will win in the end.”

In the same broader debate, AP News described how some providers paused services entirely after Friday’s 5th Circuit ruling and others pivoted to misoprostol-only regimens, with Dr. Angel Foster saying her organization was preparing to send misoprostol only but was able to switch back.

The Supreme Court’s temporary order buys time, but multiple outlets described a continuing legal process that could still change access.

AP News said the latest order will remain in effect for another week while both sides respond and the high court considers the issue more fully, and it said Monday’s ruling offers more time to figure out a course of action in case mifepristone prescriptions are curtailed again.

ACI Prensa

Politico reported that Alito’s order is in effect through May 11, giving all nine justices time to consider requests from the drug’s manufacturers to keep the appeals court’s ruling on ice while the Supreme Court considers whether to take up the issue.

SCOTUSblog reported that Justice Samuel Alito issued an administrative stay putting the 5th Circuit’s order on hold and temporarily restoring access to mifepristone by mail while the justices consider the drug companies’ request, and it said Alito instructed the FDA and Louisiana to respond by 5 p.m. EDT on Thursday, May 7.

The Guardian described that the order would remain in effect until at least 5pm ET on 11 May and that Alito gave Louisiana until 5pm ET on Thursday to respond to efforts seeking to block the appeals court ruling.

In the meantime, NBC News said the high court was weighing separate emergency requests filed by drugmakers Danco and GenBioPro, and it said Alito ordered Louisiana to file its response to the companies' request by the end of the day Thursday.

Scientific American reported that the FDA must give the court a status update on the review by no later than October 7, tying the immediate stay to a longer timeline for the underlying review.

For rights advocates, the immediate consequence was operational disruption and uncertainty, with Planned Parenthood Action Fund calling the situation “whiplash and chaos,” while opposition leaders vowed to continue the legal battle and argued that the stay left unresolved safety concerns.